Carol Hall

Healthcare Professional

An experienced healthcare professional with over 25 years’ experience in medical coding, billing and documentation. Demonstrated leadership building a clinic wide coding department. Managed all regulatory changes for government and private payers. Strong analytical and research skills. A detail-oriented, self-directed professional with strong communications skills, able to liaison with all staff and management levels. adoz3u@r.postjobfree.com 858-***-**** San Diego CA

WORK EXPERIENCE

Regulatory Research Manager

XIFIN, Inc.

08/2005 - 12/2018, San Diego CA

XIFIN is a health information technology company that leverages diagnostic information to improve the quality and economics of healthcare.

Responsible for maintaining all federal and state coding and billing edits per insurance guidelines

AAPC certification allowed me to be a Subject Matter Expert on coding/billing related issues

Interfaced with management, engineering and project managers regarding policy guidelines and regulatory changes impacting laboratory customers Interpreted data, created spreadsheets for quarterly and yearly updates Ability to multitask, prioritize workload and possess strong verbal and written skills

Responsible for creation of monthly newsletter distributed to all clients regarding all current/future industry regulatory changes

Coding Reimbursement Specialist

Centre for Health Care

07/1993 - 08/2005, San Diego CA

Multi-specialty medical group/surgery center

Project Leader implementing "Code Scan" program clinic wide Developed new fee tickets w/ Hierarchical Condition Categories (HCC) Designed training documentation for 12 specialties Created coding edits to identify potential claim denials Audited each dept. fee tickets, analyzed coding errors Results of program generated clean claims within 3 days Collaborated with CFO on reimbursement issues

Monitored claims for payer down coding and inappropriate reimbursement EDUCATION

BA in Psychology, Cum Laude

California State University Long Beach

09/1975 - 06/1977,

Business Courses

National University

1980, San Diego CA

CERTIFICATES

AAPC CPC Certified Professional Coder

(06/1997 - 12/2018)

SKILLS

Research and Data Analysis

Medical Coding Medical Billing

Medical Terminology HIPPA Training

Auditing Experience Critical Thinking

Attention to Detail Active Listening

Teamwork Problem Solving

Productivity and Organization

Time Management Empathy

Patience

COMPUTER SKILLS

Windows OS

Windows 7/10

Microsoft Office Suite

Excel, Word and Outlook

HONOR AWARDS

Exceptional Commitment to Quality

(10/2010)

XIFIN

Outstanding Service with Integrity

(11/2008)

XIFIN

Achievements/Tasks

Achievements/Tasks

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