Rayhena Santos

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