Director of Privacy and Compliance
Resume:
Director of Health Information Management
QUALIFICATIONS PROFILE
Multifaceted, goal-driven, and dynamic professional, offering comprehensive experience in process management, biomedical/health informatics, and clinical documentation/consultation. Armed with well-defined communication, technical, multitasking, and organizational skills, essential in overseeing staff, transcription, budget, and regulatory compliance and coordinating new client implementation with different companies. Adept at building productive business relationships and developing performance-based measurements toward business growth.
CORE COMPETENCIES
Administrative and Clinical Management
Program and Project Coordination
Medical Terminology and Coding
Rapid Conflict Resolution
Cross-functional Leadership and Training
Strategic Planning and Analysis
PROFESSIONAL EXPERIENCE
Phoenix Coding and Consulting Services – Allen, TX
Auditor Independent Contractor (PRN) Jan 2017–Mar 2018; Oct 2019–Present
Client Relations Personnel Mar 2018–Oct 2019
Deliver first-rate auditing services supporting various emergency department professional services.
Supervise workflow, coder assignment, and vacation coverage.
Complete training to coding staff regarding client software and systems.
Take charge of developing coding resources and tools; facilitating internal/external audits; and submitting deficiency/acuity reports.
Presidio Health – San Francisco, CA
Consultant, Outpatient Professional Emergency Department Oct 2014–Jan 2016
Provided exceptional services on ICD-9 CM, ICD-10-CM, CPT and E/M coding to professional ER visits.
Conducted physician training and education, as well as audit review evaluation and management.
Catholic Health Initiative – Hot Springs, AR
Clinical Documentation Review Specialist (PRN) Mar 2013–Present
Coding Specialist II Nov 2011–Oct 2013
Clinical Documentation Review Specialist (Full-time) Sep 2010–Nov 2011; Oct 2013-Mar 2013
Identified appropriate diagnosis-related group (DRG) by keenly evaluating inpatient documentation.
Prepared queries for physicians based on documentation in chart and resources such as coding clinics, coders desk reference, and DRG desk reference.
Facilitate training to providers for documentation improvement.
Accurately encoded data into clinical documentation improvement system (CDIS) and proficiently utilized 3M encoder to determine working DRG.
Broadened knowledge of coding through continuous research while reviewing inpatient charts on 4E, 3W, 2W, C5, and ICU.
Maxim – Hot Springs, AR
Independent Contractor May 2010-Aug 2010
Displayed expertise in rendering services on ICD-9 CM, CPT and E/M coding for professional ER visits.
Nicka & Associates, Inc. – Plano, TX
Coding Coordinator Apr 2009–Apr 2010
Coding Liaison May 2004–Feb 2008
Coder Jan 2003–May 2004
Independent Contractor Feb 2002–Jan 2003
Held responsibility in managing client needs including setup, education, training, coding audits, and reviews
Conducted training for coding staff on client software and systems.
Generated deficiency and acuity reports as well as administered workflow, coder assignment, and vacation coverage for all clients.
Developed coding resources tools and executed internal and external audits while providing feedback to staff and clients.
Provided client coding profiles and state specifics of each assigned facility to coding staff.
Established the first Hybrid Online -Facility Team with six members, in charge of receiving charts and coding via remote facility access.
Trained individuals with limited computer skills to perform all required job duties and tasks.
Led a team, which was used as the foundation for client-onboarding and coder training and education for the current company practices.
Designed the new hire coder assessment for the company as the coding coordinator.
Fulfilled human resource functions, including staff recruitment, training, and performance evaluation.
Earlier Positions Held:
Alpha Thought – Richardson, TX HCA Healthcare – Valley Ranch, TX
North Central Medical Center – McKinney, TX Veterans Administration – Fayetteville, AR
Outpatient Coding Specialist/Emergency Department Professional Coder Jun 2000- Feb 2002
ADDITIONAL EXPERIENCE
Arkansas State University-Three Rivers (formerly College of the Ouachitas) – Malvern, AR
Instructor, Medical Office Administration Program Jan 2015–Present
Demonstrate in-depth subject knowledge in teaching different classes, including:
Adult learners on correct coding guidelines and rules for Healthcare Common Procedure Coding System (HCPCS), current procedural terminology (CPT), ICD-10-CM, and ICD-10-PCS; and
Students on current billing rules and regulations for multiple payers, such as CMS, Medicaid, Workers Compensation, BC/BS, and commercial, as well as on Health Insurance Portability and Accountability Act (HIPAA) compliance, medical terminology, and anatomy/physiology.
Successfully redeveloped the entire program to meet healthcare community current needs.
EDUCATION
Master of Science in Biomedical Health Informatics: Dec 2019 University of Illinois - Chicago, Chicago, IL
Bachelor of Science in Health Information Management: Jun 2000, Arkansas Tech University, Russellville, AR
PROFESSIONAL DEVELOPMENT
License
Registered Health Information Administrator (RHIA)
Certified Outpatient Coder (COC) Certified Professional Coding Instructor I (CPC-I)
Certified Medical Reimbursement Specialist (CMRS)
Certified Medical Coding Specialist (CMCS)
Certified Medical Coding Specialist I, For Renewal
Training
The Arkansas Health Information Management Association Convention
Texas Health Information Management Association Training
AFFILIATIONS
American Medical Billing Association
American Health Information Management Associations
American Academy of Professional Coders
TECHNICAL ACUMEN
Microsoft Office Suite (Word, Excel, PowerPoint, and Outlook) Exsys Corvid
Coding Software: Code Right, 3M, Quadra Med, and A-life Find-A-Code
Systems: EPIC CDIS, McKesson, Meditech, Pulse Check
drchrono, VistA, CIOX Health ROI
Coding Platforms: IHSI, CMBS, Presidiohealth, Nicka & Associates, and SimChart
Contact this candidate