Jane Szewczyk, MHA, RHIA, CPMA, CHONC

Lockport, IL • 708-***-**** • ad4qbt@r.postjobfree.com

Coding Regulations • Quality Assurance • Process Improvement

Maximizing Revenue, Ensuring Compliance, and Leading High-Performance Teams for Optimal Billing Efficiency.

Dynamic Healthcare Professional with a proven track record of effectively overseeing and optimizing billing operations in outpatient settings. Adept at managing a team of billing specialists to achieve departmental objectives, while navigating complex coding guidelines, reimbursement policies, and regulatory requirements. Demonstrated ability to implement quality control measures, conduct thorough audits, and provide targeted training to enhance team performance. Proven expertise in coordinating with healthcare providers and payers to resolve coding-related issues efficiently. Committed to maintaining the highest standards of quality and integrity in billing practices while maximizing revenue and minimizing errors.

Signature Strengths:

Healthcare Administration Electronic Health Records (EPIC, Athena, MD Audit, CAC) Billing Operations Revenue Cycle Management Performance Metrics Outpatient Billing Supervision & Training Healthcare Compliance Claims Processing

Professional Experiences

ADVOCATE AURORA HEALTHCARE ILLINOIS - REMOTE 02/2022 - PRESENT

Physician Educator, Professional Billing

Overview: Designated to formulate comprehensive coding and billing training sessions for physicians, non-physician practitioners, coders, and other personnel, encompassing curriculum development, training material creation, and competency assessment. Vigilantly monitor coding and billing regulations to ensure strict compliance with governmental and payer standards. Serve as a knowledgeable resource for providers and staff, offering expert guidance on complex coding issues.

Selected Career Benchmarks:

Established strategic plans for delivering ongoing coding education to physicians and staff, crafting tailored training materials for CPT, ICD-10-CM, and HCPCs in alignment with coding guidelines.

Consistently exceed performance expectations by conducting meticulous audits and providing targeted feedback to drive continuous improvement in coding and billing practices.

Earned the privilege of conducing informative coding orientation sessions for new providers, focusing on coding procedures and guidelines to uphold compliance with regulatory standards.

LURIE CHILDREN’S HOSPITAL OF CHICAGO REMOTE 01/2021 – 01/2022

Physician Billing & Analyst

Overview: Laid the groundwork for analyzing and reviewing medical claims to ensure adherence to CPT and ICD-10CM coding standards, while identifying and addressing coding trends and potential risk areas through thorough analysis of analytical data. Researched and implemented effective denial resolutions to optimize claims processing, alongside creation of customized appeal letters for denied claims in compliance with regulatory guidelines. Adhered to CMS guidelines in all aspects of physician billing and coding, utilizing EPIC EMR and MdAudit systems efficiently for billing, coding, and analysis purposes.

Selected Career Benchmarks:

Enhanced outcomes by implementing quality control measures to maintain the accuracy and integrity of physician billing processes, participating in projects related to change integrity, focusing on resolving moderately complex issues.

Demonstrated expertise in the billing and reimbursement processes for HMOs, Medicare, and Medicaid, staying informed on changes in reimbursement policies and guidelines to ensure compliance.

COMMUNITY HEALTHCARE NETWORK MUNSTER, IN 01/2019 – 12/2020

Clinical & Coding Analyst

Overview: Took charge of OIG audits by actively investigating and expertly resolving compliance issues associated with coding, billing, documentation, and reimbursement activities. Conducted comprehensive audits on E/M visits for physicians, outpatient hospital claims, and inpatient claims to maintain accuracy and compliance. Evaluated patient medical records for alignment with legal and procedural standards, ensuring provider documentation complies with regulatory mandates.

Selected Career Benchmarks:

Played a vital role in enforcing rigorous compliance with the guidelines of prominent healthcare entities such as the American Health Information Management Association (AHIMA), American Medical Association (AMA), American Hospital Association (AHA), and Joint Commission.

Aligned the organization for growth by delivering targeted education to staff and clinicians, imparting insights into documentation nuances, quality standards, and optimal coding practices.

Scrutinized and interpreted inpatient medical records, meticulously assigning and sequencing diagnostic/procedure billing codes in strict adherence to third-party payor requirements.

DUPAGE MEDICAL GROUP DOWNERS GROVE, IL 04/2017 – 12/2018

Coding Specialist, Coding Helpline

Overview: Recruited as a vital member of the internal support team, offering guidance and assistance to coders and other departments with insightful solutions derived from meticulous research into coding guidelines and reimbursement policies. Analyzed and reviewed insurance claims, actively participating in denial projects to address and resolve coding-related challenges. Served as an Epic Trainer for new sites, ensuring a smooth onboarding process and providing ongoing support to enhance the proficiency of our coding team.

Selected Career Benchmarks:

Impact driving force behind the analysis and review of delinquent accounts, implementing strategies to expedite resolution and enhance overall revenue cycle efficiency.

Successfully conducted second-level coding reviews, including split visit reviews, TCM, and Critical Care coding, to maintain accuracy and compliance with coding standards.

Achieved measurable outcomes by compiling and completing billing reports, engaging in data analysis to identify trends, areas for improvement, and opportunities for optimization in the coding process.

RECORD CONNECT MICHIGAN LISLE, IL 08/2014 – 03/2016

HIPAA Trainer and Compliance Specialist

Overview: Turned around performance and promoted a culture of compliance within the organization by ensuring all team members adhere to regulations surrounding protected health information (PHI). Manage and oversee third-party requests for information, ensuring compliance with HIPAA regulations and organizational policies.

Selected Career Benchmarks:

Touted and epitomized excellence in customer service by providing expert advice and guidance to customers with billing questions, fostering positive relationships and ensuring a smooth resolution to any billing-related inquiries.

Exceeded key performance indicators by conducting EPIC training sessions for the release of information and billing processes, empowering team members with the knowledge and skills necessary for efficient and compliant operations.

Education & Certifications

Rasmussen College – Minnesota, MN

Master of Science, Healthcare Administration

Rasmussen College – Minnesota, MN

Bachelor of Science, Health Information Management

Moraine Valley Community College – Palos Hills, IL

Associate of Science, Health Information Technology

Certified Professional Medical Auditor (CPMA) AAPC- 2024

Certified Hematology and Oncology Coder (CHONC) – AAPC 2023

Registered Health Information Administer (RHIA) issued by American Health Information Association (AHIMA) - 2018

Registered Health Information Technician (RHIT) issued by American Health Information Association (AHIMA) - 2016 - Superseded

Contact this candidate