X

CONTACT US NOW

X
X
X
Toll Free 888-357-3226
presentation

Rayhena Santos

Expertise In: Mental Health

Name : Rayhena Santos
Experience : 28
Specialty : Mental Health
Location : StatenIsland,NY
Description :

Rayhena Santos wants a diversified position in the healthcare field and one that offers an opportunity for career growth and advancement.

Skills:

  • ICD-9 ; code all oasis assessment according to Medicare/CMS guidelines

Experience:

  • Clinical Reimbursement Spec.
  • ICD-9 ; code all oasis assessment according to Medicare/CMS guidelines
  • Up Front Reviewer for all documentation OASIS submitted by Field Staff –RN and PT
  • Review for acuity do all coding as needed and make corrections prior approval

Oasis Department Supervisor

  • Team Leader training and supervision of team employees; teach and assist with data entry, check acuity and make corrections as needed.
  • Use Microsoft Excel and Word to compile monthly quota report.
  • ICD-9 coding classes with the Board of Medical Specialty Coding (BMSC) 2007 and retraining withICD-10; code all oasis assessment according to Medicare/CMS guidelines.
  • Hold weekly meetings with all department personnel to ensure ICD-9 coding and outcomes that are accepted by Medicare guidelines to meet monthly revenue.
  • Data entry validation bi-monthly reports.
  • Assist corporate department in relation to coding and billing, and IT department on Oasis Discrepancies.
  •  Work with Case Managers to resolve issues with 485s; run reports of outstanding oasis.

Nursing Voucher Coordinator/Medicaid Rep

  • Monitored high volume switchboard and directed phone calls; received and routed Incoming/outgoing correspondence.
  • Verification of vendor visits prior to forwarding of invoice to Billing Department.
  • Contact patient’s physician to facilitate signature of treatment orders.
  • Responsible for all vouchers incoming with nursing reports and reviewed to assure documents are present.
  • Communicate with all managers, supervisors, and home care coordinators in handling all incoming nursing documents.
  • Contact Medical institution for verification of doctor’s order, referrals and pending discharges.
  • Recruit the appropriate nursing personnel for client medical needs; enter all client data into computer for admission upon approval.
  • Conducted financial screening for the Medicaid population in the community who are eligible according to broad-based financial criteria defined by the State of New York for Medicaid eligibility.
  • Met Medicaid conversion standards and maintained file/record keeping on confidential information.
  • Monitor application process and updates.
  • Process recertification of applicants’ criteria changes by transporting all applicants internally to department of Medicaid program and Social Security Administration.
  • Review and screened all potential applicants, ensure updates were maintained and posted consistently in order for favorable outcomes within a timely manner.
  • Motivate patients and maximize all opportunities to convert all potential applicants to Medicaid.

Clerical Aide

  • Entered reports into patients’ chart via P.C.; updated new data.

Office Aide/Ward Clerk

  • Performed tasks in CCU, CRU, SICU, OR, Recovery, Labor and Delivery, Nursery and floated throughout the hospital surgical and medical floor.
  • Maintained patient charts, medical supplies and stationary for the units, filled and obtained laboratory results via computer.
  • Assisted doctors, nurses, social workers, nutritionists and Administrative staff.
  • Updated policy and procedure manuals regarding quality assurance, laboratory and nursing.

Office Manager/Medical Assistant

  • Managed daily operations of the clinic; maintained medical records; collected laboratory data for analytical purposes.
  • Responsible for accounts payable, medical billing and coding.
  • Assisted doctor in patient examinations and special procedures such as colonoscopy, cryosurgery, and punch biopsy.
  • Educated patients on hygiene, STDs, pregnancy prevention methods, labor and delivery, and gave sterility counseling.

Medical Assistant

  • Assisted M.D. in examination and immunizations maintained and ordered immunization supplies, processed pediatric patients: weight, height, temperature, and growth charts.
  • Responsible for assessing all children for up to date immunization schedules.
  • Medical coding and billing for Medicaid and private insurance.

Education:

  • Completed 50 Credits for Nursing