Medical Manager
Resume:
Narda J. Mattos, CCS, CPC, CPC-I, CPMA
*** *********** ****, ***. ****
Oakland, CA 94607
***********@*****.***
April 30, 2019
Dear Hiring Manager,
Thank you for taking a few moments to review my resume.
I have 25 years of professional coding/auditing/compliance experience and enjoy the field tremendously.
I have a strong background in HEDIS/P4P/Pop Health and am a certified medical chart auditor through AAPC as well as a coding instructor. I am also certified as a CCS through AHIMA (dual certified).
While working as a physician trainer at Kaiser, I was responsible for training physicians and their staff on the quality aspects of coding and documentation, specifically HCC Coding. Over the course of three years, I was responsible for the improvement of our physician coding accuracy by over 35%.
I am fast and efficient and know coding/auditing inside and out. I would enjoy bringing my diverse skillset to an organization which can appreciate my wealth of experience and diverse skillset.
**Please note: If you are a recruiter, read my resume in its entirety before contacting me and asking me for my salary requirements. There are several resources, which I’m sure you have available to you, to help you better understand my experience and what I can bring to an organization. The salary ranges are also listed.
Sincerely,
Narda J. Mattos
Narda J. Mattos, CCS, CPC, CPC-I, CPMA
Certified Coding Specialist
Certified Professional Coder
Certified Professional Coding Instructor
Certified Professional Medical Auditor ***********@*****.***
121 Embarcadero West Apt. 2224
Oakland, CA 94607
Home: 209-***-****
Professional Profile Certified Coding Specialist with 25 years in the industry, with specific expertise in coding and revenue cycle for Medicare, Medicaid, PPO and Workers Comp. Also experienced in the FQHC/RHC (Federally Qualified Healthcare Clinic/Rural Health Clinic) setting. Skilled in CPT, ICD-9, ICD-10, HCC, HEDIS Measures, HCPCS, compliance, instruction, code-set training and official guidelines. Most recent experience includes proficiently coding/auditing/training physicians in accurate coding and documentation. Proficient in Coding Clinic, 3M software, Epic, Cerner, Excel, Word, Power Point as well as the ability to research the internet for multiple resources to perform my duties.
Experience July 2018 – Nov 2018 University Healthcare Alliance – Stanford Healthcare
Coding Quality Coordinator – Chart Pursuit
Responsible for training physicians in P4P, HEDIS/Quality Measures
Review assigned medical records to abstract clinical data elements for P4P/HEDIS reporting, e.g. results of laboratory tests, the most recent blood pressure reading, prenatal and postpartum care services, etc.
Document abstraction findings into HEDIS database tool
Communicate additional pursuit strategies for additional medical records, if needed, to other members of the team
Integrate data collected from a variety of electronic and paper sources
Communicate significant findings, including potential risk management issues, to the Lead Population Health Nurse in a timely manner
Nov 2013 – June 2018 Dec 2015 – June 2018 Kaiser Permanente
Manager, Finance Department
Manage 15-28 Remote Auditors to ensure quality documentation by clinicians
Review disagreements by QA department and discuss with staff/auditors
Manage/discuss appeals with remote auditors
Provide daily/weekly/monthly feedback with auditors regarding disagreements/appeals
Create and conduct monthly webinars for auditors and QA staff to ensure consistent distribution of information throughout the department
Promote the highest quality output of information to leadership
Complete and conduct yearly evaluations for staff
Dec 2013 – Oct 2015 Golden Valley Health Centers Merced, CA
Director of Revenue Cycle Department
Project Lead, ICD-10 Implementation
Direct billing management and staff to ensure that accurate submission of all claims and timely collections occurs in accordance with all third-party contract terms including, Medicare, Medi-cal, managed care, commercial insurance, and direct patient pay
Manage medical coding department, auditing of charts and provide feedback to clinicians to ensure coding integrity throughout the organization
Manage continuous improvements within the revenue cycle process
Provide mentoring, coaching and performance reviews for direct reports
Manage all outreach billing operations, including hiring, orientation, training, development, coaching, corrective actions, and ongoing monitoring of all staff work-related activities
Ensures consistent quality of the billing services by distributing and assigning duties and responsibilities to employees, ensuring skill levels are appropriate to the assigned tasks, and monitoring the department’s productivity
Sept 2010 – 2013 Kaiser Permanente-DSA Walnut Creek, CA
Data Quality Trainer
Responsible for auditing Clinical Documentation Integrity, both in the outpatient and acute inpatient areas
Audit ICD-10 CM and PCS for readiness. Develop and deliver training material to ensure that physicians and staff would be prepared for rollout.
