Certified inpatient coder
Resume:
RS
REBECCA SHEAFFER
***********@*****.*** 843-***-**** Myrtle Beach, SC 29577
Salutations. I have been telecommuting with Cotiviti since 2022 and thoroughly enjoyed working for such an exemplary employer. I have been able to expand my very diverse skillset daily, have been presented with many opportunities for growth. My background includes 7 years as a Registered Respiratory Therapist, 5 years as an acute care Registered Nurse, and 9 years in Facility Medical Necessity Reviews, DRG Reviews, Clinical Validation Reviews, Reconsideration Reviews, and Appeal Reviews.
Document Management
Medical Record Security
Data Entry
Data Security Procedures
ICD-10-CM and ICD-10-PCS Coding
Electronic Health Record Applications
Medical Terminology
Patient Data Identification
Proficiency in Microsoft Suite
Certified Inpatient Coder
DRGs Patient Assignments
Protected Health Information
Records Review
EMR Systems
Records Scanning
Inpatient Coding
Cotiviti South Jordan, UT
Medical Coder, CIC
10/2022 - 08/2023
Work autonomously to investigate, review, and provide coding in the application of medical and reimbursement policies within the post-pay claims process. Perform complex conceptual analyses after precise extraction of key clinical and coding documentation. Apply relevant governmental regulation, payer protocols, and sanctioned coding guidance, determine case outcome and prepare detailed written correspondence with findings, when applicable. Optum Eden Prairie, MN
Post-Pay Facility Lead
02/2022 - 09/2022
Work autonomously to investigate, review, and provide coding and clinical expertise in the application of medical and reimbursement policies within the post-pay appeals adjudication process. Perform complex conceptual analyses after precise extraction of key clinical and coding documentation. Apply relevant governmental regulation, payer protocols, and sanctioned coding guidance, determine case outcome and prepare detailed written correspondence with findings, when applicable.
Optum Eden Prairie, MN
Senior Recovery/Resolution Analyst
10/2015 - 02/2022
Work autonomously to investigate, review, and provide coding and clinical expertise in the application of medical and reimbursement policies within the pre- and post-pay claims process. Perform complex conceptual analyses after precise extraction of key clinical and coding documentation. Apply relevant governmental regulation, payer protocols, and sanctioned coding guidance, determine case outcome and prepare detailed written correspondence with findings, when applicable.
Novitas Solutions Mechanicsburg, PA
Nurse Analyst
01/2012 - 06/2013
Perform retrospective medical necessity reviews and DRG audits, rendering decisions under the Recovery Audit Program using Centers for Medicare and Medicaid Services National Requirements as well as the Medicare Summary
Skills
Experience
Administrative Contractor local policies.
Pinnacle Health Harrisburg, PA
Registered Nurse, Acute Dialysis
02/2012 - 12/2012
Safely prioritize, implement, and complete hemodialysis, exclusively in the acute care environment. Efficiently and effectively construe changes in patient response to treatment and respond accordingly. Safely organize and institute peritoneal dialysis, when applicable. Provide caring and compassionate education and training to patients regarding disease process and therapy. York Hospital York, PA
Registered Nurse, Medical-Surgical Unit
02/2008 - 02/2012
Coordinate and provide direct patient care in an acute care medical setting utilizing the Relationship Based Care Nursing Model. Implement and adapt palliative and/or end-of-life care measures for patients entering the final stage of life. Efficiently, effectively, and thoroughly communicate patients care needs to Physicians, Allied Health Practitioners, and oncoming staff. Delegate care to patient extenders while overseeing the safety of care provided. Perform timely, thorough, and accurate documentation of all assessments, progress notes, plans of care, education, and ad hoc charting. Provide caring and compassionate communication and education to patients. Hanover Hospital Hanover, PA
Registered Respiratory Therapist
04/2003 - 02/2008
Provide respiratory based patient care in diverse medical settings including medical units, surgical units, intensive care, pediatrics, post-anesthesia care, acute rehabilitation, and emergency care. Provide caring and compassionate communication and education to patients. Operate and maintain associated respiratory machinery and laboratory equipment per hospital and governmental standards.
Hanover Hospital Hanover, PA
Registered Respiratory Therapist
04/1991 - 05/1993
Provide respiratory based patient care in diverse medical settings including medical units, surgical units, intensive care, pediatrics, post-anesthesia care, acute rehabilitation, and emergency care. Provide caring and compassionate communication and education to patients. Operate and maintain associated respiratory machinery and laboratory equipment per hospital and governmental standards.
Excelsior College Albany, NY
Associate of Applied Science in Nursing
05/2008
University of Maryland - Baltimore Baltimore, MD Master of Science in Microbiology/Molecular Biology 05/1999
York College of Pennsylvania York, PA
Bachelor of Science in Respiratory Therapy
05/1993
Certified Inpatient Coder (CIC), AAPC, 2017
Education and Training
Certifications
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