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Skills

  • Medical billing code accuracy
  • 3M Encoder
  • Organization
  • Medical coding quality assurance
  • Problem resolution
  • Data-driven approach to coding decisions
  • Cross-functional team collaboration
  • Continuous education on regulatory updates
  • DRG assignment
  • ICD-10-CM coding expertise

Work Experiences

  • Audited outpatient records bi-weekly.
  • Achieved a 63% reduction in appeal rates.
  • Achieved an error rate below 76%.
  • Addressed recurring issues.
  • Used classification manuals to learn more about disease and diagnosis processes.
  • Authored a comprehensive best practice manual on outpatient coding structures.
  • Coded complex outpatient procedures.
  • Easily interacted and communicated with department personnel and the general public.
  • Avoided potential penalties worth $4.
  • Audited outpatient records as part of a bi-weekly quality assurance process, uncovering coding deficiencies that resulted in a 55% correction rate.

Summaries

  • Dedicated to learning, growing, and succeeding in Healthcare.
  • Adept at reducing medical coding errors and claim rejections using sophisticated trend analysis tools, achieving a coding accuracy increase of 54%.
  • Adept at integrating coding processes within HIPAA guidelines.
  • Addressed coding lapses within the past year.
  • Boosted team efficiency within three years.
  • Accurately processed over 14 claims weekly.
  • Completed special coding projects efficiently.
  • Overall morale and productivity are boosted by experience in policy development and staff management procedures.
  • Recognized on a regular basis for outstanding performance and contributions to the Healthcare industry's success.
  • Outpatient Coding Specialist with 12 years of successful performance reporting and team leadership experience.

Accomplishments

  • Collaborated with team of 7 in the development of standard.
  • Standardized procedure codes across multiple outpatient service lines, contributing to a streamlined coding process and a 56% improvement in audit scores.
  • Contributed to special task force to address flagged outpatient records, correcting 84% of errors and supporting the recovery of $13 in additionally reimbursed claims.
  • 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.
  • Performed regular audits on submitted claims, resulting in a 70% increase in the initial approval rate for outpatient service claims.
  • Supported management of the outpatient coding department by providing leadership during crucial CMS regulatory updates, successfully ensuring zero compliance failures.
  • Resolved product issue through consumer testing.
  • Identified and corrected coding issues on outpatient claims, improving accuracy by 19% and leading to a 16% increase in reimbursement for initiative cases.
  • Spearheaded the implementation of a software upgrade for hospital-wide coding, reducing overall coding errors by 28% and improving billing turnaround times by 6 days.
  • Initiated and led quality assurance program for outpatient coding department, reducing coding submission errors by 19% over 2 quarters.

Affiliations

  • National Birth Defects Prevention Network (NBDPN)
  • Jaycees
  • Association for Computing Machinery
  • Continuing Education Provider Program for Healthcare Coders
  • Outpatient Care Coding Best Practices Initiative (OCCBPI)
  • Freemason
  • Toastmasters
  • Association of Information Technology Professionals
  • Healthcare Financial Management Association (HFMA)
  • Certified Coding Specialist (CCS) Credential by AHIMA

Certifications

  • Certified Coding Specialist - Physician-based (CCS-P) – Harbor & Co.
  • Health Insurance Portability and Accountability Act (HIPAA) Certification – Beacon Labs
  • Microsoft Certified Systems Engineer (MCSE)
  • CompTIA Network+
  • Compliance Certification for Healthcare Professionals (CCHP) - Northwind
  • Medical Terminology Certificate - Summit Group
  • ICD-10-CM Coding Certification – Cedar Works
  • Salesforce
  • Certified Professional Coder (CPC) - Brightline
  • Certified Coding Specialist (CCS) – Lakeside Partners

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