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Medical Records

Location:
San Antonio, Texas, United States
Posted:
August 09, 2018

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Resume:

Christina Majors

**** ******* *****, *** *******, Texas 78239 • 210-***-**** • ac6l17@r.postjobfree.com

Professional Summary

•Healthcare Insurance contract professional whose aptitude has been repeatedly recognized by selection for assignments of increasing responsibility

•Over 17 years of experience in healthcare coding and technology

•Strong knowledge of contracting for commercial and government insurances

•Innovative and proactive, staying abreast of current best practices and technological advances

•Excellent organizational and interpersonal skills

•Excellent verbal and written communication skills

Technical Skills

MS SharePoint, MS Visio, MS Office (Word, Excel, PowerPoint, Outlook, Access), Salesforce CRM, Electronic Health Record systems, Medical Practice and Revenue Cycle, Management systems, Military Health System Management Analysis and Reporting Tool (M2, and other military databases, such as CHCS, Essentris, CCE and AHLTA, 3Mendcoder

EXPERIENCE

Experian Health - San Antonio, TX August 2014 - March 2017

Contract Analyst II

•Reviewed and analyzed managed care contracts to load and test contract variables via Oracle Application, Sales Force Cloud and other software

•Reviewed and download provider manuals, reimbursement and medical policies

•Developed methods (logic) for accurately valuing outpatient claims

•Manipulated fee schedules for loading into the contract management software program

•Created mapping tables which relates the Experian Healthcare contract code to the appropriate practice management system (PMS) contractual identifier(s)

•Created and provided reports to management and clients while manipulating data using pivot tables and macros

•Provided elbow support to end users regarding their claims and/or policies on medical coding and system analysis to improve process of claims management

•Maintained relationships with third party vendors for integration testing

•Assisted in the development of policies and procedures for contract definition

•Attended and participate in internal and client meetings as needed

Healthcare Resolution Services - San Antonio, TX January 2002 - June 2014

Mapping Specialist Jan 2013 – June 2014

•Created maps from current ICD-9 codes to ICD-10 codes for compliance and optimal use of codes to reduce risk of over or underpayments

•Reviewed medical policies for coding gaps and alternatives

•Gathered business requirements through a variety of techniques to facilitate design sessions

•Provided leadership and guidance to less experienced personnel

Medicare Integrity Auditor Jan 2012 – Dec 2012

•Served as a team lead for medical records review on individual and team work assignments

•Trained 5-10 staff members to use various tools/techniques such as direction, utilization of financial tools, medical records and maintaining databases for upper management

•Conducted specific medical reviews, analyzed findings to determine applicability of financial data, mades recommendations for corrective actions and prepared formal report

Coding Associates Jan 2011 - Dec 2011

•Abstracted patient-related data from out/inpatient records for coding purpose

Compliance Auditor and Trainer May 2002 - Dec 2010

San Antonio Military Medical Center

•Created and initiated patient flow analysis to meet command directed regulation of 3 business day completion of documentation and coding timeliness of outpatient services in coordination with implementation and transmission of new electronic health records system

•Provided and implemented education, documentation, and coding compliance training for electronic health record usage to 15-30 physicians and resident providers in various clinics, which resulted in more efficient processes for higher quality outcomes

•Served as the senior medical auditor/trainer for area of operation providing guidance on issues and courses of action to over 30 employees in coding and billing, and flow of process to identify and mitigate risk factors

•Maintained detailed and organized records for internal and external audit

•Assisted with onboarding process & create procedures and implement education of medical records coding and auditing staff

EDUCATION AND CREDENTIALS

Registered Health Information Specialist Program, St. Philip’s College, San Antonio, TX

Documentation Specialist, St. Philip’s College, San Antonio, TX

Certified Coding Specialist, Physician-Based (CCS-P) AHIMA (2001-2012)

Retail Sales A.A.S., Robert Franck College, Germany



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