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.
