Medical Coder/Auditor

SUMMARY OF QUALIFICATIONS

Healthcare professional with over 31 years’ experience along with relevant CPC Certification through AAPC. Possess a diverse background in auditing and coding anesthesia, radiology, cardio, EKG, pain management, dental and E/M. Working with patients of all ages and diagnoses within a variety of medical fields. Reliably manage patient electronic medical record and communicate with coders, CDI, and physicians to make sure coding is the same as the diagnosis in the record. In order to achieve optimal billing outcome.

Auditor

Pro Fee coder

Hospital coding

Administrative Assistant

AAPC CPC Certification

HIPPA Privacy Officer

HIM Director

Medical Billing & coding

Electronic Health records

Excel Spreadsheet, Power Point, Word

Notary

EXPERIENCE

Conifer Health Solutions, Frisco, TX.-Remote

5/1/2022 to present Auditing and IQR managing.

Monthly auditing of pain management, anesthesia, radiology, dental, EKG. Preparing all IQR testing and tracking for all new coders. Building the IQR test for all specialties. Working with the Pro-fee coders to improve their MQR scores. Weekly IQR reporting to management. Outside auditing for recruiting.

2/1/2021 to 4/1/2022 Pro-fee coding and reporting.

Coding E/M pain management, procedures, radiology, dental, EKG’s. Maintained a 98.5% the 15 months that I coded. Out of the 8 months I received 100% x8. Managerial reports when I had completed all charts in the cues. Helped out other specialties after completing the reporting.

Advanced Pain Medicine of North Florida, Jonesville, Fl. -Remote

February 2019 - February 2021

All coding and billing for the practice-anesthesia and pain management. Procedures and E/M. Auditing, verifying insurance. Posting payments, appeals, educating employees and physicians.

The Cardiac and Vascular Institute, Gainesville, Fl.

June 2018 – February 2019

Coding all hospital cases, E/M, OBS, Inpatient, Outpatient, EKG, Echocardiograms, ICD-10 CPT, AR, Ins Billing, Verifications, and authorization.

Cancer Care of North Fl, Lake City, FL

October 2017-June 2018

Notary, Scheduling Physicians and blocking times. Scheduling On-call at the Hospitals in Lake City for Practice. Helping with credentialing Physicians. Coding invoices and approving them to be paid. Supply ordering and tracking. Assisting with Insurance verification, referrals incoming and outgoing. Hospital coding and charges. Icd-10. Helping in Checkout and Check in and medical records. Assisting in any areas that are needed. IT, Maintenance scheduling, Patient Point. Scheduling

Reps’ lunches for the facilities. Setting up Tumor board meetings, Power points for the meetings. Office Currier. Restocking patient snack area . All secretarial duties.

Shands Lake Shore, Lake City, FL

Audited all coding and billing, adding modifiers when needed ICD -9 and CPT coding ICD-10 education. Utilized the electronic health record, health information systems, and healthcare applications, good working knowledge of information technology. Reviewed and updated policies and procedures that are aligned and comply with hospital and department and policies and procedures and regulatory agencies. Thorough understanding the transition to the electronic health record and core HIM functions such as document management and imaging, transcription, chart completion and coding. Experience with the electronic health record, health information systems and healthcare applications. Expertise in healthcare compliance: knowledge of privacy and security regulations, confidentiality, laws, access, and release of information practices Developed, maintained, and implemented policies and procedures; evaluated and improved the Effectiveness of policies and procedures and workflow Remote work on Holidays and Weekends. Daily code auditing had to be done for billing.

Shands Lake Shore Regional Medical Center, Lake City, FL

ICD -9 and CPT coding, Icd-10 education, Obtained ICD-9, and CPT codes for all Inpatient authorizations.

Administrative Assistant 10/2017 – 2018

Interim HIM Director & HIPPA Officer 7/2014 – 3/2015

Authorization Coordinator 7/2011 – 7/2014

Appealed insurance denials, audited medical records, prepared excel sheets for audits, worked Rac audits and appeals, Department secretary for Case Management.

Palms Medical, Bell, FL

July 2007- July 2011

Trained employees on Medicare processes for billing, billed all Medicare accounts. Medicare and Medicaid Appeals. Maintained sliding fee applications. Patient collections. Built power points for training. Secretarial duties.

HCA Lake City Medical Center, Lake City, FL

September 2006- July 2007

Scheduled Outpatient testing, registrar Inpatient, Er and Outpatients for treatment. Trained new employees, Verified insurance benefits. Obtained authorization for services. Collection of co-pays and payments from patients. Worked for HCA Hospitals for 15 years.

Medical billing and collections 7/2007 – 7/2011

Patient account services 9/2006 – 7/2007

EDUCATION

AAPC - CPC Certification Medical Coding ICD-10, CPT and HCPCS 2017

Gainesville, FL

AAPC CPC Certification

Penn Foster - Medical Billing and Coding Medical Billing and Coding GPA: 3.7 2016

Scranton, PA

Introduction to allied health

law, ethics, and confidentiality in allied health

office procedures

body systems/terminology 1

body systems/terminology 2

basic pharmacology

word and excel

business English

medical coding 1

Step-by-Step Medical Coding

ICD-9-CM

CPT

medical Coding 2

electronic medical records

Everglades City School - High School GPA: 3.8 1983

Everglades City, FL

System worked in:

Citrix, Optum 360, Codify, 3M Code finder, IDX, Class marker, Practicode, TC Dental Coding, Next Gen, Athena Hospital Billing’ Athena Clinical Billing, Meditech, Mc Kession, Med Host, Care Cloud, Intergey, E-charms, Map, HPF, Medical Manger, Emdeon, Know Med, G-4, Gate way Edi, Green Way, DDE, Pulse, OB trace, Transcend, Nuance, Word, Excel, Power Point and Mac compatible programs.

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