A Medical Record Reviewer examines medical documents for accuracy and works in medical facilities to handle patient records and insurance paperwork. Common work activities are found on the Medical Record Reviewer Resume as – working in hospitals, physician offices, nursing homes; reviewing and auditing medical records for accuracy and completeness, coordinating in-service meetings to educate the medical staff on proper documenting procedures; keeping abreast of new coding, government and insurance guidelines, checking for missing documentation, checking for physician’s notes, finding problems with the record, and ensuring all medical records is up to compliance.
The most common requirement for this post includes the ability to stay abreast of new coding, insurance guidelines, and government; the ability to work in a highly computerized environment, negotiation skills, call management skills; and the ability to adhere and participate in the company’s mandatory HIPAA privacy and practices. Aspirants can enter this occupation by earning a degree in Medical record management, or health information technology.
Summary : To obtain a Medical Record Reviewer position within the healthcare field where I can help improve and maintain excellent quality and effectiveness of healthcare by providing support, education, and guidance to healthcare providers, institutions and the companies who serve them.
Skills : Customer Service And Medical Patient Interaction Accounting, Cash Transition, And Sales Entry General Office Operations And Management Written And Verbal Communications.
Description :
Provided services as an independent contractor in the medical field.
Worked very well independently as well as with others.
Reviewed medical records of patients for upcoming appointments for AME, QME and Panel QME for Workers' Compensation cases.
Recorded reviews included orthopedics, pain management, emergency medicine, neurology, psychology/psychiatric, internal medicine, surgical procedures and radiology reports.
Required to read and abstract information from medical records from doctors' visits, hospital records, urgent care records and from depositions.
Viewed Subrosa Videos and documented the recorded activities of applicants.
Reviewed and compiled entire case into template for trial, depositions, etc.
Experience
10+ Years
Level
Senior
Education
High School Diploma
Medical Record Reviewer Resume
Objective : A nurse with HEIDIS experience wishing to obtain a position with your company to provide quality work accurately analyzing medical records. Effective problem solving, analytic and communication skills. Ability to collect from medical records accurately, with minimal error. Excellent interpersonal and organizational skills Professional phone etiquette Maintained QA score of 99% with last project Experienced in geriatrics, pediatrics, and mental health nursing.
Skills : Computer Skills, Customer service.
Description :
Performed a clinical review of medical records and/or other documentation to determine that services billed to and paid by the Medicaid agency are supported.
Included review for correct coding and medical necessity.
Completed medical review form, accurately documenting findings, and provide policy/regulatory support for determination.
Integrated knowledge of Medicaid/Medicare claims and reimbursement requirements to make accurate claim determination.
Provided support to internal staff, subcontractors and providers with respect to Medicaid related issues.
Conducted claim research using the appropriate systems.
Participated in and contribute to the quality management system.
Experience
2-5 Years
Level
Junior
Education
Master's In Biotechnology
Medical Record Reviewer Resume
Objective : Obtain a Medical Record Reviewer position in a reputable company to continue developing and enhancing my hands-on skills and knowledge in the medical field.
Skills : PowerPoint, Spreadsheets, Outlook.
Description :
Met project timelines and deliverables.
Worked with Project Team to prepare and write audit documents.
Briefed expert witness for trial regarding the information from casework.
Reviewed the Adverse event case narrative, coding, product/Indication, labeling in accordance with the respective reference safety documents, causality and Medical history for medical completeness, accuracy, and overall medical content.
Analyzed medical data to investigate causes and treatment of toxicity, pathogens, or chronic diseases and adverse event reaction caused due to drugs given for medication.
Reviewed and provided PV therapeutic area input for development of protocols, IBs, SAPs, CSRs and other relevant project/study documents.
Reviewed a Line Listing of cases and evaluates the coding and labelling and confirm the events are evaluated correctly.
Experience
2-5 Years
Level
Junior
Education
Master's In Biotechnology
Medical Record Reviewer Resume
Headline : To obtain a responsible Medical Record Reviewer position within an organization where my education, clinical knowledge, and experience will be utilized for organizational and personal growth.
Skills : Qualified Developmental Disability Professional, Qualified Mental Health Professional.
Description :
Scanned relevant components of the medical record to support reviews performed.
Uploaded scanned medical records daily.
Maintained communication lines with assigned advocate.
Communicated effectively and professionally with care provider offices, clinics, hospitals, other clinical facilities.
Traveled to medical facilities in specified area of region from home to complete review services.
Managed review of cases according to internal timelines.
Contributed to solving reconciliation medical coding issues/discrepancies.
Experience
5-7 Years
Level
Executive
Education
MA In Mental Health Counseling
Medical Record Reviewer Resume
Objective : Seeking a Medical Record Reviewer profession with an outstanding career opportunity that will offer a rewarding work environment along with a winning team that will fully utilize management skills.
Skills : Analyzing Skills, Searching Skills.
Description :
Provided in-depth analysis and reviews of medical records.
Ensured compliance with HIPPA and HEDIS guidelines/measures.
