Physician Director of Clinical Coding Quality

Motivated, results-driven healthcare administrator with extensive experience in operations management, medical coding, process improvement, & quality assurance. Proficient in analyzing & validating high volumes of patient information, diagnoses, and coding to achieve organizational goals.

Skills

CMS Quality Measures compliance & education

Project & personnel coordination and supervision

Medicare, Medicaid, and private insurance claims

Team Building, Staff Education & Development

Developed Training Programs & Curriculum

Skilled ICD-10/CPC assignment; Audits &Training

Expert in Medical Terminology, Anatomy, & Physiology

Process Improvement & Practice Optimization

Extensive experience using E-Clinical, IMS, Tracknet, & T-systems EMR platforms; Skilled Phlebotomist

Educational & Professional Qualifications

Certified Professional Coder (CPC)

Certification through The American Academy of Professional Coders (AAPC), November 2017

Expertise in CPT & ICD-10 requirements, Physician Auditing & EMR platforms, and CMS Quality Measures.

Adept in multiple EMR and Compliance Tracking systems, CORE Billing, Epic Resolute, Oracle, & Windows.

Completed Advanced Medical Coding Continuing Education class, Richland Community College, Summer 2017

University of Texas Medical Branch Galveston, TX

Doctor of Medicine, 2001- 2005

University of Texas at Austin Austin, TX

Bachelor of Arts, Biology, 1997-2001; 3.94 GPA; Graduated Magna Cum Laude; Phi Beta Kappa.

Professional Experience

American Journal Experts June 2018 – Present

Independent Medical Editor

Edit scholarly manuscripts originally written by non-native English speakers; helping authors with the manuscript preparation process and minimizing the language barrier, facilitating research communication.

BEMER Medical Device August 2017 – Present

Independent Distributor, BEMER Medical Device

Educate others about this cutting-edge, Class 1 medical device; There have been 46 publications and four PubMed studies discussing its ability to stimulate blood flow & improve restricted/impaired microcirculation

PPG Health Fort Worth, TX May 2017 – August 2017

Director of Clinical Coding Quality

Managed a Coding & Compliance staff of five; Supervised coding practices to ensure compliance with national standards; Improved upon current MIPS & coding quality identification practices.

Developed and implemented coding curricula and training sessions to enhance staff skill and expertise, improve documentation quality, and promote adherence with coding guidelines.

Provided continuing education and support on current billing, coding, and compliance procedures, guideline updates, and defined goals and objectives.

Performed chart audits on all 70 physicians in our multi-specialty group practice; reviewed medical records to ensure appropriate documentation and coding quality.

Assigned proper codes and DRG’s for data analysis and reimbursement purposes, in accordance with nationally recognized standards.

Provided educational guidance and support regarding ICD-10 CM & CPT coding guidelines; created customized practitioner training sessions based on their audit findings, enhancing coding competency.

Spearheaded process improvement initiatives; Established & maintained a positive work environment that encouraged and rewarded excellence while fostering team-spirit through engagement.

Adjusted professionally, effectively, & diplomatically, to change when working within new structures, processes, or cultures; Unfortunately, due to corporate restructuring, my position was eliminated.

The Heartbeat Clinic Dallas, TX April 2015 – May 2017

Director of Clinical Affairs

Managed all operational aspects for a cardiology practice including project and personnel management, coordination of patient care, staff training and education, EMR utilization, clinical research and publications.

Completed all patient records and updated charts; Reviewed accuracy of all documentation and coding.

Trained staff on efficient use of EMR, emphasizing the importance accurate and detailed data entry.

Developed and implemented a continuing education program to optimize familiarity with medical conditions, testing, and treatments commonly encountered in our clinic.

Provided physician instruction and promoted staff development through individual and group assignments, journal article discussions, and clinical skills training; Provided education on billing and coding practices.

Supervised clinic research activities, proposals, data gathering and statistical analysis; Reviewed and edited all medical publications and case report presentations prior to submission; including my own 8 publications.

Management Collaboration to establish policy, procedure, & protocol to optimize clinic efficiency & precision.

Trained, motivated, supervised, and evaluated staff to ensure maximum utilization of individual and group capabilities, in turn improving efficiency and compliance; Promoted integrated care and optimal outcomes.

Coordinated patient care with other clinics, hospitals, insurance companies, and pharmaceutical companies.

Completed insurance forms, prior authorizations, and pharmacy paperwork, always advocating for patients.

Developed, implemented, and monitored attainment of goals and objectives; Utilized current data and statistical analysis, integrating clinic projections and experiences, ensuring planning supports set objectives.

Promoted excellence through continuous assessment, communication via biweekly meetings, & team building.

North Texas Foot & Ankle Irving, TX February 2015 – April 2015

Medical Transcriptionist / Clinic Assistant

Supervised clinic operations, medical records, and patient care activities. Increased productivity and patient satisfaction through motivation, team-work, and emphasizing the importance of communication.

Oversaw communications with insurance and pharmaceutical companies, completed all necessary paperwork, and followed up on claims and prior authorizations until a favorable resolution was reached.

Reviewed and entered patient data into the EMR; Finalized all documentation and reviewed records to ensure accuracy, proper code assignment, and effective organization of records and patient information.

Provided instruction on clinic procedures, EMR utilization, and proper documentation and coding practices.

Managed a flawless transition to a new EMR platform, integrated all patient information & administrative tools.

Discussed performance and quality improvement activities with practice owner and staff physician, facilitating increased compliance with federal and state documentation regulations & coding guidelines.

Medical Practice & Training

Coon Memorial Hospital Dalhart, TX

Emergency Medicine Physician, 2009 –2010

Provision, coordination, & management of patient care; Oversaw allocation of materials and resources.

Staff supervision and training; EMR utilization for communication with other healthcare providers & insurers.

Johns Hopkins Hospital Baltimore, MD

Resident, Department of Anesthesiology & Critical Care Medicine, 2006-2008

Harbor Hospital Baltimore, MD

Transitional Internship, Department of Internal Medicine, 2005-2006

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