Responsible for training and providing feedback to clinicians in order to properly capture, document and address conditions which are reported to CMS and other payers
Assist auditors in providing quality feedback for CMS reporting purposes
Develop and deliver detailed training materials for clinicians to ensure proper coding and documentation of chronic conditions
Have been an instrumental part in increasing physician coding accuracy by 20% in the past 12 months
2008-2010 Kaiser Permanente-Regional Livermore, CA
Medical Documentation Auditor
Responsibilities included auditing diagnoses to validate HCC’s and identify problem areas for better physician training and feedback
Responsible for auditing E&M, CPT, ICD-9 and HCC codes for outpatient, ambulatory and ED
Identify and report missed opportunities
Research all coding and reimbursement sources to accurately identify correct coding
Jan-Apr 2008 Alta Bates Comprehensive Cancer Center Berkeley, CA
HIM Coder
Responsibilities included abstracting pertinent medical information from patient charts
Assigning correct and accurate CPT, Diagnosis and HCPCS codes including correct use of modifiers to ensure maximum reimbursement
Preparing reports to identify missing information
Attention to detail when coding for accuracy
2001-2009 MedTech Medical Billing Tracy, CA
Revenue Cycle Director
Responsibilities included managing and directing all activity for the billing and coding departments with a staff of 10+. This included verifying all patient and insurance information
Posting all services; including office, inpatient and outpatient surgery, Medical Legal Reports, deposition and expert testimony
Weekly reporting of all activity to client. Involved with decision making to improve the quality assurance and accounts receivable in the billing department. Responsible for reviewing CPT, ICD-9, HCPCS and their accuracy for reimbursement purposes
1998-2001 No. Ca. Neurosurgery Fremont, CA
Medical Billing Manager/Coordinator
Responsibilities included managing and directing all activity for the billing and coding departments. This included verifying all patient and insurance information
Posting all services-including office, inpatient and outpatient surgery, Medical Legal Reports, deposition and expert testimony
Weekly reporting of all activity to the clinicians and President/Owner of the company. Involved with decision making to improve the quality assurance and accounts receivable in the billing department
Responsible for assisting with the professional growth of the billing staff in order to provide support for a more productive billing department, while keeping the overhead costs at a minimum. Responsible for decreasing A/R by 25%
Education 1986 A.A. Stagg - Stockton, CA
2008 LS Coding/CPC preparation
Certificates Certified Coding Specialist, AHIMA. Certified Professional Coder, AAPC, Certified Professional Medical Auditor, AAPC, Certified Professional Coding Instructor, AAPC. Currently hold certificates for Medical Manager Fundamentals Training, and Report Generation. I also hold Certificates of Completion in Professional Supervision Skills, State of California-Division of Workers’ Compensation, Billing Management, Medicare and Private Insurance Workshops, Extended Training for billing by the American Association of Neurological Surgeons, Collection Law, and various awards of excellence from my previous employment, including Perfect Attendance and Appreciation Awards. Also am current with Medicare Compliance Rules and Regulations.
Computers NextGen, Lytec, Medical Manager, Infinity, Epic. Coding Clinic, 3M, Windows, Microsoft Office, Word, and Excel, Fully literate with Internet Services. Well versed in remote work.
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