Kathryn Dietzel 917-***-****

Kmastro***@gmail

Skills

• Expert knowledge of MDaudit Software, Cerner, Athena/IDX.

• Team player.

• Proficient time management skills.

• Excellent oral, written, and communication skills.

• Experience with administrative operations and analytical tasks.

• Strong knowledge of CPT & ICD-10 codes, HCPCS, Modifiers, HEDIS, Medical Terminology, EMR Software and basic HIPAA principles.

Experience

SB CLINICAL PRACTICE MANAGEMENT PLAN INC

8/22 – Present

Compliance Medical Auditor – CPMP Compliance Department

• Conduct medical record documentation and coding/billing audits assessing the accuracy of CPT codes, diagnoses, and modifier assignments billed by CPMP, UFPC, and MHL providers; determine compliance with appropriate policies, procedures, bylaws, clinical staff rules and regulations, and the timeliness of documentation.

• Monitoring to identify patterns, trends, and variances during and from audits.

• Communicate with providers via email about their results, providing feedback which can include remedial training and/or a re-audit.

• Conduct follow-up audits as indicated to appraise the adequacy of corrective actions and determine whether deficiencies are corrected.

• Assist the Billing Compliance Manager and the Associate Director of Compliance on projects, including updating material for our new provider education and training programs.

• Present documentation, coding, and billing compliance training for all new providers.

• Attend and participate in the department’s quarterly Coding Compliance Collaborative, which explores current and new material in accordance with the Compliance Work Plan.

• Collaborate with the Billing Compliance Manager in researching relevant regulations and communicating the need for policies, procedures, and education to stakeholders.

• Sustaining a current knowledge of regulatory requirements associated with professional coding, billing, documentation, and reporting requirements in an academic medical center and in hospital clinics and physician offices.

• Pursuing ongoing training and development to gain additional expertise in fulfilling the elements of an effective Compliance Program.

• Maintaining professional skills and knowledge through attendance at relevant educational programs, participation in professional organizations and applicable webinars, and reviewing current literature.

2

CPMP/STAFFCO – STONYBROOK UNIVERSITY HOSPITAL

7/17 – 8/22

Medical Coder – Department of Pediatrics

• Worked in an offsite pediatric department of a busy, prestigious regional hospital as part of a coding and administrative team.

• Exercised proficiency in coding disciplines of emergency services, inpatient, outpatient, facility, and physician care in all specialties and primary care.

• Interpreted medical terminology and pharmacological information, translating information into a coding system.

• Verified accuracy of procedure codes, proper coding sequencing of diagnoses, as well as modifiers used on claims, ensuring proper reimbursement levels.

• Created detailed reports highlighting areas of improvement or potential risk associated with certain types of claims.

• Provided feedback to clinicians on best practice approaches for improving efficiency during the medical coding process and documentation requirements.

• Maintained current knowledge of coding changes, updates, and new rules.

• Fulfilled positive working relationships with fellow staff and management.

• Adhered to HIPAA guidelines ensuring patient safety.

• Streamlined day-to-day office processes meeting long-term goals.

• Applied coding rules established by the American Medical Association (AMA) and Centers for Medicaid Services (CMS) for the assignment of procedural codes.

• Performed quarterly audits to capture and ensure all billing and coding was processed in a timely manner.

• Attended and summarized monthly team meetings discussing coding accuracy, software updates, and department changes.

LEISURE PHYSICAL THERAPY - RIDGE, NY

1/14 – 7/17

Medical Receptionist/ Medical Biller

• Scheduled appointments collected and posted patient copayments.

• Verified insurance eligibility and obtained authorizations for physical therapy.

• Interacted with referring doctor offices daily for patient status updates, prescription renewals, and Plan of Care signatures.

• Processed billing through MD Online Clearinghouse, posted payments from insurance EOB’S and Medicare remittance advices.

• Reconciled outstanding patient and insurance claims from monthly aging reports.

• Insurance plan credentialing.

BILLING SERVICES INC – Ronkonkoma, NY

11/11 – 12/14

Medical Biller

• Responsible for charge posting for providers servicing the Hospital for Special Surgery in NY.

• Formulated and maintained client protocols.

• Interacted with clients on a daily to weekly basis, ensuring accuracy in superbill coding for proper insurance reimbursement.

• Supervised a team of five billers.

3

MEDICAL DATA RESOURCE PROVIDER – Nesconset, NY

3/06 – 11/11

Medical Biller

• Prepared electronic claims for Medicare, Medicaid, and Commercial insurance patients.

• Fielded patient calls and resolved account discrepancies.

• ICD-9, CPT, and HCPCS coding for all outpatient hospital and office services.

• Verification of insurance eligibility.

• Recognition of Workman’s Compensation and No-Fault claims in a timely manner. Education

HUNTER BUSINESS SCHOOL

Medical Billing Specialist Diploma

GPA: 4.0/4.0

May 2017

LAGUARDIA COMMUNITY COLLEGE

Associate Degree in Veterinary Science

GPA: 3.5/4.0

August 1997

Certifications

AMERICAN ACADEMY OF PROFESSIONAL CODERS (AAPC)

Certified Professional Coder (CPC)

October 2020

*Currently attending a CPMA bootcamp through AAPC*

Contact this candidate