Objective

Dedicated Health Information Management professional seeking an opportunity to expand my knowledge in the Health Information Management Department.

Education

Arapahoe Community College Associate Degree in Health Information Management Littleton, Co 1992

American Health Information Management Association Registered Health Information Technician October 1993 ID#0473442

Professional Experience

Children’s Hospital Colorado

Scanning Lead/Health Information Management January 2006-October 2012

Coding Integrity Analyst October 2012-April 2016

Reviewed and evaluated claim denials and rejections pertaining to coding and medical necessity issues. I also assisted with development and implementation of corrective action plans to prevent similar denials and rejections from recurring.

Performed second level review of encounters to verify DRG assignment for accuracy of coding prior to billing. Audited medical record documentation and charge information to identify compliance and/or any risk areas.

Prepared written reports and maintained detailed findings of audits to Coding Manager, HIM Director, Compliance and Finance departments daily.

Provided coding and guidance for non-standard documentation and billing. Demonstrated extensive knowledge of clinical documentation and its impact on reimbursement under statutory/regulatory requirements. I also provided explanatory and reference information to internal and external customers regarding clinical documentation requiring authoritative reference information from a variety of sources.

I served as the subject matter expert for quality and accuracy issues that may be the result of coding error/problems (claims reject, reimbursement/billing issues, clinical effectiveness data, etc) troubleshoot assigned codes, coding documentation and related materials supporting data to understand, identify, and resolve issues of potentially serious dimension; follow-up to ensure adjustments/corrections are made as necessary.

Utilized financial reports to identify accounts in multiple work queues requiring review by HIM. This process routed accounts to the appropriate coder, manager or a second level review was performed to resolve the issue.

Coded outpatient accounts using ICD 9 CM/ICD 10 CM and CPT codes.

Move, delete and replace documents as necessary to maintain an accurate, legal medical record for each patient encounter

Ensure scanned/imported images are readable and linked to appropriate patients/encounters

Developed/maintained systemic quality review of scanning, indexing and verifying to ensure all scanned images are processed with a 98% quality rate

Participate in the merge/overlay cleanup process in DCTM

Troubleshoot/facilitates problem resolution with IT department

Knowledge of interface specifications and have confidence in escalating problem/issues to appropriate supporting areas

Assess workload and assign priorities and tasks to staff daily

Monitor compliance of customers with sending document to HIM for scanning

Monitor Input Accel on a daily basis to ensure documents are going through to Epic

Identify processes are inefficient and have the ability to propose and develop new, improved, more efficient processes.

Meet with customers to assess needs and requirements

Perform analysis of operational impact of new customer on existing operation

Inventory of all forms and update all reference material accordingly

Testing of system in test and production environments, testing of document types and form barcodes independently and extensively

Communicate with house supervisors and other necessary staff of Children’s Hospital Colorado in the event of any HIM department closures

Receive HIM scanning staff late attendance or sick calls

Mentor students who are on their practicum within the Health Information Management Department at Children’s Hospital Colorado

Upload documentation from OBIX into Epic for MFM patients

Hold staff accountable for expected quality and productivity standards

Monitor and report weekly productivity to Scanning Manager

Knowledge of scanning machines and understand what to do with each individual machine to get the highest quality image possible

Prioritize workflow on a daily basis, keeping in mind all agreed on turnaround times/expectations

Exempla Saint Joseph Hospital/Exempla Good Samaritan Medical Center Nov 2000-Dec 2005 Health Information Specialist II

Scanning and indexing of ER documents (St Joseph Hospital), scanning of inpatient and ER documents (Exempla Good Samaritan Medical Center)

Worked closely with ER physician for signature before processing ER documents into legal medical record (St Joseph Hospital)

Worked closely with Digistor after Exempla outsourced their scanning as PDM coordinator

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