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Skills

  • Compliance audit readiness
  • Interdepartmental communication for issue resolution
  • Budgets
  • 3M Encoder
  • Complex outpatient case coding
  • Process improvement
  • Clinical documentation improvement (CDI)
  • Claim submission accuracy
  • Error rate reduction strategies
  • CPT coding proficiency

Work Experiences

  • Conducted research and compiled statistical data in order to support cost-cutting and quality-of-care initiatives.
  • Authored a comprehensive best practice manual on outpatient coding structures, producing successful results, including a 66% reduction in appeal rates.
  • Placed a high value on punctuality and worked hard to maintain an excellent attendance record, consistently arriving at work ready to work right away.
  • Oversaw a 14-month project to revamp the filing system, resulting in a 13% increase in department productivity.
  • Oversaw the system conversion and ensured that there was minimal downtime during the updates.
  • Achieved a 69% correction rate.
  • Achieved a 34% reduction in compliance violations.
  • Achieved a 63% reduction in appeal rates.
  • Addressed coding lapses within the past year.
  • Easily interacted and communicated with department personnel and the general public.

Summaries

  • Achieved recovery within 18 months.
  • Accurately processed over 14 claims weekly.
  • Clarified high-complexity coding.
  • Costs were consistently reduced while profits were increased.
  • Accomplished Outpatient Coding Specialist.
  • Achieved a 52% reduction in coding-related inquiries.
  • Within Healthcare, senior Outpatient Coding Specialist and outstanding performer in vendor management and strategic planning.
  • Adept at integrating coding processes within HIPAA guidelines.
  • Adept at reducing medical coding errors and claim rejections using sophisticated trend analysis tools, achieving a coding accuracy increase of 54%.
  • Achieved a 38% reduction in rejected claims.

Accomplishments

  • Collaborated with billing and insurance teams to address discrepancies in outpatient coding, helping reduce resubmissions by 75%.
  • Led a project to update coding templates, enhancing team efficiency by reducing time spent on redundant coding tasks by 8 hours per week.
  • Successfully reduced claims-processing times by 10 days by streamlining coding workflows and adopting advanced coding technologies.
  • Served as a subject matter expert for major coding regulatory changes, providing guidance and ensuring compliance with CMS guidelines, resulting in no discrepancies reported during 2023 audit.
  • Developed error-reduction frameworks in outpatient coding processes, decreasing resubmission of claims due to coding mistakes by 44%.
  • Standardized procedure codes across multiple outpatient service lines, contributing to a streamlined coding process and a 56% improvement in audit scores.
  • Reviewed and coded outpatient services for 16 patient encounters weekly, ensuring full compliance with HIPAA and other regulatory standards.
  • Participated in the revision of procedure documentation methodologies, increasing coding compliance with CMS regulations and reducing audit risks.
  • Documented and resolved process which led to system.
  • Supported management of the outpatient coding department by providing leadership during crucial CMS regulatory updates, successfully ensuring zero compliance failures.

Affiliations

  • Revenue Integrity Coding Network
  • American Academy of Professional Coders (AAPC)
  • National Birth Defects Prevention Network (NBDPN)
  • American Health Information Management Association (AHIMA)
  • Association of Clinical Research Professionals (ACRP)
  • American Society of Safety Professionals
  • National Cancer Registrars Association (NCRA)
  • National Association of Healthcare Access Management (NAHAM)
  • Certified Professional Coder (CPC) Credential by AAPC
  • National Certified Medical Office Managers (NCMOM)

Certifications

  • Compliance Certification for Healthcare Professionals (CCHP) - Northwind
  • National Healthcareer Association (NHA) CBCS Certification - Ironclad Systems
  • Apple Certified Associate (ACA)
  • Project Management Professional (PMP)
  • Salesforce
  • CompTIA Security+
  • Certified Coding Specialist - Physician-based (CCS-P) – Harbor & Co.
  • Certified Public Accountant
  • Certified Outpatient Coder (COC) - Brightline
  • Microsoft Certified Systems Engineer (MCSE)

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