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Skills

  • Medical billing code accuracy
  • 3M Encoder
  • Client Relationship Management in Auditing
  • Problem resolution
  • Project organization
  • Records review
  • Data Confidentiality and Security Adherence
  • Supervision
  • Healthcare Coding Regulation Mastery
  • CMS (Centers for Medicare & Medicaid Services) compliance

Work Experiences

  • Pushed for operational changes that resulted in cost savings and higher profit margins.
  • Achieved a 49% improvement in billing efficiency.
  • Audited patient discharge summaries.
  • Collaborated with IT to integrate automated auditing software.
  • Achieved results over a 6 months period.
  • Oversaw the delivery of method project by system team, which resulted in program.
  • Analyzed medical records for documentation and coding.
  • Achieved savings over several months.
  • Ensured that medical records and health information were accurate, complete, and secure.
  • Went over the charts and highlighted any information that was missing or incorrect.

Summaries

  • Medical Chart Auditor with 10 years of successful stakeholder engagement and team leadership experience.
  • Accomplished Medical Chart Auditor.
  • Advised providers on best practices.
  • Proven leadership, operational excellence, and organizational development skills, as well as a thorough understanding of the standard business.
  • Medical Chart Auditor is a multi-talented Medical Chart Auditor who is consistently rewarded for planning and operational improvements.
  • Within Miscellaneous, senior Medical Chart Auditor and outstanding performer in budget management and cross-functional collaboration.
  • Adept at coordination across quality assurance and billing departments, resulting in streamlined processes and increased revenue collections by $16.
  • Addressed documentation discrepancies.
  • Committed to reducing healthcare compliance violations.
  • Dedicated performer with experience processing subpoenas and court orders.

Accomplishments

  • Designed a workflow improvement system that decreased the time to complete chart audits by 39% and improved regulatory submission deadlines.
  • Served as the point of contact for both internal audits and external reviews conducted by regulatory agencies, ensuring compliance with all requests.
  • Monitored adherence to compliance standards during medical chart reviews, achieving 14% accuracy in medical coding input.
  • Developed and managed an audit feedback loop improving chart quality monitoring and reducing review time by 13 days.
  • Reviewed 9 healthcare provider contracts, identifying 78% that were non-compliant with current payer guidelines.
  • Trained a team of 15 junior auditors in the latest chart auditing software, resulting in a 78% reduction in report generation time.
  • Prepared and presented audit findings in executive-level briefings, leading to revised organizational policies for better regulatory adherence.
  • Detected and resolved key deficiencies in medical coding, resulting in a 32% reduction in claim denials over one year.
  • Facilitated onboarding and training workshops for new medical auditors, ensuring all staff were proficient in the latest ACA compliance guidelines.
  • Utilized robust analytical tools to process and audit large volumes of medical data, achieving a 49% increase in productivity.

Affiliations

  • Local HIM Professional Group - Actively engaged in educational sessions on EMR auditing techniques.
  • Quarterly Healthcare Auditors’ Networking Group - Regular Conference Attendee.
  • Certified Coding Specialist (CCS) through AHIMA – Certified since 2017.
  • Society of Human Resource Management
  • Certified Medical Auditor (CMA) through Practice Management Institute - Certificant since 2021.
  • National Health Care Anti-Fraud Association (NHCAA)
  • International Council of Nurses
  • Revenue Cycle Optimization Community (RCOC) – Member; engaged in revenue recovery initiatives.
  • Association for Supply Chain Management (APICS)
  • Healthcare Internal Audit Association (HIAA) - Chair for the Coding Compliance subgroup.

Certifications

  • CompTIA A+ Technician
  • Certified Public Accountant
  • Certified Clinical Auditor (CCA) - HCCA
  • Certified Healthcare Revenue Cycle Auditor (CHRCA) - AAHAM
  • Certified Business Analysis Professional (CBAP)
  • SHRM Certified Professional (SHRM-CP)
  • ServSafe
  • CRC - Certified Risk Adjustment Coder - AAPC
  • Registered Health Information Technician (RHIT) - AHIMA
  • Certified Health Data Analyst (CHDA) - metric

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