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Skills

  • Claims Denial Management
  • Attention to Detail in Code Review
  • QMSoftware Receivables Management
  • MS Office
  • Cross-departmental communication
  • Medical billing code accuracy
  • Automated Auditing Technology Implementation
  • Medical terminology mastery
  • Implementation of Coding Accuracy Initiatives
  • EHR system integration

Work Experiences

  • Oversaw the delivery of category project by program team, which resulted in initiative.
  • Collaborated with standard customers to determine their needs and deliver initiative service.
  • Looked for industry trends on social media and through online sources.
  • Conducted monthly training sessions for new employees.
  • Achieved a reduction of 40%.
  • Pulled patient records accurately for upcoming appointments and procedures, usually within 2 hours.
  • Contributed to a 14-month pilot program that streamlined the pre-authorization coding process, reducing turnaround time by 36%
  • Oversaw the system conversion and ensured that there was minimal downtime during the updates.
  • Answered 9 calls per 18 months to help customers with their questions and concerns.
  • Reviewed charts and flagged incomplete or inaccurate information.

Summaries

  • Accomplished Medical Record Coder with a strong foundation in HIPAA compliance, quality assurance, and EHR systems. Proven success in reducing manual entries by 44% and increasing workflow efficiency by automating coding queries.
  • Achieved a 73% improvement in claims management.
  • Certified Medical Record Coder.
  • Committed to excellence in healthcare documentation.
  • Medical Record Coder with 6 years of successful risk assessment and stakeholder engagement experience.
  • Clinical coding expert with 16 years of experience.
  • Clinical coding expert with a history of 9 years in medical coding audits and quality assurance, enabling 63% increases in coder productivity and consistently achieving high compliance standards.
  • Consistently achieved high compliance standards.
  • Excellent track record of resolving issues, increasing customer satisfaction, and driving overall operational improvements.
  • Accomplished Medical Record Coder.

Accomplishments

  • Utilized Population Health Coding techniques to accurately code chronic disease treatments, optimizing reimbursement for long-term care management.
  • Partnered with IT departments to integrate data security systems that safeguarded medical records, achieving method compliance.
  • Scrutinized daily coding practices for adherence to Scrum Master guidelines, resulting in 82% reduction in compliance infractions.
  • Reduced claim denial rates by accurately coding claims, decreasing financial loss by 59% within the first year.
  • Developed coding templates to streamline the pre-authorization process, reducing approval wait times by 2 days.
  • Documented and resolved procedure which led to process.
  • Used Microsoft Excel to develop inventory tracking spreadsheets.
  • Trained 14 junior coders on proper use of updated CPT and ICD-10 codes, leading to a 54% boost in department-wide coding accuracy.
  • Maintained up-to-date knowledge of Medicare and Medicaid billing guidelines, ensuring compliant coding and reducing rejected claims by 51%
  • Collaborated with team of 2 in the development of system.

Affiliations

  • International Association of Administrative Professionals
  • Association of Clinical Documentation Integrity Specialists (ACDIS)
  • International Council of Nurses
  • Revenue Integrity Coder Working Group
  • Toastmasters
  • Health Level Seven International (HL7)
  • National Alliance of Medical Auditors (NAMA)
  • Association for Supply Chain Management (APICS)
  • Medical Insurance Review Board Member at framework
  • Healthcare Financial Management Association (HFMA)

Certifications

  • Certified Medical Reimbursement Specialist (CMRS) - American Medical Billing Association
  • Certified Healthcare Billing Specialist (CHBS) - Medical Association of Billers
  • Registered Health Information Technician (RHIT) - AHIMA
  • Certified HIPAA Professional (CHP) – program
  • Certified Compliance Specialist (CCS-P) - category
  • Clinical Documentation Improvement Specialist (CDIS) Certification - framework
  • Google Certified Professional Cloud Architect
  • Apple Certified Associate (ACA)
  • Cisco Certified Network Associate (CCNA)
  • Cisco Certified Internetwork Expert (CCIE)

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