Bernadette Cartwright
Jonesboro
Summary
Experienced in preparing for the upcoming HEDIS season and committed to obtaining an AHIMA certification in addition to Medical Coding. Recently promoted from Front Line to Senior Support Agent after successful service as a Travel Agent for 2 1/2 years. Demonstrated expertise as a Quality Assurance Nurse for multiple insurance carriers during HEDIS seasons. Authorized to work in the US for any employer.
Overview
18
18
years of professional experience
1
1
Certification
Work History
Senior Support Representative
Aspire Loyalty Travel Solutions
06.2021 - 10.2024
- Bookings for Wells Fargo Facilitated scheduling for international and domestic trips. under Bakkt LLC
- Delivered exceptional customer support to address inquiries and resolve concerns efficiently.
- Travel
- Demonstrated proficiency with GDS platforms including Travel Port, Amadeus.
- Streamlined operational processes through integration of Five9, Epsilon, and Core systems.
HEDIS Data Abstractor
Matrix
01.2018 - 04.2018
- Knowledge of measures for current measurement year
- Systems based training and webinars
- Worked remotely and in office
- Communications with providers and facilities to coordinate records retrieval
- Organization and time management to uphold given daily metrics
Quality Assurance Nurse Associate
Rose International
01.2017 - 04.2017
- Knowledge of NCQA Standards
- Systems based trainings and knowledge of EMR software
- HIPAA Compliant Certifications
- Medical Record Abstraction
- Communicate at Facilitate Onsite Reviews
Quality Customer Service
Office Team/Robert Half International
12.2015 - 02.2016
- Quality Assurance (Centene)
- Abstraction of medical charts (over reads); to obtain components of HEDIS measurement
- Knowledge of proposed measures for the HEDIS Season
- Quality Customer Service calls to facilities, Doctors, etc
- To communicate what is needed to complete chart review
ROI Specialist
Healthport
04.2015 - 07.2015
- Processing for Ivy League account with necessary credentials
- Expediting processed requests when in priority status
- Logging and scanning in new requests for various sites
- Delivered excellent customer service regarding status or additional feedback
HEDIS Facilitator
Anthem/BCBS
12.2014 - 03.2015
- Oversee pursuit team by making sure they have the tools needed to make calls to providers and deliver quality customer service
- Maintain special handling and large group facilities
- Work with Leads to hold meetings and update/inform pursuit team
- Deliver quality customer service by making return calls to providers with questions or concerns
HEDIS Coordinator
BCBS of Ga
01.2014 - 05.2014
- Deliver quality customer service by making calls to providers for Medical Record Review
- Maintain accurate data within multiple software programs
- Consistently maintain quality in communication with provider's offices
- Consistently maintain call averages for efficient project completion
Chart Acquisition Specialist
Outcomes Health Information Solutions
01.2012 - 04.2012
- Deliver quality customer service by making calls to doctors and/or facilities requesting charts for HEDIS or PIA season
- Assigned Special Handling for priority clients
- Requested invoices to accompany charts for prepay clients
- Appropriately marked sites that used copy centers
- Completed reports to track and follow up on invoicing
- Scheduled onsite visits with offices or facilities that requested field reviewer
Case Associate in call center
Intracorp (Cigna)
05.2009 - 01.2010
- Deliver quality customer service
- Handling Several hundred calls per day
- Knowledge of multiple software packages
- Prior authorizations specified by insurance
- Data entry into necessary fields and track follow up
- Update records on consumers
Patient Account Representative
GWINNETT MEDICAL CENTER
12.2008 - 05.2009
- Patient Accounts
- Worked outsourced accounts
- Searched accounts need for rebilling
- Wrote letters of Appeal and submitted to Insurance Companies
- Worked Adjustments/Write Offs
- Various tasks not limited to rebilling and printing and sending medical records
Documentation Specialist
CCS MEDICAL
01.2007 - 07.2008
- Supported New/Existing Intake department
- Deliver quality customer service calls to physicians/ patients (including bilingual)
- Verified of insurance by phone or via internet
- Scanned completed files
- All necessary clerical assistance
- Knowledge of company software for data entry
- Obtained documentation to support need for DME supply
- Reviewed Incomplete/Discrepant scripts and returned to physician
- Completed Request for various dept
- Via PIMS QUE
- Close out patient orders and release to ship
Education
Health Science - ECCE With Focus On Special Needs And Inclusion
Gwinnett Technical College
Lawrenceville03.2009
Business Information Systems -
Herzing College
Atlanta, GA05.1995
Skills
- HEDIS
- Computer skills
- Microsoft Word, Excel, Power Point
- CPT Coding
- Windows
- Managed Care
- Insurance Verification
- EMR systems
- NCQA Standards
- Communication skills
- Customer service
- ICD-9
- HIPAA
- Documentation
- Medical terminology
- Database management (10 years)
- Medical Records
- Proofreading
- Quality assurance
Certification
- CPR Certification, 09/23 to 09/26
- First Aid Certification, 09/23 to 09/26
- Driver's License, 09/23 to 09/26
Timeline
Senior Support Representative
Aspire Loyalty Travel Solutions
06.2021 - 10.2024
HEDIS Data Abstractor
Matrix
01.2018 - 04.2018
Quality Assurance Nurse Associate
Rose International
01.2017 - 04.2017
Quality Customer Service
Office Team/Robert Half International
12.2015 - 02.2016
ROI Specialist
Healthport
04.2015 - 07.2015
HEDIS Facilitator
Anthem/BCBS
12.2014 - 03.2015
HEDIS Coordinator
BCBS of Ga
01.2014 - 05.2014
Chart Acquisition Specialist
Outcomes Health Information Solutions
01.2012 - 04.2012
Case Associate in call center
Intracorp (Cigna)
05.2009 - 01.2010
Patient Account Representative
GWINNETT MEDICAL CENTER
12.2008 - 05.2009
Documentation Specialist
CCS MEDICAL
01.2007 - 07.2008
Business Information Systems -
Herzing College
- CPR Certification, 09/23 to 09/26
- First Aid Certification, 09/23 to 09/26
- Driver's License, 09/23 to 09/26
Health Science - ECCE With Focus On Special Needs And Inclusion
Gwinnett Technical College
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