With over a decade of experience in healthcare, I've cultivated a deep passion for making a tangible difference. Specializing in continuity of care management and regulatory compliance, I navigate challenges effortlessly. My dedication to quality assurance and auditing, coupled with strong communication skills and a collaborative mindset, ensures that every task is approached with precision and enthusiasm. Committed to lifelong learning and adaptation, I continually add new skills to my repertoire, striving to leave a lasting, positive impact on healthcare delivery with each endeavor.
Overview
14
14
years of professional experience
1
1
Certification
Work History
Clinical Data Integrity Analyst
Datavant
02.2022 - Current
Conduct regular audits of the computerized Master Patient Index (MPI) to identify and resolve any data discrepancies or duplications with a high degree of accuracy and attention to detail
Extracted and abstracted clinical data from diverse sources, including EPIC, patient charts, and medical databases
Performed medical record reviews, abstract a large volume of clinical case records, and manage record retrieval processes
Applied abstracting and coding knowledge to ensure accurate assignment of codes for diagnosis, severity of illness, procedures, and treatment
Implement data validation procedures, resulting in a 95% accuracy rate in clinical data abstraction
Conducted comprehensive data extraction from the Athenahealth, ensuring accuracy and completeness, then executed data transformation for compatibility with EPIC
Aligned data fields and elements through meticulous data mapping for accurate placement in the EPIC
Lead quality assurance checks, verifying the accuracy, completeness, and integrity of transferred data
Successfully multitasked across various data integrity projects, navigating multiple EHR systems simultaneously to ensure accurate and efficient completion of tasks
Managed client projects by providing regular updates on project progress, identifying challenges, presenting findings, and collaborating with clients to develop solutions for data analysis projects
Conducted training and education sessions for staff on the new EHR system, providing insights into updated features and workflows
Orchestrated post-migration audits to assess the effectiveness of the clinical abstraction process and optimize the new EHR system's use.
Implemented electronic health record systems, improving the accessibility and organization of medical documentation.
Reviewed charts and flagged incomplete or inaccurate information.
Reviewed medical records for completeness and filed records in alphabetic and numeric order.
Used classification manuals to gain additional knowledge of disease and diagnoses processes.
Patient Information Coordinator
Dr. Anjali Chaudhary, LLC
05.2010 - 01.2024
Oversaw the completion of patient registration, billing, follow-up, and collection tasks across diverse payer types
Supervised administrative staff, actively contributing to the onboarding process by interviewing, hiring, and training new personnel
Additionally, provided comprehensive training sessions to staff on patient registration procedures
Coordinated patient appointments for physicians and other clinical professionals, serving as the primary contact for patients and addressing their inquiries and concerns regarding appointments
Validated and authorized requests for releasing medical information in compliance with HIPAA guidelines
Collaborated with medical staff to collect relevant clinical documentation for patient registration
Provided superior customer service, efficiently managed computer software and EHR systems, and attended educational training sessions
Conducted various registration, billing, follow-up, and collection tasks across all payer types, analyzed denials, and pursued resolution of unpaid claims
Analyzed denials, resolved patient concerns, and collaborated with patients/payers to rectify, adjust, or resubmit claims
Pursued resolution of unpaid claims within designated billing cycle timeframes
Demonstrated meticulous attention to detail, precision, and analytical skills, enabling timely and independent decision-making
Provided constructive feedback to management, actively engaging in resolution efforts to enhance billing timeliness and quality.
Prepared patient charts by gathering and organizing medical records ahead of appointments.
Developed policies and procedures for effective practice management.
Health Information Compliance Specialist
Alaris Health
03.2021 - 02.2022
Reviewed health information records to ensure compliance with HIPAA rules
Developed and implemented procedures to improve efficiency and meet regulations
Responded to questions and requests for information, maintaining a 98% client satisfaction rate
Implemented procedures to check authorizations and protect sensitive patient information
Conducted regular checks of health information records to ensure compliance and privacy
Created training materials and managed training for compliance policies and regulations
Successfully managed credentialing and re-credentialing processes to comply with standards
Proven success in credentialing and re-credentialing processes, focusing on compliance with NCQA, Medicare, and Medicaid standards.
Implemented robust record-keeping systems that ensured accurate documentation was maintained according to regulatory requirements at all times.
Served as a point of contact for employees seeking guidance on compliance matters, instilling confidence in the organization''s commitment to regulatory adherence.
Supported team by pitching in to complete special projects.
Coordinated responses to subpoenas and other legal requests for medical records, working closely with legal counsel as necessary to protect patient privacy rights.
Processed medical records requests from outside providers according to facility, state, and federal law.
Maintained patient records in compliance with security regulations.
Maintained patient confidence by keeping patient records information confidential.
Fulfill additional duties as assigned by the Staffing Manager, Director of Nursing, and/or Administrator
Scanned medical records in digital format for easy retrieval and accessibility.
Printed and photocopied documents to provide patients with copies of medical records.
Education
Bachelor’s Degree in Mathematics -
Gujarat University
Skills
Technical Skills: Microsoft Office Suite - Google Workspace - Electronic Health Record (EHR) System Navigation (EPIC, AthenaOne, eClinicalWorks) -SQL
Certification
A.O.S in Medical Assisting, IHE Institute, New Jersey
Certified EKG Technician, IHE Institute, New Jersey
Certified Medical Assistant, IHE Institute, New Jersey
Certified Phlebotomist Technician, IHE Institute, New Jersey