Medical Billing

MOLLIE A. DAY-HUGHES, CPC

EDUCATION AND CERTIFICATIONS:

CPC – Certified Professional Coder

ICD-10 Certified, AAPC

Registered Health Information Technology, Volunteer Community College, (2014 – Current) EXPERIENCE:

1/2/2016-PRESENT

Central Iowa Hospital-REMOTE BASED

ED CODER

(Assignment – 748 beds)

• Responsible for accurately abstracting and appending ICD-9, CPT, and HCPCS for ED charts.

• Cleared edits from EPIC for each ED chart coded.

• Responsible for meeting deadlines in productivity- based environment.

• Coded E/M, I&I, I&D for Emergency Dept. (ED)

• Diagnostic coding for facility based

7/2015-12/2015

JACOBUS CONSULTING- REMOTE-BASED

ED Coder

(Assignment – Great River, Blytheville, AR 148 bed Acute Care)

• Responsible for accurately abstracting and appending ICD-9, CPT, and HCPCS for ED charts.

• Cleared edits from EPIC for each ED chart coded.

• Responsible for meeting deadlines in productivity- based environment.

• Coded E/M, I&I, I&D for Emergency Dept. (ED)

10/2008-6/2015

HEALTHSPRING - REMOTE-BASED

FT HCC Auditor

• Reviewed medical record information to identify all appropriate coding based on CMS HCC categories.

• Demonstrated knowledge of ICD-9-CM and CPT coding guidelines, medical terminology, anatomy and physiology.

• Demonstrated analytical and problem-solving ability regarding barriers to receiving and validating accurate HCC information.

• Responsible for physician education as it relates to appropriate documentation to support diagnosis codes selected by physician.

• Educated coders, auditors and physicians related to audit findings via departmental presentations.

1/2014-6/2014

KFORCE – REMOTE-BASED

FT Coder

(Assignment – Vanderbilt, 983 bed Level 1 Trauma)

• Cleared edits from EPIC Claim Edit WQ.

• Cleared edits from EPIC Charge Review WQ.

• Coded E/M, I&I, I&D for Emergency Dept. (ED)

• Coded SDS, Wound care and Observation.

10/2013-5/2014

NATIONAL STAFFING – REMOTE-BASED

FT Coder

• Cleared edits from Mysis WQ.

• Verified accuracy of coding using documentation via Power Chart.

• Provided support for coding department and educated coders using CCI edits and NCD/LCD guidelines.

9/2013-5/2014

UNIVERSAL HEALTHCARE – REMOTE-BASED

FT Coder

(Assignment – Kaiser, 500+ bed Level 1 Trauma)

• Coded charts for Cardiology department, assigning CPT and ICD-9 Codes.

• Responsible for auditing physician coding and correcting if necessary.

• Provided feedback to in-house coding staff as needed. 10/2013– 1/2014

COMFORCE – REMOTE-BASED

FT Coder

• Responsible for accurately abstracting and appending ICD-9, CPT, and HCPCS for ED charts.

• Cleared edits from EPIC edit WQ.

• Responsible for meeting deadlines in productivity- based environment.

• Coded E/M, I&I, I&D for Emergency Dept. (ED)

• Coded SDS, Wound care and Observation.

• Assisted with EPIC Go-Live for facility.

10/2005-10/2008

HEALTH MANAGED SYSTEM - OFFICE-BASED

APPLICATION SUPPORT ANALYST

• PROVIDED PHONE SUPPORT TO HMS CLIENTS FOR PATIENT ACCOUNT MODULE

• EXPECTED TO DEVELOP A THOROUGH WORKING KNOWLEDGE OF EACH PATIENT ACCOUNT APPLICATION AS WELL AS THE IBM AS400 OPERATING SYSTEM

• REQUIRED TO LEARN HOW TO USE VARIOUS IBM UTILITIES (I.E. QUERY) AS WE AS DEVELOP SOME KNOWLEDGE OF OUT PROGRAMMING LANGUAGES.

• SOME INTERACTION WITH QA FOR TESTIN PROGRAM CHANGES, NEW RELEASES, OR USER DOCUMENTATION.

6/2013– 9/2013

NATIONAL STAFFING – REMOTE-BASED

PT ED Coder

• Responsible for accurately abstracting and appending ICD-9, CPT, and HCPCS for ED charts.

• Cleared edits from EPIC for each ED chart coded.

• Responsible for meeting deadlines in productivity- based environment.

• Coded E/M, I&I, I&D for Emergency Dept. (ED)

7/2012– 5/2013

KFORCE - REMOTE-BASED

Coder Support/ED

(Assignment - OCHSNER HEALTH SYSTEMS)

• Assisted the coding and denials department with denials related to incorrect CPT, ICD9, HCPCS and modifier application.

• Provided support for coding department and educated coders using CCI edits and NCD/LCD guidelines.

• Coded E/M, I&I, I&D for Emergency Dept. (ED)

• Abstracted from OP charts with detail and accuracy, to include ancillary and urgent care.

•Cleared facility-based edits daily.

5/2012 – 7/2012

KFORCE - REMOTE-BASED

ED Coder

(Assignment – UAB, 1134 Beds, Level 1 Trauma)

• Responsible for meeting deadlines in a productivity- based environment.

• Coded E/M, I&I, I&D for Emergency Dept. (ED)

• Responsible for coding ED charts with and without E/M Leveling

• Cleared facility-based edits out of Edit WQ.

11/2011 – 5/2012

KFORCE - REMOTE-BASED

Coder Level II

(Assignment, KAISER – 500 bed Level 1 Trauma)

• Functioned as a PSC II (coder 2) Code all hospital professional services for all specialties, surgeries, E&M, Emergency Department and Anesthesia using Epic Software.

• Reviewed encounters with system triggered coding edits to verify the documentation in the electronic medical records within KPHC to support procedures billed.

• Corrected all coding for all specialties, corrected usage of CPT, ICD9, HCPCS and modifiers.

• Applied Kaiser specific policies and desktop procedures to correct edits 9/2011 – 6/2012

PEAK HEALTH SOLUTIONS - REMOTE-BASED

Remote HCC Coder

• Responsible for accurately abstracting and reporting ICD-9-CM codes according to the Hierarchical Conditional Category, CMS Correct Coding Initiatives, and ICD-9 guidelines.

• Responsible for meeting productivity requirements daily.

• Assists in the development and maintenance of tools, policies and procedures.

• Utilizes knowledge of anatomy, physiology, medical terminology and pathology. 4/2001 10/2005

TENNESSEE ORTHOPEDIC ALLIANCE - NASHVILLE, TN

Medical Billing & Coding Specialist

• Responsible for overseeing accurate billing, follow-up, and correct reimbursement for all procedures.

• Directly responsible for all outgoing and incoming correspondence to and from all insurance carriers.

• Monitors and audits productivity reports daily in a timely manner.

• Ensures that insurance carriers process claims according to contract while reporting receivables weekly to practice administrator.

12/2009 – 7/2010

OUTCOMES HEALTH SOLUTIONS - REMOTE-BASED

Remote HCC Coder/Auditor Seasonal

• Responsible for accurately abstracting diagnoses and assigning correct ICD-9 codes from medical records.

• Completes assigned workload in a timely manner.

• Inputs ICD-9 codes into internal software system.

• Received various bonuses for timely and accurate completion of workload. SYSTEMS:

• E-Clinical

• Sunrise

• Medisoft

•GE

• IDX

• 3M

• Epic

• HDM

• Cerner

• Power Chart

• Mysis

• Meditech

•HPF

PROFESSIONAL ASSOCIATIONS:

• AAPC American Academy Professional Coders

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