Over 24 years in nursing including medical-surgical, longterm care, rehab, dermatology, plastic surgery. Ten years
in Management including medical office management, store management. Experienced trainer/preceptor in medical data review and analysis. Proof of passing ICD-10
AAPC test. Five years in ICD-9, CPT coding, medical data abstraction, recent utilization review experience. Experienced in HEDIS, NCQA and CMS guidelines.
HEDIS Quality Consultant NurseSep 2015 to Current
Maryland Physicians Care - Linthicum, MDMy current focus is CIS- Childhood Immunizations Status but I have worked Closely with Over 12 NCQA HEDIS measures. Initial chart reviews, finale chart
over-reads and approvals, medical data collection/abstraction.Provider outreach, hospital outreach, member outreach. Familiar with Qnxt,
ImmuNet, NextGen, CRISP.
Seasonal HEDIS Review NurseApr 2015 to Jun 2015
Altegra - Remote TeleworkHEDIS review nurse,
data abstraction of medical charts. Seasonal temporary work only.
Utilization Management NurseMar 2014 to Oct 2014
Wexford Health Source - Columbia, MDParticipate in collegial review with Statewide Physicians
and Regional Physicians of patient cases for medical necessity, applying Milliman and InterQual guidelines to
justify decisions. Data entry of ICD-9, CPT codes, distribution of claims
approval. Review of claims process for later inquiry as needed.
Preceptor-TrainerAug 2011 to Feb 2012
Inovalon, Inc - Annapolis, MDTrain and evaluate nurses and CPCs in Medical Data
Abstraction, ICD-9, HCC review and HEDIS abstraction.
Medical Record Review Nurse ConsultantJan 2010 to May 2011
Inovalon, Inc - Bowie, MDMedical record review consultant in Risk Adjustment Quality.
Promoted to CES-Clinical Education Specialist where I did HCC abstraction, ICD-9 coding,
chart audits, development of instructional material. Experienced in
projects: HCC, CARA, DRG, HEDIS, and Claims Integrity. Experienced in the
following operating systems: SRSA, DCT, Microsoft Power Point, and Microsoft
Office/Word.
Co-OwnerJan 2007 to Dec 2015
Savvy Investment Properties LLC / Schaechtel Property Management LLC - Severna Park, MDSmall Family Business with my husband and I purchase property
as rental or remodel and sale. Staff of
1-7 depending on sub-contractors on given job site. I also deal with clients.
Fielding phone calls, meeting with potential renters and doing background
checks, credit checks, verifying employment etc. [We shuttered our company the end of 2015.]