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Credentialing Specialist Medical Staff

Location:
Kansas City, MO
Posted:
March 27, 2024

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Resume:

Cheyenne Hoenshell-Reardon

816-***-**** ad4lyo@r.postjobfree.com

* * ****** ****, ****** City MO, 6414

TECHNICAL SKILLS

Proficient in Microsoft Office

Experienced with EPIC, ECW, Meditech, Mosaic, Point Click Care, and Patient Keeper.

CERTIFICATIONS

1/2024 CPCS Course completed

11/2018 CPC, Member #01594992

EDUCATION

08/2017 Penn Valley Community College, Kansas City, MO

EXPERIENCE

Coding Quality Analyst – Coder II

Prime Healthcare

July 2022-Present

Analyze, abstract, and code diagnostic and procedural information in physician outpatient and office medical records using ICD-10 and CPT codes. Enter coded and abstracted data into the electronic information system, ensuring compliance with regulatory agencies and specific guidelines. Support coding quality for billing purposes, conduct reviews before release, and address coding questions for stakeholders. Train staff, perform quality reviews and audits, and communicate findings to management. Collaborate with clinical documentation teams, quality analysts, and offshore coding entities. Apply CPT Coding Convention, AMA guidelines, AHA Coding Clinic, and Hospital Policy. Maintain unbiased, honest, and ethical code assignment and reporting. Summarize audit results, prepare educational materials, and consult with medical staff for clarification. Prioritize coding tasks, report to the office or hospital when needed, and meet productivity and quality standards. Adhere to HIPAA guidelines while working from home, ensuring confidentiality and security in handling health information. Participate in continuing education for professional growth and maintain certification requirements.

Director of Central Supply & Medical Records

Kansas City South Nursing and Rehab

November 2021-June 2022

Collaborated with nursing staff to develop accurate care plans for rental equipment and supplies. Managed central and vendor orders, ensuring sufficient inventory levels. Oversaw supply check-in, verified against purchase orders, and reported discrepancies. Monitored and documented supply usage patterns, addressing discrepancies with administrators and nursing directors. Maintained organized supply and storage rooms, auditing and disposing of expired supplies. Managed paperwork, filing, and maintained up-to-date paper charts for physician review. Conducted regular audits of orders, labs, progress notes, and admissions, ensuring compliance with HIPAA guidelines for records release. Attended daily manager, weekly Medicare review, and monthly QAPI meetings.

Patient Financial Coordinator

HCA Healthcare

February 2016-November 2021

Collaborated with nursing staff to ensure accurate treatment plans and secured prior authorizations from insurance companies. Verified medical necessity coverage for Medicare patients and assisted in obtaining financial assistance. Coordinated oral medication delivery and insurance coverage with pharmacies. Functioned as a backup for the front desk scheduler, answering phones and assisting patients. Entered procedure orders, scheduled patients per doctor's specifications, and maintained communication with insurance companies for prior authorizations. Liaised between doctors and patients to ensure correct procedures and treatments. Managed electronic health record documentation, cleared declined claims, and entered monthly charges for billing accuracy. Managed claim clarification with insurance companies, ensuring timely payments. Checked in and checked out patients, updated insurance information, collected co-pays, and scheduled appointments both in-person and over the phone. Prioritized and managed medical records, fulfilling urgent requests promptly.

E-File Representative

DataFile Technologies

August 2018-February 2019

Navigate electronic health records using a virtual machine, filing documents and patient charts based on client requirements. Route documents to appropriate clinical staff as needed and assess daily document volume, adjusting goals to ensure compliance. Communicate any issues with client service line agreement to supervisors. Track and log daily time and document count. Adhere to HIPAA guidelines while working from home, ensuring confidentiality and security in handling health information.

Office Manager

Molly Maids

August 2015-February 2016

Coordinate home service professionals' daily routes, distribute keys, and ensure they have necessary supplies and equipment. Answer phones, assisting clients with service setup. Conduct interviews for potential associates and contribute to the hiring and firing process. Conduct surprise quality evaluations and audits on homes after cleaning, ensuring service standards are upheld.



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