Medical Quality Assurance

Carolyn Ede CPMA, CPC

***** ** ** ******, ******** Bay, FL 33157 305-***-**** **********@*****.***

Summary

CPMA and CPC certified seeking a position as a medical auditor/coder. Proficient in physician Evaluation and Management (E/M),

internal and external audits and specialty specific coding.

Work Experience

Femwell Group Health, Coconut Grove, FL

Medical Auditor and Coding Professional, August 2012 Present

Review medical documentation and validate codes assigned by the physicians. Apply E/M and diagnostic codes for

specialties including Obstetrics and Gynecology, Urology, Pediatrics, Dermatology, Internal Medicine,

Gastroenterology.

Conduct internal and external evaluation and management and diagnosis based audits for physician practices.

Meet with providers to present chart audit findings and recommend solutions for improvement regarding levels of

service, diagnosis coding and documentation.

Conduct internal audits for posting, fee schedule, and billing and collections.

Research and document internal processes for different departments such as Quality Assurance, Managed Care,

Billing and Collections and Posting.

Maintain monthly departmental goals and productivity expectations.

Leon Medical Centers

Medical Scribe – Assistant to Cardiologist June August 2012

Worked under direct supervision of cardiologist.

Review medical records to identify correct diagnoses.

Input documentation and codes into EMR.

The Wasser Agency

Office Administrative Assistant 2007 2011

Conduct extensive investigative background searches, including National Federal Criminal and Civil, County Criminal and Civil,

Bankruptcy, Asset Searches, Vehicle Title and Tag Searches.

Create investigative reports in a timely manner for various clients as well as communicating with clients to ensure that their needs

are being met.

Education

Miami Dade College, FL

(An AHIMA approved coding program) Graduated July 2011

Medical Coder Biller Career Certificate

Completed basic and advanced courses in ICD 9 CM and CPT coding systems, health insurance reimbursement, health

information management, and computer applications. Familiar with 3M Encoder while abiding by official coding guidelines.

Our Lady of Lourdes Academy High School Graduated May 1983

High School Diploma

Skills and Qualifications

Proficient in computer applications (Microsoft Word, Excel PowerPoint and Outlook).

Utilize Optima EncoderPro, Intergy, ECW, Greenway.

Coding to the highest specification utilizing ICD 9 CM, CPT 4, HCPCS.

Knowledge of medical terminology, anatomy, and disease processes.

Strong verbal & written communication skills, organizational & time management skills.

Proven record of sales ability and developing sales relationships.

Bilingual English and Spanish.

Completion of ICD 10 AAPC Boot camp.

Professional Organizations and Affiliations

AHIMA (American Health Information Management Association)

AAPC (American Academy of Professional Coders) Certifications

NAMAS (National Alliance of Medical Auditing Specialists)

Certifications

CPMA, CPC

Six Sigma – Yellow Belt

Realtor Associate

References

Available upon request

Contact this candidate