DELOIS GOSBY

*** ***** ***** ****** ******, GEORGIA 31093

PHONE 478-***-**** E-MAIL acz4xr@r.postjobfree.com

OBJECTIVE

To obtain a challenging and rewarding career position with your company where my initiative, skill and experience will be of value.

WORK EXPERIENCE

2014-2017 GCP-Terra Health Medical Chantilly Va

Reviews the entire medical record of all outpatient services to assign the admitting, primary, and secondary diagnoses to support medical necessity for all services performed. Maintains a working knowledge of CPT and ICD-9 coding principles, government regulations, protocols, and third part payer requirements regarding coding and billing. . Identify and resolve issues or errors, such as incomplete or missing records and documentation, unclear or nonspecific documentation, or codes that do not conform to approve coding principles by the DOD (Department of Defense) guidelines. Conduct medical coding audits to ensure compliance with Government accuracy standards following Air Force Medical Support Agency (AFMSA) New Coding Audit Methodology and prepare related reports. Highly adaptable and dependable employee with professional skills that include, using positive leadership abilities to manage Auditing/Coding operations. Very Knowledgeable with AHLTA, CCE and CHCS. Current active DOD Security Clearance. AAPC CPC certification October

2011-2014 Federal Staffing Resource/78th Med Group Robins AFB

I perform a variety of technically complex duties to review and analyze outpatient medical diagnoses, procedures and provide assistance to the professional staff. My job requires an extensive knowledge of coding accreditation references, medical terminology, and anatomy in addition to an overall knowledge of medical regulations Selection the appropriate codes and modifiers requires, determining from several possible codes and references the one which most accurately describes the proper primary and subsequent diagnosis when multiple diagnoses are present. Conduct medical coding audits to ensure compliance with Government accuracy standards following Air Force Medical Support Agency (AFMSA) New Coding Audit Methodology and prepare related reports.

2009-2011 Terra Health/78th Med Group Robins AFB GA

Reviews and screens the entire medical record to abstract medical, surgical, laboratory, pharmaceutical, demographic, social and administrative data from the medical record in a timely manner. Ensures providers that all diagnoses and procedures that may impact the facility's reimbursement. Identify and resolve issues or errors, such as incomplete or missing records and documentation, unclear or nonspecific documentation, or codes that do not conform to approve coding principles by the DOD (Department of Defense) guidelines. Educates and advises staff on proper code selection, documentation, procedures, and requirements; identifies training needs, prepares training materials, and conducts training for physicians and support staff to improve skills in the collection and coding of quality health. Conduct medical coding audits to ensure compliance with Government accuracy standards following Air Force Medical Support Agency (AFMSA) New Coding Audit Methodology and prepare related reports.

1999 – 2009 Cornerstone Medical Management Warner Robins, GA

Evaluates medical record documentation and charge ticket coding to optimize reimbursement by ensuring that diagnostic and procedural codes and other documentation accurately reflect and support the outpatient visit, and to ensure that data comply with legal standards and guidelines; interprets medical information such as diseases or symptoms, and diagnostic descriptions and procedures for a given visit in order to accurately assign and sequence the correct ICD-9 and CPT codes. Reviews Medicaid, Insurance and Medicare reimbursement claims before submission for completeness and accuracy and to minimize claim denial; evaluates records and prepares reports, on such topics as number of denied claims, documentation or coding issues.

1985 – 1999 Houston Medical Center Warner Robins, GA

Maintains all medical records per hospital policies and procedures in a neat and orderly manner, properly labeling each page and filing testing results and other information in individual medical records, accurately and in a timely manner. Under general supervision responsible for accurate coding of all inpatient, and/or outpatient services diagnoses, procedures and conditions, working from the appropriate documentation in the medical record. Codes routine diagnoses and treatment of hospital patients and abstracts information from patient records following established methods and procedures. Reviews the entire medical record of all appropriate secondary diagnoses and procedures. Ensures the DRG grouping assignment is accurate before transmitting account for billing. Seeks to obtain proper documentation in a timely manner. Reviews the entire medical record of all outpatient services to assign the admitting, primary, and secondary diagnoses to support medical necessity for all services performed. Maintains a working knowledge of CPT and ICD-9 coding principles, government regulations, protocols, and third part payer requirements regarding coding and billing. Adheres to hospital and departmental policies and procedures.

EDUCATION

2001-2004 Fort Valley State University Fort Valley, GA

Business Management 3.00 GPA

2004 – 2006 Macon State College Macon, GA.

Health Services Administration 2.65 GPA

December 2007 American Academy of Professional Coders

Professional Coders; Certification CPC

2006-2007 Georgia Military College Warner Robins GA

Business and Logistics Management 2.85 GPA

REFERENCES AVAILABLE UPON REQUEST

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