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Skills

  • Collaboration with Healthcare Teams
  • NDCMedisoft
  • Data Security and Privacy Safeguards
  • Records review
  • Anatomy and physiology knowledge
  • Attention to Detail in Code Review
  • Adaptation to regulatory changes
  • Claims Denial Management
  • Organization
  • CPT Codes Mastery

Work Experiences

  • Assisted in recovering $8 in revenue by identifying errors in a 2024-backlog of misfiled claims.
  • Had an excellent attendance record and was always on time for work.
  • Reviewed charts and flagged incomplete or inaccurate information.
  • Contributed to a 2-month pilot program.
  • Contributed to a 14-month pilot program that streamlined the pre-authorization coding process, reducing turnaround time by 36%
  • Actively participated in audits mandated by framework.
  • Used classification manuals to learn more about disease and diagnosis processes.
  • Collaborated cross-departmentally.
  • Assisted in recovering $13 in revenue.
  • Collaborated with clinicians.

Summaries

  • Accomplished Medical Record Coder.
  • Contributed to Excellence Award submissions.
  • Clinical coding expert with 16 years of experience.
  • Overall morale and productivity are boosted by experience in policy development and staff management procedures.
  • Achieved 56% efficiency improvements.
  • Respected Medical Records Specialist with exceptional attention to detail and expertise in analyzing and correcting medical records.
  • Medical Record Coder with over 9 years of experience in the healthcare field.
  • Adaptable in coding and data entry.
  • Bilingual achiever with experience scanning and indexing medical records to the correct chart.
  • Collaborative Medical Record Coder with extensive experience working alongside physicians and healthcare professionals to rectify inconsistent diagnoses, improving the quality of medical documentation and reporting for key submissions.

Accomplishments

  • Implemented a robust quality control system for auditing high-priority cases, improving overall coding accuracy by 82% within 9 months of rollout.
  • Led an initiative to adopt best practices in coding for Population Health, which resulted in a 20% increase in reimbursement for chronic care management.
  • Played a key role in obtaining full compliance with procedure regulations by conducting regular internal audits of high-risk claims.
  • Collaborated with other departments on the development of a coding strategy that led to the accreditation of CPA, enhancing compliance with industry standards.
  • Decreased AR days by streamlining the coding process for surgical procedures, leading to faster claim approvals by 73% days.
  • Led the overhaul of coding workflows, reducing average claim processing time by 10 days and improving overall operational efficiency for the department.
  • Assessed and mitigated coding risks for high-dollar claims, resulting in a 48% improvement in first-pass claims approvals.
  • Documented and resolved procedure which led to process.
  • Proactively identified and corrected pre-billing errors, reducing denied claims by 34% and improving first-pass payment rates.
  • Ensured compliance with HIPAA guidelines by closely monitoring all coding processes, preventing unauthorized access and data breaches.

Affiliations

  • Insurance Claims Reviewers' Association of Denver
  • Society for Health Systems (SHS)
  • Health Level Seven International (HL7)
  • National Committee for Quality Assurance (NCQA)
  • Medical Billing and Coding Professional Association of Phoenix
  • Medical Reimbursement Specialist Society
  • Jaycees
  • Association of Clinical Documentation Integrity Specialists (ACDIS)
  • Healthcare Information and Management Systems Society (HIMSS)
  • American Health Information Management Association (AHIMA)

Certifications

  • Google Certified Professional Cloud Architect
  • Health Care Information Security and Privacy Practitioner (HCISPP) - initiative
  • ServSafe
  • Certified Professional Compliance Officer (CPCO) - AAPC
  • Clinical Documentation Improvement Specialist (CDIS) Certification - framework
  • Certified Healthcare Billing Specialist (CHBS) - Medical Association of Billers
  • Certified HIPAA Professional (CHP) – program
  • SHRM Senior Certified Professional (SHRM-SCP)
  • Certified Inpatient Coder (CIC) – initiative
  • Certification in Risk Adjustment Coding (CRC) – AAPC

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