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Medical Records Abstractor Field Reviewer Resume Example

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MEDICAL RECORDS ABSTRACTOR FIELD REVIEWER
Professional Summary

I have 19 years of combined experience in various healthcare positions & specialties. Specialties include Dental, Podiatry, some radiology, Family Practice with OB, dexa imaging , and Field reviewer for chart abstraction during HEDIS and other annual audits.
Positions include, Prior Authorization specialist for imaging, medications, procedures and home medical equipment. I also preformed medical assistant duties, billing and charge entry, CPT, ICD 9&10 and HCPCS coding. Streamlined the medical records department during the conversion from paper charts to electronic for a five physician family practice.

Skills
  • Proficient with the following electronic medical records. Epic, Next-Gen, AllScript, Practice Partner, Cerner, Centricity, Informatix, Meditech, Greenway EHS, Evident, Office Practicum, E-Clinical, Athena, and more.
  • CMS-1500 billing forms
  • Extract data from patient records within requested date range
  • HIPAA compliance
  • Medicare, Medicaid and Private insurance understanding
  • Completion of CPC course through AAPC
  • High accuracy with a quality control score of 99.98% for 4 years straight. Average 15 electronic charts per hour for PCMH, and 13 for HEIDIS measures. Average paper chart collect and scan rate of 10 per hour.
  • ICD-9, ICD-10, CPT and HCPCS
  • Strong knowledge of medical terminology, anatomy and medications.
  • Willing to travel anywhere overnight for large volume contracts
Work History
Medical Records Abstractor Field Reviewer, 10/2016 to Current
Change Healthcare Corporation – Alpharetta, GA

•Travel to and from medical offices and hospitals arriving on time and in business casual appearance.

•Use laptop and scanner to abstract requested information from patients charts using flash drive and or scanner for paper charts and EMR charts.

Careful attention to detail as only certain portions of patients chart is requested. Being mindful of HIPAA.

Knowing correct flow of how patients chart should be organized.

•Upload scanned charts to corporate data center using high-speed Wi-Fi internet connection with VPN•

Medical Records Supervisor /Coding & Prior Authorization Specialist, 03/2001 to 12/2014
ProMedica Health System – Toledo, OH
  • Received and routed medical records
  • Received and processed medical records requests
  • Audited records for accuracy
  • Reviewed and corrected incomplete or inaccurate information
  • Created new physical and computer-based files
  • Processed patient admission and discharge documentation
  • Obtained patient releases for dissemination of information
  • Increased department productivity 95%. This was completed by moving all phone prior authorizations to online processing
  • Entered and scanned outside consultations into EMR system efficiently and without errors
  • Scheduled appointments, registered patients and distributed sample pharmaceuticals as prescribed
  • Coded inpatient charts and Office visits
  • Precisely completed appropriate claims paperwork, documentation and system entry
  • Professionally and courteously verified appointment times with patients
  • Meticulously identified and rectified inconsistencies, deficiencies and discrepancies in medical documentation
  • Verified patients' eligibility and claims status with insurance agencies
  • Transition from paper medical records to electronic
  • Performed clerical duties, such as word processing, data entry, answering phones and filing
  • Coded Family Practice charts for billing
  • Correctly coded and billed medical claims for various hospital and nursing home encounters
  • Applied official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services to assign diagnostic codes
  • Processed insurance company denials by auditing patient files, researching procedures and diagnostic codes to determine proper reimbursement
Assistant Office Manager, 02/1998 to 10/2000
Dr. Stephen Humphrey – Bryan, OH
  • Managed various general office duties such as answering multiple telephone lines, completing insurance forms and mailing monthly invoice statements to patients
  • Performed monthly inventory and maintained office and medical supply counts
  • Transported patients to and from different departments
  • Took and recorded patients' temperature, pulse and blood pressure
  • Prior authorization for drug refills and provided detailed prescription information to pharmacies
  • Assessed patients and documented their medical histories
  • Evaluated patient care needs, prioritized treatment, and maintained patient flow
  • Interviewed patients to obtain medical information, weight and height measurements and vital signs
Certifications
  • Certified Professional Coder, through AAPC - Nov 2020
  • Licensed GXMO radiology through Ohio Dpt Of Health License# - G2679521 Next renewal date 10-07-2022
Education
Switched Major And Colleges: Criminial Justice/Social WorkThe Defiance College - Defiance, OH
Medical Coding: Medical Office, 1993
Owens - Oregon, OH
ODH GXMO License: Basic radiology, 1999
Akron Childrens Hospital - Akron, OH
Certified Professional Coder ( CPC): Medical Coding , 11/2020
AAPC - Online
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Resume Overview

Companies Worked For:

  • Change Healthcare Corporation
  • ProMedica Health System
  • Dr. Stephen Humphrey

School Attended

  • The Defiance College
  • Owens
  • Akron Childrens Hospital
  • AAPC

Job Titles Held:

  • Medical Records Abstractor Field Reviewer
  • Medical Records Supervisor /Coding & Prior Authorization Specialist
  • Assistant Office Manager

Degrees

  • Switched Major And Colleges : Criminial Justice/Social Work
    Medical Coding : Medical Office , 1993
    ODH GXMO License : Basic radiology , 1999
    Certified Professional Coder ( CPC) : Medical Coding , 11/2020

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