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Skills
- Standardizing coding workflows
- DRG (Diagnosis-Related Group) assignment
- Problem-solving for coding-related issues
- Accurate assignment of ICD-10 and CPT codes
- Process optimization for coding efficiency
- Revenue cycle management
- Clinical documentation improvement (CDI)
- Facilitating educational sessions for physicians
- Clinical coding compliance oversight
- Billing and reimbursement procedure knowledge
Work Experiences
- Reduced coding-related claim rejection rates by [Percentage]%.
- Streamlined reporting processes.
- Achieved [Percentage]% closure rate in disputed claims.
- Led a team of [Number] coders.
- Maintained up-to-date knowledge of coding standards.
- Successfully completed coding of [Number] high-complexity patient records daily, maintaining compliance with federal and payer-specific guidelines.
- Reviewed physician documentation for completeness, ensuring it aligned with appropriate clinical codes, leading to a [Percentage]% increase in accurate claims submission within [Timeframe].
- Collaborated with case management and billing teams.
- Ensured proficiency in cutting-edge coding technologies.
- Conducted workshops to train [Number] physicians.
Summaries
- Deep knowledge of payer-specific guidelines.
- Ensured HIPAA compliance.
- Conducted regular coding audits.
- Adept at standardizing coding procedures.
- Experienced in auditing physician documentation.
- Proven ability to lead teams and train new coding personnel, achieving a [Percentage]% retention rate while enhancing coding accuracy and productivity.
- Adept at reducing claim denials by up to [Percentage]% through proactive collaboration with physicians and payment departments, ensuring revenue cycle integrity and productivity.
- Expert in DRG assignment.
- Saved [Amount] in annual claim denials.
- Certified Coding Specialist.
Accomplishments
- Worked with the QA team to ensure proper use of technology for coding, leading to an overall [Percentage]% efficiency improvement.
- Collaborated with clinical staff to ensure accurate ICD-10 codes were applied, improving documentation completeness by [Percentage]%.
- Reduced compliance concerns by integrating a dual-auditing system across [Number] facilities, enhancing coding accuracy by [Percentage]%.
- Reduced accounts receivable time by [Percentage]% through coding corrections validated against documentation standards.
- Generated detailed reports on medical coding patterns, driving a [Percentage]% improvement in revenue cycle efficiency.
- Conducted daily auditing of [Number] medical charts, ensuring 100% compliance with ICD-10 and CPT guidelines.
- Provided bilingual coding support in [Language], reducing miscommunication and improving coding accuracy by [Percentage]%.
- Reviewed and updated coding protocols for high-volume departments, reducing audit discrepancies by [Percentage]%.
- Collaborated with clinical staff to clarify ambiguous documentation, facilitating quicker coding and faster claim turnaround by [Percentage]%.
- Reduced claim processing times by [Percentage]% through detailed reviews of provider documentation and coding accuracy.
Affiliations
- Regular volunteer for Coding Audits at [Organization]
- National Association of Healthcare Revenue Integrity (NAHRI)
- Medical Practice Compliance Association (MPCA)
- Health Level Seven (HL7) International
- Certified Professional Coder (CPC) Certification - AAPC
- Healthcare Financial Management Association (HFMA)
- Medical Group Management Association (MGMA)
- Continuing Education Programs via HIMSS
- Organized medical coding workshops at [Institution] for ongoing professional development
- Board of Medical Specialty Coders (BMSC)
Certifications
- Certified Coding Specialist – Physician-Based (CCS-P) - AHIMA
- Certified Electronic Health Records Specialist (CEHRS) - National Healthcareer Association (NHA)
- ICD-10 for Health Care Providers Certification - [Online Training Platform]
- Certified Coding Specialist (CCS), American Health Information Management Association (AHIMA)
- Registered Health Information Administrator (RHIA) – [AHIMA]
- Certified Professional Coder (CPC) - AAPC
- Certified Medical Administrative Assistant (CMAA) - National Healthcareer Association (NHA)
- Certified Healthcare Revenue Integrity Professional (CHRIP) - National Association of Healthcare Revenue Integrity (NAHRI)
- Healthcare Coding and Billing Certification - [Local College or University]
- Certified Healthcare Technology Specialist – Technology Solution Development and Implementation (CHTS-TS) - AHIMA
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