Julie Keane, CPC, CMRS
ac62zb@r.postjobfree.com
Professional Summary
Results driven, client focused administrative professional with progressive responsibility. Proven success in building relationships and providing support to all levels of the organization, ensuring organized office management processes that drive the short and long-term strategic goals of the business.
EXPERIENCE
The CSI Company, Inc May 2017-July 2018
Telecommute/Contracted HCC Sr. Coding Auditor, Certified Professional Coder
Certified Medical Reimbursement Specialist
Responsible for auditing HCC codes on medical provider clinical documentation while adhering to Medicare Advantage Plans regulations and Risk Adjustment guidelines. ICD-10 Certified, ICD-9, CPT and HCPCs knowledge.
Review and analyze patient documentation to assign correct HCC codes for reimbursement
Sustaining the accuracy of data inserted in the company software and completing around 26-33 charts every day.
Strong knowledge base of medical terminology, Medical abbreviations, disease processes
Met daily production goal and quality goals
Ability to be flexible in work environment with organization skills
Adhere to The Health Insurance Portability and Accountability Act (HIPPA)
Maintain professional certification
Staying abreast with changing coding guidelines
Hennepin County Medical/Trauma Center-Minneapolis, MN January 2016-May 2017
Telecommute Certified Professional Coder II, Certified Medical Reimbursement Specialist
Responsible for assigned medical charts to code for family practice clinics, dental clinics and outpatient, CDT, ICD-10 Certified, ICD-9, CPT, HCPC, Medicare Risk Adjustment-HCC, charge entry, medical terminology; required knowledge of Medicare requirements, Federal and State billing regulation/coding changes.
E/M leveling (Evaluation and Management Coding)
Reviewed and analyze patient medical charts electronically
Abstracted and code diagnosis documentation information
Provided effective feedback to the providers and fellow coders
Met daily production goal and quality goals
Identified and resolved clinical documentation and charge capture discrepancies
Maintained coding education and certification
Accurately assign and sequence ICD-10-CM and CPT-4 code(s) for multiply specialties
HCC auditing-2+ years
Mayo Clinic Health System Faribault/Owatonna/Waseca, MN January 2006-January 2016
Certified Professional Coder II
Responsible for clinic patient medical coding; Medicare Risk Adjustment (HCC), ICD-10 Certified, ICD-9, CPT and HCPCS, charge entry, Prior authorization coding for outpatient physician and medical terminology; requires knowledge of Medicare requirements, federal and state billing regulations/coding changes.
Analyzed clinical documentation; assigned appropriate diagnosis and procedures
E/M leveling for Provider Based specialty clinics and Critical Access Hospital
Abstracted the codes and other clinical data
Identified and resolved clinical documentation and charge capture discrepancies
Provided feedback to the physicians and fellow coders
Met departmental quality and productivity standards
Accurately assign and sequence ICD-10-CM, HCPCS and CPT-4 code(s) for multiply specialties
Staying abreast with changing coding guidelines and government regulations as well as insurance specific coding guidelines.
Certified Medical Reimbursement Specialist January 2006- January 2008
Responsible for clinic medical coding; ICD-9, CPT and HCPCS, charge entry, insurance billing and claims for various insurance carriers (Tri Care, Tri Care for Life, VA, MMSI, M.A., NO Fault, WC, MC/Uni Care, MMSI/SCHA); requires knowledge of Medicare requirements, federal and state billing regulations/coding changes, MN Work Comp law, HCFA 1500 and UB94 insurance claim forms, explanation of benefits statements, preauthorization and medical terminology.
Processed inpatient and outpatient claims as well as secondary insurance billing for hospital and clinic
Completed work comp and disability forms for physicians for review and approval; provided chart, dictation and relevant information needed to complete and remit forms
Identified unpaid claims; researched and resolved by providing supporting documentation or appropriate coding to ensure timely and accurate payment; requested reprocessing as needed to ensure accurate payment
Generated and reconciled daily/monthly reports for clinic and hospital accounts; reprocessed outstanding items, reconciled lab and charge slips and completed all required documentation for insurance submission
Served as liaison between patient and insurance carrier to resolve issues related to coverage for procedures, reason for non-payment or delay in payments; ensured dictation accompanied claim to ensure appropriate payments
Program Assistant - Adult Mental Health Case Management January 2009-October 2010
South Central Human Relations Center, Owatonna, MN
Manage administrative data regarding client service eligibility to ensure timely and accurate responses.
Oversee case manager’s maintenance of the necessary monthly paperwork
Drive client information for administrative reports in order to maintain the integrity of the data
Lead and coordinate the flow of information for claims submission
Provide customer service by answering phones and directing calls to the appropriate case managers
Complete general office duties
Generate monthly billing for adult case managers and child case managers
Rep-Payee Assistant; pay bills and balance clients checking accounts monthly, file and keep accounts organized
Cashier 2006-2009
Wal-Mart, Waseca, MN
Participated as a member of interior construction crew responsible for initial store set up; assembled shelving, set up displays and stocked inventory according to store instructions and parameters; performed a variety of other responsibilities
Served as cashier providing customer service/check out; answered phones and directed callers for multi-line phone system; responsible for balancing register of receipts ranging from $10,000 to $20,000 per shift
Customer Service/Classified Ad Specialist 1998-2006
Arabian Horse Times Magazine, Waseca, MN
Provided clerical support to classified advertisement and graphics departments by working with customers to prepare advertisements and type classified ad within tight timeline; cleaned, cropped and retouched photos in preparation for print
Served as receptionist and answered multi-line switchboard; directed callers, resolved issues and answered questions from advertisers and horse owners
Responsible for shipping magazines and merchandise to customers; saved $10,000 a month in shipping costs by selecting most appropriate delivery method
Recipient of employee of the month award; awarded for teamwork, initiative and managing costs
ADDITIONAL SKILLS
Standard Microsoft Office Suite: Outlook, Word, Excel, Internet, PowerPoint
Medical claims and billing systems: HCC Coding Assistant, Epic, Cerner, Meditech, LSS, MRMS, Rycan, Quantum, MedAssist/Code Correct, ICD-10 certified, ICD-9, CPT, HCPCS, CDT, EMR
EDUCATION
Certified Medical Reimbursement Specialist (CMRS): U.S. Career Institute, AMBA
Certified Professional Coder (CPC): AAPC Certified Coder Training: LS Coding & Education LLC
Online Evaluation and Management Training
Online HCC Risk Management Training
Medical Billing and Claims Specialist Diploma: U.S. Career Institute
ICD-10 Certified
Quality Supervisor Management Certificate, Medical Terminology: Riverland Community College
Phi Theta Kappa: Riverland Community College
Certified Dental Assistant, Certified Dental Practice Management: Rochester Vocational Technical Institute
ACTIVITIES
American Medical Billers Association (AMBA) Member
American Academy of Professional Coders (AAPC) Member
Waseca Co. Red Cross Executive Board Member/Chairman
Waseca Co. 4-H Project Leader