Encoder Coding Specialist

Soofia Sheikh, MD

**** ****** *****,*****, **-***74 972-***-**** **********@*****.***

CERTIFIED clinical documentation specialist/Improvement –CCDS-II

Versatile, Resourceful, and Results-driven professional with Excellent qualifications to support diverse functions relating to Clinical documentation, Reimbursement Compliance and adherence to Industry standards and regulatory Requirements. Skilled at performing well independently and collaboratively as part of a team in fast-paced Hospital Environments to complete tasks and projects while adhering to all deadlines and quality standards. Self-motivated individual with proven ability to work effectively and productively with Co-workers, Colleagues, Team members, and Management.

Areas of Strength

Clinical Documentation Improvement . CMS/ HIPAA Regulations compliance . *Experience in Microstrategy website and Onbase web.

EPIC/3M Encompass 360 Systems trained. *ECFMG CERTIFIED Knowledge of Medhost/HMS/Map Systems.

Medical/Healthcare Terminology. ICD-10/ICD-9 + CPT Coding.

Knowledge of Health Information Management . Performing Well Under Pressure .

Excellent Critical thinking + Interpersonal Skills Data Analysis and Interpretation

Punctual and Organized.

Administrative / Office Functions (Emails,Fax,Scans,Microsoft Excel,Word, Powerpoints,Etc) .

Professional Experience

Certified Clinical Documentation Specialist (CCDS),2019

Certified Coding Specialist(CCS)- ICD-10 + EPIC systems, Dallas,TX.Jan/2014-Nov-2021

In-Depth experience in Coding, Abstracting and assigning MS-DRGs to Inpatient Records Usign EPIC systems and 3M Encompass Encoder 360 with 95% Accuracy.Also performing Dual coding with ICD-9/ICD-10 + CPT .Worked in 2 Major Level 4 trauma Hospitals,Dallas Medical Center (DMC) and Dallas Regional Medcial Center (DRMC –Current position).

●Comphrehensive knowledge of healthcare policies and Clinical documentation improvement using guidelines to evaluate overall quality and completeness of Patient accounts. Facilitating appropriate clinical documentation to ensure the intensity of services and level of acuity of the patient accurately reflected in the medical record.

●Knowledge of Revenue cycle,Microstrategy reports and Onbase web chart search.

●As a Foreign Medical Physician and ECFMG certified,strong board based Clinical knowledge and understanding of Pathology/Physiology of disease processes.

●Performing initial Inpatient chart reviews for documentation of Inpatient admission Criteria and assigning working DRG within 24 hrs of admission. Also communicating effectively with Physicians, Coders, CDI colleagues,Quality management and Admin to appropriately capture Hospital Acquired Conditions(HAC),Present on Admission (POA)and patient safety indicators(PSI) to ensure accurate reporting and promoting improvement in delivery of patient care.

●Working with Physicians and Medical staff to improve concurrent Clinical documentation, Utilizing 3M Encompass Encoder to determine more accurate ICD-10 codes/ MS-DRG & APR-DRG assignment with expected Severity of Illness(SOI) and risk of Mortality(ROM).

● Utilizing both Clinical and Coding knowledge to obtain appropriate documentation through extensive interaction with Physicians, nurses and HIM staff.

●Having Knowledge of Medicare reimbursement methodology for inpatient services as it pertains to clinical documentation + coding. Also Knowledge of resource management plans in effort to decrease resource consumption while adequately maintains effective operations.

●Reviewing Inpatient Medical records for identified Payer populations e.g Medicare, analyzing Clinical status of patient, current treatment plans + identifying potential gaps in physician documentation.

●Resolving inconsistent, conflicting or ambiguous Clinical documentation through Concurrent and retrospective Physician Query process electronically/ verbally and conducting follow-up reviews of patients clinical charts to ensure issues discussed and clarified in a query have been recorded/documented by the Physician in next Progress note / Discharge summary.

●Working with Health Management Coding Staff, Physicians, and Financial services with regards to payment denials, Medical necessity and documentation Issues. Instructing staff on proper documentation in Medical Records for Proper coding.

