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Skills

  • Medical report turnaround time reduction
  • Process improvement
  • Metric equipment
  • Siemens Soarian Financials
  • Clinical documentation review
  • DRG assignment
  • Expert in adverse event reporting
  • QMSoftware Receivables Management
  • Data management in clinical reviews
  • Development of standard operating procedures (SOPs)

Work Experiences

  • Pushed for operational changes that resulted in cost savings and higher profit margins.
  • Assigned accurate disability status for over 10 claimants annually.
  • Achieved approvals within 6 months.
  • Pulled patient records accurately for upcoming appointments and procedures, usually within 6 hours.
  • Was in charge of resolving disagreements and negotiating mutually beneficial agreements between parties.
  • Placed a high value on punctuality and worked hard to maintain an excellent attendance record, consistently arriving at work ready to work right away.
  • Discovered new ways to improve the management of medical records.
  • Looked for industry trends on social media and through online sources.
  • Ensured that medical records and health information were accurate, complete, and secure.
  • Aligned evaluations with customer success stakeholders.

Summaries

  • 6+ years of experience in clinical documentation review.
  • Averted $11 in potential legal costs.
  • Accomplished Medical Review Specialist proficient in adhering to stringent CPA guidelines, overseeing 9 reports monthly while improving document accuracy by 28%.
  • Achieved a department-wide audit pass rate of 37%.
  • Advanced skills in regulatory compliance.
  • Bilingual achiever with experience scanning and indexing medical records to the correct chart.
  • Dedicated performer with experience processing subpoenas and court orders.
  • Consistently improved review accuracy.
  • Achieved President's Club recognition.
  • Boosted team efficiency.

Accomplishments

  • Reduced subjective errors in evaluating clinical trial data by suggesting and implementing new rubric guidelines, improving reviewer consistency by 81%.
  • Supported clinical safety reporting by maintaining accurate records of adverse event cases, improving FDA compliance across multiple drug categories.
  • Collaborated with team of 6 in the development of framework.
  • Developed training modules targeting common errors within patient safety narratives, reducing revision requirements by 42% across the department.
  • Developed a set of automated reports for easier identification of critical safety cases, improving early detection of adverse drug reactions by 37%.
  • Led system implementation for medical review software that facilitated easier ICD-10 code interpretation, reducing inaccurate coding by 15%.
  • Authored over 8 patient safety narratives, successfully aligning submissions with FDA guidelines, resulting in the expedited approval of 18 NDA submissions.
  • Led post-market surveillance initiatives for Jira, ensuring full compliance with FDA reporting requirements, which reduced reporting discrepancies by 66%.
  • Provided expert oversight in the review and approval of 17 investigational new drug applications, achieving 100% compliance with regulatory timelines.
  • Performed reviews of adverse event reports, including analysis of 7 submitted cases, to ensure timely and accurate reporting to regulatory bodies.

Affiliations

  • Health Care Compliance Association (HCCA)
  • American College of Medical Quality (ACMQ)
  • American College of Clinical Pharmacy (ACCP)
  • Academy of Managed Care Pharmacy (AMCP)
  • Freemason
  • Jaycees
  • International Serious Adverse Event Consortium (iSAEC)
  • American Association for the Advancement of Science (AAAS) - Health Sciences Chapter
  • American Society of Health-System Pharmacists (ASHP)
  • Association of Information Technology Professionals

Certifications

  • Apple Certified Associate (ACA)
  • Certified Disability Management Specialist (CDMS) - Ironclad Systems
  • Certified Medical Administrative Assistant (CMAA) - method
  • SHRM Certified Professional (SHRM-CP)
  • Certified Quality Improvement Associate (CQIA) - American Society for Quality (ASQ)
  • CompTIA Security+
  • Certified in Health Care Risk Management (CHRM) - American Hospital Association
  • SHRM Senior Certified Professional (SHRM-SCP)
  • Data Standards & Reporting Certification - Clinical Data Interchange Standards Consortium (CDISC)
  • Certified Health Data Analyst (CHDA) - procedure

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