Robert M. Zigman, CCS ada2jg@r.postjobfree.com

717-***-**** 1628 Lowell Lane, New Cumberland, PA 17070

Summary of Qualifications

Certified Coding Specialst since 1993 with over 34 years of inpatient coding experience and 19 years of performing DRG validation on Higher-weighted DRG adjustments.

Professional Experience

KEPRO, Harrisburg, PA 2014-2019

Medical Coder

•Performed DRG validation on Higher-Weighted DRG adjustments

•Assisted Operations Manager with the interviewing process and training of newly hired coders

•Assisted Operations Manager with IRR reviews

•Reviewed DRG letters of the coding staff to ensure accuracy before they were issued to providers

QUALITY INSIGHTS OF PENNSYLVANIA, Harrisburg, PA 2003-2014

DRG Validation Coordinator

•Performed DRG validation for Higher-Weighted DRG Adjustment (HWDRG), Clinical Data Abstraction Center (CDAC) and Acute Long Term Care Facility (LTACH) reviews

•Responsible for training nurses, coders, physicians, and other employees ICD-9-CM coding and the importance of physician documentation as it relates to DRG reimbursement

•Developed instructional teaching materials utilized by providers and carriers such as DRG Decision Aids, DRG Self-Audit Tools, Coder CD-ROM, and Physician Documentation Poster while fulfilling CMS contract requirements of the Hospital Payment Monitoring Program (HPMP)

•Worked with Data Analyst to identify potential errors in data prior to final analysis.

•Responded to provider’s corrective action plans to provide educational feedback on coding issues

•Assisted supervisor and analyst with project plans and project results documents for submission to CMS

•Facilitated meetings with providers, CMS, Fiscal Intermediaries, and representatives of the State Attorney General’s office as needed

Review Services Manager

•Provided leadership and direction to the professional nursing staff and administrative support staff

•Conducted performance evaluations with review staff with input from the Corporate Director of Review Services

• Ensured timely and accurate completion of all timesheets for Review nursing staff

•Monitored the electronic physician timesheets

•Worked in conjunction with the Corporate Director of Review Services to schedule review staff to ensure adequate coverage for appeal and other types of review

• Served in a liaison role with national, state, and local agencies, the medical community, advocacy groups, customers and service providers related to QIO contract responsibilities to ensure that contractual and regulatory requirements were met, and revisions were appropriately monitored, communicated, and implemented

•Participated in review activities conducted by subcontractors in an advisory and technical support role

•Provided support to establish internal quality control measures to ensure departmental and contractual compliance with performance standards

HARRISBURG AREA COMMUNITY COLLEGE, Harrisburg, PA 2005-2015

Instructor Non-Credit Healthcare

•Taught Introduction to ICD-9-CM and ICD-10-CM coding

Education & Training

Health Care Management Certificate; The Pennsylvania State University; 22 Credits of Instruction with High Distinction; February 1998

Certificate in ICD-9 Clinical Coding; Reimbursement Resource, Inc., October 1993

Medical Administrative Specialist Certificate; 240 Hours Conducted by the School of Health Care Sciences; Sheppard Air Force Base, Wichita Falls, TX, November 1980

Credentials

Certified Coding Specialist through the American Health Information Association, July 1993.