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Skills

  • Supervision
  • Team management
  • Medical claims auditing
  • Chronic disease documentation improvement
  • HCC coding expertise
  • First Aid/CPR
  • EHR (Electronic Health Records) management
  • Organization
  • Monthly coding review process
  • Coding error reduction methodologies

Work Experiences

  • Cut clarification requests by 82%.
  • Appointed lead over a team of 7 coders.
  • Cross-referenced patient history, symptoms, and physician notes.
  • Analyzed outcomes across 17 departments.
  • Abstracted and coded diagnosis data from medical records.
  • Was in charge of financial documents like expense reports and invoices.
  • Addressed inconsistencies in documentation.
  • Conducted remote coding for Boston-based health clinics and achieved compliance for 7 Medicare Advantage plans, with minimal discrepancies.
  • Conducted targeted audits on high-risk claims.
  • Created custom educational materials for ongoing HCC training, enhancing coder efficiency by decreasing average audit errors from 12 to 6.

Summaries

  • For a busy metric practice, a capable HCC Coder capable of handling all medical administrative needs.
  • Positive and upbeat personality with strong interpersonal communication skills.
  • Dedicated to streamlining organizational procedures in order to improve office environments.
  • Knows how to manage charts, forms, and payments.
  • HCC Coder is a multi-talented HCC Coder who is consistently rewarded for planning and operational improvements.
  • Excellent track record of resolving issues, increasing customer satisfaction, and driving overall operational improvements.
  • HCC Coder is a well-organized HCC Coder who is well-versed in healthcare processes and administrative requirements.
  • Dedicated to learning, growing, and succeeding in Healthcare.
  • Accomplished HCC Coder with attention to detail.
  • Achieved a 15% improvement in chronic condition identification.

Accomplishments

  • Performed quality assurance checks on coders’ output during audit preparations, achieving 27% error-free submissions.
  • Collaborated with cross-functional teams to improve communication surrounding patient documentation, reducing coding discrepancies by 67%.
  • Contributed to a 6 months coding backlog reduction effort, resulting in a 57% decrease in pending documentation issues.
  • Performed retrospective chart reviews and suggested corrections for chronic condition coding, recovering $95,000 in lost reimbursements.
  • Participated in the transition to new coding software Workday, resulting in a 38% improvement in coding speed and consistency.
  • Reduced claim denials for risk-adjusted Medicare conditions by reviewing and correcting documentation before submission, improving first-pass acceptance rate by 66%.
  • Resolved discrepancies in medical records for 3 cases, reducing diagnosis reporting errors by 54% and improving billing accuracy.
  • Generated actionable reports from coding and clinical data, enabling leadership to enhance risk stratification accuracy and improve patient care delivery.
  • Conducted gap analysis to identify neglected chronic conditions in coding, which improved compliance with chronic condition coding requirements by 67%.
  • Updated coding practices to adhere to payer-specific rules for risk adjustment, increasing reimbursement potential by 29%.

Affiliations

  • Certified Coding Specialist (CCS) – metric 2016
  • Certified Risk Coder (CRC) – process
  • Association for Integrity in Health Care Documentation (AIHCD)
  • Lead Presenter for Educational Sessions on CMS Updates at Vantage – 2015
  • Active Participant in AHIMA Mentor Match – 2018
  • Jaycees
  • Healthcare Financial Management Association (HFMA)
  • Coding Roundtable Participation – Austin, 2022
  • American Health Information Management Association (AHIMA)
  • Risk Adjustment Coding Certification Training Program – initiative

Certifications

  • Certified Professional Coder (CPC) - AAPC
  • Cisco Certified Network Associate (CCNA)
  • Certified Health Data Privacy Professional (CHDPP) - AAPC
  • Certified Risk Adjustment Coder (CRC) - category
  • ServSafe
  • Revenue Cycle Representative Certification - AAHAM
  • First Aid/CPR Certified
  • Microsoft Certified Systems Engineer (MCSE)
  • Certified Coding Associate (CCA) - metric
  • Certified Professional Medical Auditor (CPMA) - AAPC

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