Claudette

Skilled professional demonstrates success working with local, state and federal governments in partnership with Homeland Security as well as the Federal Emergency Management Agency during disasters. Excellent interpersonal and communication skills. Committed to providing the highest level of customer service.

Applicant Service Program Specialist - Federal Emergency Management Agency - Washington, DC

(2017-08 - 2025-06)

• Responded to individual case inquiries and provided information on Individual Assistance programs.
• Verified applicant's information in National Emergency Management Information System and updated accordingly.
• Confirmed that applicants understand the application and assistance process along with the current status of their case.
• Referred applicants to appropriate agencies services or resources that may provide additional assistance.
• Updated the applicant's file with respect to incoming documents as well as provided clarification on outgoing correspondence.
• Informed applicant of any additional required documentation; made copies as necessary, and ensured that original documents were returned to the applicant.
• Ensured that all steps were taken to provide assistance to applicants.
• Provided status update, created work packets when needed and explained program eligibility.
• Reviewed program guidance and remained up to date on current policies and procedures.

Medical Records Specialist - Jackson Memorial Hospital - Miami, FL

(2017-07 - 2017-08)

• Maintains medical records operation by following policies and procedures; reporting needed changes.
• Resolves medical record discrepancies by collecting and analysing information.
• Provides medical record information by answering questions and requests of patients, hospital staff, law firms, insurance companies, and government agencies.
• Maintains the stability and reputation of the hospital by complying with legal requirements.
• Contributes to team effort by accomplishing related results as needed.

HEDIS Specialist Quality Reporting - Molina Healthcare INC - Miami, FL

(2017-02 - 2017-06)

• Review & audit completed provider files for quality process.
• Prepares Data for reporting purposes internal and external.
• Submit documents for Credentialing Committee review.
• Perform credential verification and request information from appropriate data banks.
• Serves as the subject matter expert preparing and providing training to personnel on HEDIS.
• Participates in committees and assists in the implementation of Systems, Policies, and Procedures.
• Prepare reports, samples information and providers files for internal and external audits.
• Assist and represents the department and/or Supervisor functions during the internal and external audits and other functions as designated by management.
• Functioned as a remote HEDIS medical record analysis using electronic medical devices for processing medical records.

Nurse Management Associate - AETNA - Miami, FL

(2016-02 - 2016-08)

• Working with doctors and nurses in an inpatient and outpatient facilities in retrieving records for HEDIS projects.
• Updates Credentialing Data for reporting purposes including internal and external customers.
• Prepare, reports and send letters to providers, internal areas, and external agencies.
• Prepare documents for Credentialing Committee review.
• Interface between providers and hospital staffs to collect required information.
• Assist and represents the department and/or Supervisor functions during the internal and external audits and other functions as designated by management.
• Performs out-bound calls to retrieve records before deadline.

Medical Records Specialist - HUMANA - Miami, FL

(2015-01 - 2015-07)

• Prepares, review and retrieved medical records.
• Verisk System Training.
• Updates Credentialing Data for reporting purposes including internal and external customers.
• Prepare, reports and send letters to providers, internal areas, and external agencies.
• Prepare documents for Credentialing review.
• Interface between providers and hospital staffs to collect required information.
• Scanning and using EMR system to retrieve the documents that is needed on a daily basis.
• Performs miscellaneous job-related duties as assigned.