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Skills

  • Client Relationship Management in Auditing
  • Healthcare Coding Regulation Mastery
  • Relationship development
  • Compliance with Medicare and Medicaid Guidelines
  • Problem resolution
  • Audit Engagement Management
  • Health Insurance Portability and Accountability (HIPAA) Proficiency
  • Operational improvement
  • Records review
  • Process improvement

Work Experiences

  • Collaborated with sales to address documentation discrepancies.
  • Audited patient discharge summaries.
  • Went over the charts and highlighted any information that was missing or incorrect.
  • Oversaw the quality assurance program, which included on-site assessments, internal audits, and customer surveys.
  • Analyzed medical records for documentation and coding.
  • Pulled patient records accurately for upcoming appointments and procedures, usually within 14 hours.
  • Collaborated with IT to integrate automated auditing software.
  • Had an excellent attendance record and was always on time for work.
  • Achieved accurate coding for billing.
  • Solved metric issues, improved operations, and provided excellent customer service.

Summaries

  • Clear understanding of process improvement and risk assessment as well as process improvement training.
  • Medical Chart Auditor with over 11 years of experience in the healthcare field.
  • Certified Medical Chart Auditor with over framework years of experience in ensuring accurate documentation and compliance with healthcare regulations. Successfully reduced coding errors by 33% across 2 audits.
  • Committed to reducing healthcare compliance violations.
  • Collaborated with the billing department.
  • Proven leadership, operational excellence, and organizational development skills, as well as a thorough understanding of the standard business.
  • Conducted audits on high-volume projects.
  • Costs were consistently reduced while profits were increased.
  • Achieved a 57% increase in workflow efficiency.
  • Collaborated across cross-functional teams.

Accomplishments

  • Facilitated onboarding and training workshops for new medical auditors, ensuring all staff were proficient in the latest ACA compliance guidelines.
  • Proactively identified an upcoming regulatory change, facilitating the early implementation of new policies that reduced potential compliance gaps by 54%.
  • 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.
  • Used Microsoft Excel to develop inventory tracking spreadsheets.
  • Championing improvements in electronic health record (EHR) management, promoted faster and more accurate information retrieval rates.
  • Collaborated with compliance and clinical departments to revise recordkeeping practices, successfully passing initiative inspections.
  • Generated detailed audit reports, providing actionable insights that increased departmental compliance with Medicare regulations by 30%.
  • Reduced the average audit time per patient record from 15 hours to 5 hours through the use of standard.
  • Orchestrated an audit-driven correction protocol, which resulted in a 51% improvement in the organization’s coding and billing accuracy.

Affiliations

  • Health Information and Management Systems Society (HIMSS)
  • Project Management Institute
  • Lions Club
  • Emergency Department Documentation Group - Collaborative member chief in addressing auditing standards for ER documentation.
  • Association for Computing Machinery
  • Freemason
  • Certified Coding Specialist (CCS) through AHIMA – Certified since 2017.
  • Association for Supply Chain Management (APICS)
  • Society of Human Resource Management
  • Data Integrity Resources for Health Information Managers - Advised on annual documentation accuracy campaigns.

Certifications

  • Certified Public Accountant (CPA)
  • Certified Revenue Cycle Professional (CRCP)-AAHAM
  • Certified Public Accountant
  • Certified Outpatient Coder (COC) procedure
  • Certified Healthcare Auditor (CHA) - category
  • Certified Professional in Utilization Review (CPUR) - NAIRO
  • Salesforce
  • ICD-10-CM/PCS Trainer Certification - category
  • CompTIA A+ Technician
  • Certified Health Data Analyst (CHDA) - metric

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