HEALTHCARE EFFECTIVENESS DATA AND INFORMATION SET COORDINATOR (HEDIS) Career Focus Committed motivated Administrative Assistant exceptional customer service decision making skills. Strong work ethic, professional demeanor great initiative. Energetic, results-oriented team-player eager bring strong administrative skills growing company need top-level support. Responsible Office Manager versed mediating employee conflict running efficient daily business operations. Effective Organization Communication Skills Master New Concepts Quickly Initiate Document Control Processing Information High Level Customer Service Detail Oriented Report Composing Document Presentation Thorough Investigation Monitoring Patrol Crowd Control Access Core Qualifications Microsoft Office Suite expert People-oriented Organized Exceptional communicator Deadline-oriented Schedule management Report analysis Medical terminology Experience Healthcare Effectiveness Data Information Set Coordinator (HEDIS) 08/2013 Current Company Name City State Healthcare Effectiveness Data Information Set Coordinator (HEDIS). Educate inform members past due clinical services improve member health outcomes increase Health Plan HEDIS rates. Make outbound calls members; providing assistance obtaining services assisting appointment scheduling, arranging transportation, conducting reminder calls and/or emails. Conduct HEDIS provider chart request calls faxes support medical record capture HEDIS supplemental data review abstraction. Record document member provider outreach activity using Microsoft Office Suite applications web-based technology. Review member Health Plan eligibility using Georgia's Medical Management Information System (MMIS). Review member claims data determine need services using Health Plan proprietary information system. Identify refer members internal programs services like Case Management Disease Management. Maintain strict confidentially ensure compliance Health Insurance Portability Accountability ACT (HIPAA) outreach activities. Managed incoming outgoing calls busy medical office. Successfully established effective systems record retention creating database daily correspondence tracking. Scheduled confirmed appointments entire management team. Loss Prevention/Security Officer 12/2011 02/2013 Company Name City State Partnered local store management meet strategic loss prevention objectives. Executed internal external surveillances using state-of-the-art detection investigation systems. Prepared data property damage reports, recording malfunctioning facility equipment, attended weekly staff meetings discuss damage reports. Detected apprehend shoplifters, processing recovering merchandise, prepared case reports theft details maintained effective relationship local law enforcement agencies. Represented Macy's court proceeding related apprehensions ensured high execution company security measures designed control store shrink. Developed staff training designated stores. Security Officer 07/2010 10/2011 Company Name City State Patrolled designated areas watching unusual conditions create security concerns safety hazards. Monitored authorized entrance departure employees, visitors, persons guard theft maintain premise security. Investigated, prepared reports, maintained written logs accidents, incidents, suspicious activities. Answered telephone calls, taking messages, answered questions providing information business non-business hours. Observed departing personnel protect theft company property ensured authorized removal property conducted within appropriate client requirements. Account Receivables/Administrative Assistant 07/2007 10/2008 Company Name City State Investigated discrepancies, issued debit memos, reviewed aging balance reports identify past due accounts, collection calls, month-end close activities. Accounts receivable reconciliations; utilized collection screens quickly analyze account met department goals reducing delinquency controlling losses considerably high margin. Fielded calls 12- line multi phone system, responded email fax inquiries, managed mail client trafficfor body shop, upgraded office filing system improved efficiency locating customer files, handled official company correspondence, analyzed reconciled final billing statements ensure correct amount funds collected applied file closeout. Displayed excellent interpersonal skills phone manner interaction insurance agents, co-workers, public. Calculated time cards department employees preparation submitting payroll, collected applied funds received various insurance companies State Farm, USAA, Allstate Geico appropriate client auto claim accounts timely manner. Detention Specialist 07/2002 10/2005 Company Name City State Supervised Central Control Tower Controls Detention Center. Completed intake release detainees. Interacted defendants, attorneys general public, providing imperative information. Processed accounting functions paperwork Bonding Department. Performed duties assigned. Answered incoming/outgoing calls switchboard regarding inmates' custody issues guided resolving predicaments. Probation Case Specialist 07/2000 12/2001 Company Name City State Retrieved criminal records update history new charges probation status various specialty systems. Maintained statistical data concerning case processing activities three probation officers performed various financial transactions. Performed duties assigned include handing incoming/outgoing calls magistrate court judges, attorneys, probation officers general public. Experience Customer Service Handled customers effectively identifying needs, quickly gaining trust, approaching complex situations resolving problems maximize efficiency. Handled customers effectively identifying needs, quickly gaining trust, approaching complex situations resolving problems maximize efficiency. Data Reporting Compiled statistical data, patient admissions, discharges, deaths, births types treatment given. Document Organization Developed created effective filing system accelerate paperwork processing. Medical Records Reviewed medical records completeness, assembled records standard order filed records designated areas according alphabetic numeric filing system. Multitasking Demonstrated proficiencies telephone, e-mail, fax front-desk reception within high-volume environment. Education Certified Medical Office Assistant Medical Administration 2009 Kennesaw State Continuing Education City State USA •Medical Office Receptionist/Support Specialist, Patient Scheduling, Medical Records/Documents, CMS 1500 Medical Billing, Medical Terminology/Basic Anatomy Physiology, Specialized Billing/Reimbursement, Business Skill Management, 80 hour Medical Externship WellStar Medical Center, Certified CPR w/AED Skills Accounts receivable, Administrative Assistant, Basic Billing, CMS, excellent interpersonal skills, CPR, email, faxes, filing, law enforcement, loss prevention, Medical Billing, Medical Terminology, Microsoft Office Suite, Management Information System, payroll, safety, Scheduling staff training, switchboard