Medical Health Insurance

Location:

Posted:

March 09, 2010

Tonda M. McCray, CPC, PCS, CMC

***********@*********.***

EMPLOYMENT HISTORY:

Kaiser Permanente 2004 – Present

Independent Coding Consultant/Clinical Documentation Specialist

Responsible for coding intermediate to complex diagnostic, E&M, procedural and surgery services

following current billing, coding regulations and policies. Reviewing, analyzing, coding and abstracting clinical

data from inpatient and outpatient records.

Familiarity with CCI, NCD, LMRP, experience with 3M encoder, knowledge of HCC codes.

Educates and influences Medical Providers and clinical personnel to use appropriate coding, ensures

accurate diagnoses, procedure codes and other specified data ensuring appropriate/optimal reimbursement for

facility and/or professional charges.

Maintaining a comprehensive Chargemaster Review Process, assuring the accuracy of CPT/HCPCS codes,

revenue center code assignments, making sure modifiers are correct, and line item descriptions match the CPT

codes exactly

Ohio Department of Mental Health, Cleveland, OH 1999 – 2004

Health Information Technician II

Responsible for reviewing, analyzing, and abstracting pertinent information from medical records in order

to identify and apply the accurate diagnosis and procedure codes for data retrieval, analysis, and claim

processing; through understanding of Medicare regulations; technical knowledge of ICD-9 and CPT coding

guidelines for DOD/VA.

Medical Mutual of Ohio, Cleveland, OH 1986-1999

Senior Claims Specialist/Analyst

Responsible for performing investigations, evaluations, of health insurance benefits, knowledge of medical

terminology, ICD-9 and CPT.

Servicing employee benefit plans, conducting employee meetings, able to analyze and solve customer’s

problems.

EDUCATION / CREDENTIALS:

Certified Professional Coder (CPC)

University of Akron, Akron, OH

Major: Bachelor of Arts, Majoring in Business Administration

Cuyahoga Community College, Highland Hills, OH

Major: Health Information Management, Undergraduate Studies

PROFESSIONAL AFFILIATIONS

AAPC, AHIMA

REFERENCES AVAILABLE UPON REQUEST