Reviewed medical records for the purpose of claims integrity.
Adhered to HIPPA guidelines.
Responsible for analyzing medical records to determine if charting was sufficient enough for documented codes.
Determined if medical records addressed the necessity of procedures or services performed.
Searched medical records for information required for HEDIS measures.
Experience
0-2 Years
Level
Entry Level
Education
High School Diploma
Medical Record Reviewer Resume
Objective : Seeking a position as a Medical Record Reviewer where I will be able to utilize my education, skills and experience will benefit your facility.
Skills : RHIA, HIM, Medical Records, Abstractor, Customer Service.
Description :
Collected and managed the flow of data elements and protected health information such as: study participant consent forms, special provider release forms and cancer medical records.
Contacted various medical providers to illicit their participation in the study.
Maintained a strong interpersonal relationship with medical providers and health information specialists.
Conducted a 100% chart review of all records to ensure completeness of requested data elements.
Completed weekly and monthly reports as requested by the Principal Investigator.
Ensured program compliance as established by HIPAA, State Regulations and the Cancer Prevention Study Internal Review Board (IRB).
Recorded collected information into computer data system.
Experience
2-5 Years
Level
Junior
Education
High School Diploma
Medical Record Reviewer Resume
Headline : To establish a long-term career in a company where I may utilize my Medical Record Reviewer professional skills and knowledge to be an effective Associate Program Manager and inspiration to those around me.
Skills : ICD-9 CM Coding & CPT Coding, Computers and Healthcare Delivery Systems, Vitals , EKG and Ansar Test.
Description :
Accurately and efficiently conducted medical record review services.
Communicated effectively and professionally with care provider offices, clinics, hospitals, etc.
Abide by all HIPPA and associated patient confidentiality requirements; Travel to medical facilities in specified region to complete review services.
Scan and upload relevant components of medical record to support reviews performed daily.
Managed patient charts and other relevant information for HEDIA Review.
Reviewed and organized medical records and prepare a summary including all the case information.
Reviewed and organized legal documents and summarize into case summary.
Experience
5-7 Years
Level
Executive
Education
Diploma
Medical Record Reviewer Resume
Headline : Responsible for Researching additional or alternative resources for non-covered chemotherapy services to prevent payment denials, and also Providing a contact list for patients community resources including special programs, drugs and pharmaceutical supplies and financial resources.
Skills : Care Management, MS Office.
Description :
Communicated effectively and professionally with care provider offices, clinics, hospitals and other clinical facilities.
Abided by all HIPAA and associated patient confidentially requirements.
Uploaded scanned medical records d Scan relevant components of the medical record to support reviews performed.
Reviewed and updated generated follow-up letters for the prescribers and investigators as appropriate.
Supported in preparing aggregate safety data reviews for pre-and post-marketing ASRs including Periodic Safety Update Reports (PSURs), Periodic Benefit-Risk Evaluation Reports (PBRERs), Periodic. Adversed Drug Experience Reports (PADERs), Development safety Update Reports (DSURs), IND annual reports, and other Ad-hoc reports.
Liaised with marketing team(s) to evaluate safety impact and provide input into program design (e.g., social media, market research, patient support programs)..
Assisted in writing and/or reviewing of monthly safety signal reports.
Experience
5-7 Years
Level
Executive
Education
BS
Medical Record Reviewer Resume
Objective : Skilled, versatile and accomplished professional with a background in medical assisting. Seeking to secure a challenging and dynamic position where in my skills, knowledge and dedication will be of mutual benefit.
Skills : Microsoft Office, Multitasking.
Description :
Traveled to medical facilities or provider offices in specified areas to complete review services.
Communicated effectively and professionally with care provider offices, clinics, hospitals, other clinical facilities.
Accurately and efficiently managed paper medical records or an EMR/EHR platform to retrieve information.
Scanned relevant components of the medical record to support reviews performed.
Uploaded extracted medical records per assignment.
Maintained quality and production standards required in accordance with company policy.
Complied with HIPAA laws and regulations.
Experience
2-5 Years
Level
Executive
Education
Diploma In Medical
Medical Record Reviewer Resume
Objective : As a Medical Record Reviewer, responsible for Maintaining a good working knowledge of chemotherapy authorization requirements for all payers, State and federal regulatory guidelines for coverage and authorization, and also Adhering to confidentiality, state, federal, and HIPPA laws and guidelines with regards to patient's records.
Skills : Patient Care, Care Management.
Description :
Presented a professional appearance and attitude when on assignment - business attire is required for all appointments.
Reviewed, processed and audited the medical necessity for each patient chemotherapy treatment and documentation of regimen relative to pathway adherence.
Communicated with nursing and medical staff to inform them of any restrictions or special requirements in accordance with particular insurance plans.
Provided prompt feedback to physicians and management regarding pathway documentation issues, and payer issues with non-covered chemotherapy drugs.
Updated coding/payer guidelines for clinical staff.
Tracked pathways and performs various other business office functions on an as needed basis
Obtained insurance authorization and pre-certification specifically for chemotherapy services.
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