Primary Care General Surgery

Glenda Brock, CPC, CCS-P, CEMC

**** ****** **.

St. Charles, MO 63303

314-***-****/************@*****.***

GOAL: To utilize my coding skills on a daily basis, while learning new skills to further my career EXPERIENCE:

Professional Coding Services, CPC, CCS-P, ICD 10 Certified-Remote Himagine Solutions/Omega Healthcare

August 2018-Present

Compliance Quality Audit Coordinator

Perform quality audits on both internal and external coders to ensure 95% or greater accuracy. Provide feedback, resources, references, CCI edits etc to educate the coders to the highest of quality standards. Work with multiple clients to ensure Omega’s coder’s quality is up to standards. Perform reviews on both domestic and offshore coders for multiple clients. Reviews of multiple specialties and a mix of reviews from surgical procedures, EM services, office procedures, Hospital profee inpatient and outpatient services. Specialties include primary care, pediatrics, urology, gastroenterology, ENT, orthopedics, OBGYN, oncology, neurology, PM&R, hospitalists, general surgery, nephrology, pulmonology. Aviacode - Salt Lake City, UT

March 2014 to August 2018

Responsibilities

Work independently, on a daily basis, using all my coding expertise to code e/m visits for hospital and outpatient services contracted accounts. Apply appropriate CPT and ICD codes according to clinical documentation in multiple EMR systems including EPIC, Meditech, Cerner, Allscripts. Audit office encounters to ensure proper level of service and all procedures were coded correctly by level 1 coder as well as appropriate ICD applied and HCPC's codes used properly. Independently solving NCCI, LCD, NCD edits. Familiar with both 3M and Supercoder. Areas of coding include ED services, multi-specialty Hospitalists services, ICU services, Internal Medicine, Endocrinology, Infectious Disease, Oncology, General Surgery, Gastroenterology, Neurosciences, Palliative, Urology, Neurology, Pediatrics, Geriatrics, Nephrology and Pulmonology. Procedure coding includes but not limited to EEG, EMG, PFT, Sleep Studies, Overnight Oximetry, Post Void Studies, Injections and Infusions, Bone Marrow Biopsy, Bone Marrow Aspirations, Bed side procedures for ED/ICU services. Accomplishments

I feel I contribute to my team as I work all work ques and audit all batches on a daily basis to ensure physicians get reimbursed in a timely manner.

Skills Used

Use all parts of my CPC knowledge on a daily basis while learning new rules and regulations for coding and reimbursement on a regular basis.

Professional coder/Physician auditor CPC, CCS-P, ICD 10 Certified Managed Resources/CodingAid-Long Beach California

May 2016- November 2017

Perform PCS provider audits using audit software to help improve provider documentation and reimbursement. Audit findings sent to Providers to provide them with ways to improve their documentation while meeting coding guidelines and carrier specific guidelines. Audit Manager software is an advanced auditing software used to produce the report that is forwarded to the Providers with all audit findings.

Skills Used

Use my auditing skills on a regular basis to help me stay current on all coding aspects correct coding, NCCI, LCD, stay on the leading edge of an changes in coding rules or guidelines. Professional Coding Services Supervisor, CPC, CCS-P, ICD 10 Certified-Remote Altegra Health-Los Angeles CA

June 2016-January 2017

Responsibilities

Moved from PCS Infusion Coder to QA Analyst and Educator, to Professional Coding Supervisor Cedars Project. Cedars is one of the largest clients on the Professional Coding Side of Altegra Health. Using my multi-tasking experience to move between several job responsibilities throughout the day. I was the work que assignments supervisor for all coders on this project. I ensured all coders had work, all charges moving out of the work ques timely and monitored this very closely on a daily basis. Any provider questions about work ques or charges were asked of me and I provided that information to the managers to present to that Provider. I was also responsible for answering all questions sent to the Cedars Hotline by all coders on the project. The hotline is where every question a coder has routes to. Another responsibility is the PTO calendar for all employees on the project. This is where all time off requests are put on a calendar to ensure coverage when they are off. I check this calendar daily when assigning work que assignments for the day. I also keep track of all coder schedules for the project. As a supervisor I am required to do one coder audit per month, run bi-weekly coder meetings, provide coder education, Cedars Providers are very particular and tedious. This required me to stay on top of any coder issues, work que issues, work que coverage, including coding to help back up the coders at end of month or at client special request, etc. on a daily basis. Skills Used

