Manager Physician
Resume:
Kelley A. Morrell Gomes, CCS-P, CPMA
Haverhill Ma. 01830
Cell 978-***-****
******.*****@*****.***
Elliot Health Systems 8/19/2019 to present
Manchester NH HB Outpatient Coding Manager
Job description- Manages the day to day operations of the 9
Outpatient coding team. Oversees coding operations for
Observations, Ambulatory Surgeries, Radiology, Laboratory,
Infusions, Breast Health, Cardiology, and Therapies.
Directs the overall day-to-day activities of Coding Services
Throughout the Elliot Health System, including outpatient
Diagnosis and procedural coding. Utilizes daily, monthly
and periodic reports to manage staff performance relative to
Timely and accurate coding. Oversees DNFB daily to ensure
that coding is completed in a timely manner.
Develops reasonable productivity measures for coding of
Medical records while balancing quality and compliance
Productivity.
Hires personnel, conducts performance evaluations, counsels
employees in performance improvement and conflict
resolution, disciplinary actions, and coordination of employee
schedules for adequate coverage.
Establishes consistent training and competency standards and
tools. Coaches coding staff on coding expectations
and meeting goals related to both quality and productivity.
Actively engages in IT initiatives impacting medical records
and revenue cycle functions.
Develops, implements, and monitors policies and procedures,
guidelines, and coding compliance plans for coding
Mass General Physician Org. 8/18/2005-9/28/18- Position eliminated as of 9/28/18
62 13th Street
Charlestown Ma. 01219 Primary Care Coding Manager
Job description – Manages a team of 12+ primary care and
Psychology coders.
Oversees professional coding for multiple specialty
Boston area Providers, groups and hospitals.
Tasks include but not limited to: Running daily productivity
reports, leading Team meetings, weekly coding huddles,
daily work file reporting, denial reporting and trending.
Working with the Epic team on updating coding edits,
managing staff workloads, time off, schedules, payroll,
working special projects such as payer audits, training coding
staff on coding updates and changes, training new coding staff
as well as provider trainings on missed revenue opportunities
and documentation requirements for E/M and professional
coding services. Proficient in Epic for coding WQ’s, back end
denials and reporting. My position at MGPBO was eliminated
as of 9/28/18.
PPSI / Caritas Med Grp 10/15/2001 to 4/05
451 Andover St Ste 300
North Andover, Ma 01845 Sr. Compliance / Coding Specialist:
Job description – completes chart audits for multi-specialty physicians to include NPs, PAs and residents. Training sessions to include group meetings along with one on one training is provided. Annual code practice patterns by physician group are analyzed to ensure each physician and/or group is within their specialty code range.
New provider training for compliance on current coding and documentation guidelines. ICD-9 and CPT-4 coding of multi-specialty physician office visits. Updating new codes into the IDX dictionaries to ensure correct codes are utilized. Denial tracking to see if any patterns are found then communicated back to the provider.
Core Physician Services 2/99 - 6/01
100 Hampton Rd
Exeter NH Compliance Specialist:
Job description - Annual coding audits performed for each provider. Training sessions for each provider geared towards the audit results. Physician and staff training on proper coding and billing guidelines. Training to include looking up ICD-9 & CPT-4 codes. Basic coding guidelines reviewed with new providers. Tracking of denial trends to ensure visits were correctly coded the first time. Monthly compliance committee meetings to address any new issues. Reviewed any requests for medical records from Medicare to ensure the proper codes were utilized and the correct information was sent out.
Parkland Medical Center 12/95 – 2/99
1 Parkland Drive
Derry NH Coding Specialist:
Job description - Assigning of ICD-9 & CPT-4 codes to Emergency room and Surgical Daycare visits. Training of the Emergency room physicians on correct documentation for Evaluation and Management levels. Daily spot chart audits to ensure consistency with CPT-4 codes. Denials worked to include the proper use of coding with the medical policies by each payor.
Education Timberlane Regional High School, GED 1988
Northern Essex Community College 2 years towards Nursing
New Hampshire Technical College – Classes towards Nursing
Credentials CCS-P earned from American Health Information Management Association in 2000.
CPMA Earned from the AAPC in 2011.
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