●Performing ongoing medical record reviews of Clinical documentation for issues to be discussed & clarified in daily 1 hour Bedbaord meetings with Doctors, Case Management,E-suite and clinical staff.

●Having knowledge of and performing duties in accordance with Ethical and legal compliance standards as set by Hospital policies and procedures, State and federal Quality Improvement Organizations, Office of Inspector General, Centers of Medicare and Medicaid services.

●Determining medical necessity for Inpatient admissions based on Milliman’s Admit Criteria forms or Interqual guidelines.

●Independently recognizing and performing duties needed to be done, establishing Priorities, Organizing work and time.

●Adhereing to Attendance and Punctuality requirements per Hospital /Job policies.

●Proactively advancing my knowledge thorugh Self-study,Webinars,publications of ICD-10 Coding guidelines updates,Coding clinics, ACDIS and AHIMA websites to maintain most effective current Clinical documentation practices.

Medical Home Program Coordinator (PCMH), Department of Health, Washington, DC . 2011 – 2013

Held accountable for supporting the HIV/AIDS, Hepatitis, STD, and TB Administration (HAHSTA). Assisted senior leadership with completing all day-to-day program management activities and in promoting coordinated, integrated, evidence-based, and comprehensive patient care and treatment services for HIV infected individuals. Developed a reputation for professionalism and reliability as well as for maintaining a high level of work quality.

●Assisted senior leadership team with program implementation and design of "Patient-Centered Medical Homes (PCMH)" strategy including the write-up of a manuscript regarding PCMH design experience in DC.

●Participated in a research project on "HIV Patient-Centered Medical Home and Engagement/Retention in HIV Quality Care". Performed as Medical Home Coordinator and Interviewer for HIV/AIDS medical providers.

●Examined ICD coding and billing for HIV/AIDS related conditions and hospitalizations. Researched PubMed, other web portals, scientific journals, and conference proceedings and prepared reports for senior leadership.

●Supported Accreditation Coordinator in conducting workshops and weekly meetings. Worked as champion in Accreditation Team with the vision to lead in providing quality, effective, and appropriate public health service.

●Displayed excellent capacity to meet deadlines, build rapport with individuals at all levels and backgrounds, and to support program and project goals by facilitating an environment that met or exceeded expectations.

●Community Outreach Program Coordinator, Department of Health, Chester Hill, PA.

●2004 – 2006

●*Community health attachment in community pediatrics. Assisted with home visitation programming to assess health risks to children; health education of mothers/expectant mothers.

●*Clinical support and technical advice to city’s Childhood Lead Poisoning Prevention Program (CLPPP).

Education

●Bachelor of Medicine and Bachelor of Surgery (MBBS), Baqai Medical University,Karachi, Pakistan(Sept 1997).

●United States Medical Licensing Examination (USMLE) (Step 1-80, CK-78; CS-Pass).

●Educational Commission for Foreign Medical Graduates (ECFMG) Certified.

●American Heart Association –Heart Saver CPR AED First Aid Certified(Oct 2013).

●Completed Web Based Training Course "Protecting Human Research Participants"National Institiute of Health -NIH(Sept 2012)

Externships / Residency / Training:

●Internal Medicine Externship, Internal Medicine, IANT Clinic, Richardson, TX (2009)

●Outpatient Observership, Rheumatology Associates of North Texas, Dallas, TX (2010)

●Surgical Resident in Neurosurgery, Jinnah Post-Graduate Medical Center, Karachi, Pakistan

●Medical Resident in Internal Medicine, Baqai Medical Hospital, Karachi, Pakistan

Community Involvement:

●Health Fair Organizer, AM Women Physicians Association, Dallas, TX (2008-2011)

●Volunteer, River of Life Homes, Domestic Violence Center for Women and Children, Dallas, TX (2008-2011)

Computer: EPIC,3M Encoder, Medhost, HMS,MAP,Microsoft Office (Word/Excel/PowerPoint), PubMed, Web Portals, Healthcare Databases/Systems.

Languages: English, Urdu, Hindi, Punjabi.

Interests: Movies, Music, Documentaries,Dining out with family.

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