I now have a good knowledge of both professional and facility coding services. I utilize my E/M and ICD 10 experience on a daily basis as well as coding guidelines, NCCI edits, LCD, NCD. Familiar with 3M and Supercoder. I supervised multi-specialty professional services, laboratory services, Orthopedics including office procedures such as joint injections, Nephrology, ICU services, Hematology Oncology including injection and infusions, Gastroenterology, Hepatology, Infectious Disease, Hospitalists, Endocrinology, Pulmonology, Rheumatology, Psychology, Psychiatry, ICU, Dermatology, ENT, Internal Medicine, Neurology, Pediatrics, Urgent Care, Physical Medicine and Rehab, Pain Management, and Mental health. FCS QA Analyst and Educator, CPC, CCS-P, ICD 10 Certified -Remote Altegra Health-Los Angeles, CA

April 1 2015- June 2016

Responsibilities

Started out with a contract position on the PCS side doing injection and infusion coding remotely. Utilizing documentation in the EMR including EPIC and Cerner to properly assign CPT and ICD 9 codes. This project ended July 2015. Once the project ended, I then was offered a position as Facility QA analyst and Educator for several Outpatient multispecialty. I provided all new coder training on client specific coding directives, EMR training per client, and was the coders contact for any client specific issues, concerns, IT issues, coding questions, etc. I was the Lead QA Analyst of Roswell Park Cancer Institute and MD Anderson Cancer Center. I provided client specific training for new coders hired to the projects and perform their compliance audits, as well as covering coder coverage at end of month and per client’s request. The audits were used to ensure we are following client profile as well as policies and procedures. I created the profile for Roswell Park Cancer Institute. I was also Co-Lead on Searhc project and assist another QA Analyst increating and maintaining an up to date client profile. Coders are to maintain a 95% accuracy rate. I provide the feedback to the coders on areas of concern or need for improvement. Skills Used

I have good knowledge of both professional and facility coding due to my position as Facility QA analyst and educator. I utilized my mastered skills of E/M leveling, ICD/CPT/HCPCS, edits, oncology professional services as well as injection and infusion services. I audited OP Clinic, Urgent Care, Oncology, OB GYN, Physical Therapy, Psychiatry, non-invasive surgeries, Observation stays, ED, and ancillary accounts. I also obtained my CCS-P certification to further my career opportunities. Healthcare Resource Group- Spokane WA

January 1 2015- April 1 2015

Responsibilities

Work independently from a remote home office setting coding all infusion and injection charges. Applying the correct CPT codes per coding hierarchy rules for administration. Maintain a 95% accuracy rate at all times. Using EPIC EMR system. Accomplishments

Furthering my knowledge on all aspects of injection and infusion coding. Certified Professional Coder - Lead Hematology Oncology Coder SSM Cancer Care Central Business Office

December 2011 to May 2014

Performed all coding for medical oncology physicians(13 physicians), verifying documentation in the EPIC EMR on a daily basis, posting all hospital charges, posting all lab manifest, working all clinical coding work ques to ensure proper coding, modifiers, and errors corrected prior to billing being released. Audited and made corrections to Infusion room charges insuring proper administration charges matched documentation on all infusions including chemotherapy, other therapy treatment, hydration, injections before charges were sent out. As well as answering any coding and billing questions the physicians, nurses, and office staff had, Provider educator and direct point person. Certified Professional Coder

SSM Medical Group Central Business Office

February 2011 to December 2011

Perform all aspects of coding and billing, insurance claims verification, and follow up, reviewing medical records for correct CPT and ICD assignment, posting all physician charges outpatient and hospital, reviewing any unmatched and insurance reports, answering any coding/billing questions.

Coder/Biller/Receptionist/Front Office Team Lead

Crossroads Hospital Family Medicine Group/St. Charles Clinic Medical Group Office Team lead

September 2005 to February 2011

Coding and billing, verifying medical record for accurate coding, posting charges, collecting copayments, making bank deposits, verifying patient information, answering phones, routing phone calls, precerts and prior authorizations, addressing any provider issues or concerns, staffing, answering and addressing office staff needs. Receptionist Front Office Lead-Office Management responsibilities Town and Country Pediatrics

Front Office Lead/Referral Coordinator

June 1997 to September 2005

Scheduling appointment, scheduling all outpatient testing, collecting copayments, phone triage, precerts and prior authorizations, HIPAA compliance officer and office trainer, addressing and office staff needs and concerns as well as provider issues or concerns. Front Office Lead, Management Responsibilities.

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