Home Health Quality Assurance
Resume:
Mary Mah- CPC Email:
************@*****.***
License-Certified Professional Coder
Phone: 213-***-****
___________________________________________________________________
Education: Santa Barbara City College
Awarded Associate Science, Health Information Technology
2009
Certification: The Coding Source, LLC Voc. Certification 2006
American Academy Professional Coder (AAPC) -CPC
Industry: Home Health, Hospital, Healthcare, Health Information
Management
Software: MS Word, Outlook, Excel, Powerpoint, Access, Visio, Healthcare
Synergy, Medisoft, Ingenix, 3M Encoder, Meditech,
Cerner, EHR-Electronic Health Record
Bilingual: English and Chinese
WORK EXPERIENCE:
Angeles Home Health
6/2007-12/2009
Quality Assurance/Medical Coder
-Reviewing physician order, nursing progress notes, reconciles patient
encounter form, clinical notes, health information for consistency,
accuracy, and compliance with HIPPA rules and JCAHO standards.
-Ability to select diagnosis and procedures coding abstracting inpatient
hospital/nursing progress clinical notes.
-Utilized 3M Health Information Encoder references for coding assignment.
-Support and participate in process and quality improvement data management
case-mix diagnosis benchmark report
-Analyze related billing to improve accurate submission of coding data for
Medicare compliance reimbursement to help generate revenue.
Care Best Home Health
1/05-12/06
Medical Records Biller
-Work duties included manage and log in patient data in Healthcare Synergy
plan of care 485-nurse assessment.
-Create medical records chart, physician order, ancillary reports, dictated
reports, clinical units requesting medical records.
-Review account unbilled, denied, suspended submit and retrieve UB-04 for
Kaiser and Medi-cal TARS form.
Prime Choice Home Health Medical Data
Entry
1/04-12/04
-Work duties included recording daily log in patient data in Healthcare
Synergy.
-Retrieving nurse Oasis assessment implementing 485 plan of care report.
-Assisted file room supervisor with memos and spreadsheet physician
referral.
SKILLS:
Understanding of PC hardware, software and how networks work.
Proficient in Word, Excel, Access, Project and Windows operating systems.
Requires excellent communication, analytical, facilitation and negotiation
skills.
Ability to work in a team environment.
Ability to develop functional requirements and documentation for technical
staff.
Ability to develop data process modeling/mapping.
Ability to utilize data mapping or extraction tools.
Ability to interpret health record using ICD-9 and CPT codes abstracting
patient clinical medical record
Ability to identify encounter type assign codes inpatient vs. outpatient
Ability to sequencing diagnosis, select principle diagnosis, principle
procedures, complication/co-morbitites.
Ability to evaluate and verify DRG/APC payment methodologies reimbursement
hospital outpatient, ancillary, emergency dept. services assignment for
outpatient PPS reporting.
Understanding of Evaluate and Management code, modifiers, CPT-4 vs. HCPCS,
medical necessity, HCC-Hierarchical Condition Categories impact in Risk
Adjustment Factor score, Medicare Advantage policies, and Red Flags losing
revenue.
Member: American Academy Professional Coder (AAPC) - CPC
American Health Information Management Association
Contact this candidate