1. Y O L A N D A N I E V E S , R H I T
12100 Windriver Ln.
Hudson, FL 34667
727-815-2309
Ynieves1963@yahoo.com
AHIMA CertifiedRHIA, with workingknowledge of HIM functions, andHealth Insurance claims processingseekinga positionin Health
InformationTechnology and Administration.
S K I L L S P R O F I L E
Professional people skills andproblemsolving
Professional communication skills, verbal andwritten
Strongattentiontodetail andproficient at runningandhandlingoffice equipment
Experience with filing, charting, documentingandorganizational skills,alongwith other office requirements
Efficient in billingandcoding, andexcellent computer skills
Fully bi-lingual in English andSpanish
Experience with various EHR systems, including; Quadra Med, 3M, Quantim, Cerner, Care Tracker,ECW,All Scripts, Practice Fusion, and
EPIC, as well as others.
ED U C A TI O N
Rasmussen College Online, NewPort Richey, FL
RHIA Certified February 2013
RHIA, BS Degree graduate September 2015
R EL A TED EX P ER I EN C E
Access Health Care, LLC,SpringHill, FL
October 2015- PresentlyEmployed
CodingandDocumentationQuality Improvement Specialist
Medical chart reviews for codinganddocumentation accuracy, consistency,andintegrity.
Reviewcharts for compliance withNCQA HEDIS5 Star Measures.
Assist physician practices with documentationrequirements andHEDISmeasure submissions to various insurance carriers.
Create excel spreadsheets, andreports for various medical documentationrequirements.
Internship; Gulf Side Hospice & PascoPalliativeCare
08/13/2015-09/11/2015
PerformHealthInformation Administrativefunctions to assist management
CreatedaggregatedDRGreports
Records Retention
Revision of HIM PolicyandProcedure Manual
CreatedHIM TaskForce Competencies Assessment form for utilization in employee reviews
Reviewed, andprovidedvaluable workflowfeedback toreduce cost andworkflowredundancies
Assist in clinical documentationscanningandfiling
Experience with hybridmedical records system
Rasmussen College, NewPort Richey,FL
04/07/2015-06/15/2015
Online Tutorin Health Sciences
Provide educational tutoringandmentoringtoonlinestudents in the Bachelor’s Degree programforHealthSciences
UnitedHealthCare, FL
4/2000 – 4/2010
Claims Adjudicator
Reviewedclaims for accuracy andcompleteness in coordination withregulations.
Processedpatient medical claims with coordination ofbenefits
Ensuredpatient confidentiality per HIPAA regulations
Processedinbound/ outboundcorrespondence for reworkissues
Escalatedissue control
Processedrelease of information requests in accordance to HIPAA andAHIMA guidelines
Assistedin trainingnewhiredemployees
InboundCall Center functions includingbillingand technical troubleshooting
V O L U N TEER A C TI V I TI ES
Volunteeredservices at Dr. ReynaldoLim MD practice for2 months togain hands on medical recordprocessingexperience while in school for
HIT certification.