HCC Coder

Darlene J. Williams, RHIT

*** ******* ***. ******* **** IL. 60409

Home Phone 708-***-**** Cell Phone 708-***-****

*********@*****.***

Education:

. Certificate in Implementation Support Specialists

Moraine Valley Community College, Palos Hills, IL. 2012

. Associates in Health Information Technology 2009

RHIT Certified

Northwestern Business College, Hickory Hills, IL.

. Certificate in Medical Office Assistance

2001

College of Office Technology, Chicago, IL

Experience:

GeBBS Healthcare Solutions Englewood Cliffs, NJ Present

Remote Outpatient Coder

. Reviews medical records for the determination and accurate assignment of

all documented diagnoses and procedures

. Assigns and sequence codes based on medical record documentation

. Assign appropriate modifiers

. Communicate documentation improvement opportunities and coding

issues(discrepancies, physician queries, etc.) to the appropriate

personnel for follow up and resolution

. Codes any and all types of ED patient records( i.e. emergency room, E/M

Leveling, IV/IM)

Advocate Medical Group Oak Brook, IL 2010-2014

MRA Auditor

. Verify and ensure the accuracy, completeness, specificity and

appropriateness of diagnosis codes based on services rendered

. Interpret documents in EMR such as, encounter forms, medical records,

physician documentation, lab reports, dictated reports, and operation

instruction to identify all appropriate coding based on CMS HCC

categories

. Knowledge of medical and insurance reimbursement, HCC, ICD-9-CM, CPT

coding, disease processes, and medical terminology

. Demonstrate analytical and problem solving ability regarding barriers to

receiving and validating accurate HCC information

. Provide group and physician education regarding HCC documentation and

coding guide lines

. Work independently as well as meet deadlines and goals

. Maintain effective and professional communication skills

. Support and participate in process and quality improvement initiatives

. Interview people to obtain basic information, write correspondence

proficiently, and ability to interact with all levels of health care team

professionally

Oncall Consulting Thousand Oaks, Ca

2012- 2013

Remote HCC Coder (PRN)

. Verify and ensure the accuracy, completeness, specificity and

appropriateness of diagnosis codes based on services rendered.

. Review medical record information to identify all appropriate coding

based on CMS HCC categories.

. Complete appropriate paperwork/documentation/system entry regarding

claim/encounter information.

. Support and participate in process and quality improvement initiatives.

. Enter codes into computer applications supporting different medical plans

(CAT Forms).

. Research codes and medical terminology.

. Abstract ICD9-CM codes from handwritten charts and electronic medical

records.

St. Joseph Hospital Chicago, IL

Outpatient Coder (PRN)

2009-2011

. Coding/ Abstracting of outpatient ancillary testing, clinic visit, APC

Assignment

. Ensure all codes are assigned to patients on the unbilled (A/R) list

. Use of Star Application

. Use of Physician Portal

. Use of 3M Encoder

Advocate Ravenswood Medical Group Chicago, IL

Revenue Cycle Lead 2007-2010

. Coordinates and ensures that all charges for assigned practices are

posted to IDX in a timely

manner

. Reconciliation of patient accounts on a daily basis in an efficient and

accurate manner

. Reports compliance matters to practice manager, medical director, and the

supervisor of the revenue cycle department

. Follows up with provider for assurance of accurate code assignment and

documentation

. Ensures accurate data entry of all ICD-9-CM, CPT and HCPC codes and

modifiers in IDX

. Use of Encoder Pro

. PCS work file

. Insurance Verification

Advocate Health Center, Burbank, IL.

Patient Service Representative Coordinator

2004-2007

. Coordinates the technical functions of the PSR/HIM department to ensure

daily processes are completed

. Follows up with provider for assurance of accurate code assignment and

documentation

. Conducts Medical Record audits to ensure that charts are adequately

prepared for the doctors appointments

. Conducts monthly PSR audits to regulate each associates work file and

maintain accurate charge entry

. Maintain edits in PSR's work files

. Maintain weekly cash control for the center

. Provide leadership to department staff and assist the supervisor as

needed

Patient Service Representative

2003-2004

. Systematically organized incoming patients documentation to ensure doctor

accessibility

. Inputted patient demographic information in to customized medical

database(IDX)

. Answered incoming calls to resolve questions regarding patients

appointments

. Notated messages from patients to ensure all needed information is

submitted

. Inputted charges and diagnosis in computer from encounter forms

. Collected co-pay or balances from patients during check-in

. Prepared deposits for each PSR for the day

Advocate Health Center-Irving &Western, Chicago, IL

Health Information Associate

2002-2003

. Ensured patient confidentiality is maintained at all times

. Maintained and updated patient records to adequately prepare doctors for

appointments

. Systematically organized incoming patients documentation to ensure doctor

accessibility

. Inputted patient demographic information in to customized medical

database(IDX)

. Answered incoming calls to resolve questions regarding patient medical

records

. Reviewed messages from patients to ensure all needed information is

submitted

Accredits:

. RHIT Certified

. Certificate in Implementation Suppor t Specialists

. Certificate in Medical Office Assistance

Skills: 3MHDM Encoder, Encoder Pro, VPNs, Cerner system, Allscript, Citrix

System, IDX system, Cache system, Physician Portal, Windows 8, Windows 7,

Office XP, Power Point, Excel, and Internet

Contact this candidate