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Skills

  • Project organization
  • Chronic disease management
  • Operational improvement
  • Billing and reimbursement process enhancement
  • Business operations
  • First Aid/CPR
  • Relationship development
  • Clinical coding workflow optimization
  • Regulatory compliance
  • Diagnostic Related Groups (DRG) assignment

Work Experiences

  • Helped patients prepare for X-rays, EKGs, suture removal, and dressing changes.
  • Followed all necessary procedures to keep the patient's radiation exposure to a minimum.
  • Achieved a 29% reduction in claim submission delays.
  • Achieved a 35% improvement in coding compliance.
  • Achieved a 20% decrease in claim denials.
  • Collaborated with case managers and discharge planners, resulting in a 74% decrease in claim denials for post-acute care.
  • Achieved 48% faster insurance claim processing.
  • Collaborated with healthcare providers on delayed claims, securing 3 in recovered reimbursements within 4 months.
  • Was in charge of preparing and administering medications to help patients with their symptoms.
  • Worked with medical and administrative staff to keep the environment patient-centered, engaging, and compassionate.

Summaries

  • Achieved 19% reduction in documentation errors.
  • Clinical Coder who excelled in implementing new coding guidelines for Portland hospital, ensuring compliance and speeding up claim processing times by 26%.
  • Achieved a 59% improvement in reimbursement processes.
  • Professional with a medical background and team-building skills seeking a position in a deadline-driven environment.
  • Excellent track record of resolving issues, increasing customer satisfaction, and driving overall operational improvements.
  • Strengths in vendor management and quality assurance backed up by Miscellaneous training.
  • Recognized for motivating management team members to achieve their goals and fostering innovative work environments.
  • Positive and upbeat personality with excellent communication abilities.
  • Competent in chart organization, patient room preparation, and laboratory testing and medication administration to support diagnostic processes.
  • Accomplished Clinical Coder with a track record of increasing claim approval rates by 43% through pre-billing reviews of over 14 surgical cases.

Accomplishments

  • Provided expert input on clinical case documentation improvement projects, resulting in a 56% decrease in incomplete records.
  • Served as the point of contact for external regulatory audits, achieving full compliance over 8 consecutive audits.
  • Launched a comprehensive coding accuracy initiative across 11 facilities, improving overall compliance by 55%.
  • Optimized outpatient coding compliance within Austin, reducing errors in claims processing by 20% over a 5-month period.
  • Introduced remote coding solutions, which cut operational costs by 59% and improved coder productivity.
  • Regularly reviewed internal coding policies and proposed ongoing process improvements, resulting in a 67% cut in under-coded claims.
  • Devised coding audit reports that identified and resolved potential billing issues, recovering 12 in lost revenue.
  • Supported multi-departmental efforts to clean inventory and optimize healthcare database integrity, reducing duplicate records by 29%.
  • Transitioned manual health charts to electronic health records (EHR), reducing record-keeping errors by 47%.
  • Led the Coding and Compliance team to achieve a 71% increase in coding accuracy audit scores in 2020.

Affiliations

  • Jaycees
  • Medical Group Management Association (MGMA)
  • Medical Billing and Coding Quality Committee at method
  • Health Data Review Board Member at Meridian
  • International Association of Privacy Professionals (IAPP) - Healthcare Privacy Certification
  • Institute of Health Records and Information Management (IHRIM)
  • Physician Practice Coder Association of Massachusetts
  • International Association of Administrative Professionals
  • National Healthcare Anti-Fraud Association Member
  • Medical Reimbursement Committee for process

Certifications

  • CompTIA A+ Technician
  • Certified Tumor Registrar (CTR) - standard
  • Compliance Coding Certifications for Healthcare Fraud Prevention - Lakeside Partners
  • Certified Public Accountant (CPA)
  • Certified Medical Audit Specialist (CMAS) - method
  • Medicare Risk Adjustment Coding Certification - process
  • Anatomy and Physiology for Coders Certification - program
  • CompTIA Network+
  • Certified Documentation Improvement Practitioner (CDIP) - method
  • Certified EHR Specialist (CEHRS) - system

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