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Episcopal Hospital Medical Billing

Location:
Houston, TX
Posted:
June 28, 2022

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Resume:

ANGELA BROUSSARD-MOORE

adrjxo@r.postjobfree.com

713-***-****

Professional Summary

●Angela is a certified professional coder(CPC) with several years of hands-on revenue cycle experience in coding, Chargemaster and compliance charge capture.

●Audited medical records to ensure compliance with the organization's coding procedures and standards while also training staff members on the coding process.

●Updated, deleted, added, assigned or modified CPT, ICD & HCPCS Codes.

●Managed Chargemaster Maintenance systems process

●Provided training to ensure accurate compliance charge capture and consistency clinical documentation; in the use of charge tools and charge entry systems.

●Works with teams regarding projects enhancing the revenue cycle process aligned with implementing changes and corrections by submitting help desk tickets and tracking status with IT.

●Plan, Maintains, & Prioritize projects by keeping track of quantitative and qualitative metrics to align with meeting end goals and objectives.

●Completed BBA and MBA in Business Administration with Certified Professional Coder(CPC), Certified Medical Billing Specialist (CMBS), Project Management and Process Improvement Certificate and currently pursuing Certified Risk Coder (CRC).

Education & Certification:

University of Houston Downtown, Houston, Texas

M.B.A., August 2020

University of Houston Downtown, Houston, Texas

B.B.A., General Business, December 2012

Lone Star College, Houston, Texas

Business, December 2009

A.A., Liberal Arts

CPC (Certified Professional Coder) 01532527 Houston, TX

CMBS (Certified Medical Billing Specialist) 1988825

Lean Six Sigma Yellow Belt Certification

Technical Skills:

Data Coordinating: Analytical ability in coordinating, handling multiple projects, and prioritizing reports

Microsoft Office Suite: Word, Excel, PowerPoint, Outlook,

Software: SIS, HEMM, HBOC/STAR, EPIC, Craneware, ChartMaxx, MedAssets On Ramp, UNOS (UNET), Cerna, Health Quest, TransChart, Care4, Sovera, CMS Medical Terminology, SAP, BI Analytics, Meditech, KnowledgeSource, CodeCorrect, Optum360 RevenueCyclePro

Professional Experience:

Texas Children’s Hospital Houston, TX Apr 2019 – Present

Coding Compliance Specialist

●Audits medical records to ensure compliance with the organization's coding procedures and standards. Reviews insurance payments and denials and recommends billing corrections.

●Trains staff members on the coding process.

●Maintains a working knowledge of inpatient/outpatient coding principles, coding regulations, policies and guidelines.

●Develops and maintains coding/abstracting policies and procedures to ensure compliant and consistent coding practices.

●Conducts coding research as needed.

●Ensure appropriate dissemination of information to coding team and/or any other pertinent individuals or departments, as necessary.

●Recommends revisions to the compliance program in response to changing organizational needs or new/revised regulation, policies and guidelines.

●Participates on projects, committees and/or initiatives relative to coding, clinical documentation and/or compliance, as appropriate.

●Utilize EPIC and conducts/coordinates regular coding quality reviews and coordinates ongoing monitoring of coding accuracy and clinical documentation adequacy. Performs reviews, as appropriate and acts as coding advisor.

●Tracks and reports results of reviews.

●Coordinates resolutions of identified issues, develops actions plans and conducts focused reviews. Monitors improvements based on implemented actions and provides feedback and focused education to coding associates, clinical departments and physician/clinical providers.

●Develops and provides education and training to coding team, medical staff, and other impacted departments/associates regarding clinical documentation, coding and statistical reporting of coded data.

●Creates action plans to address identified opportunities related to coding practice, compliance and clinical documentation. Performs trend analysis, monitors and reports outcomes.

●Assists in the establishment and evaluation of ongoing department competency requirements for coding staff. Assists in the management of timely associate performance reviews.

Memorial Hermann Health System Houston, TX Oct 2017 – Apr 2019

Sr. Charge Capture Analyst

●Conducts coding and documentaries and a few hours of data of medical/patient records to ensure provider billing practices are compliant with applicable rules and regulations. Ensures accurate and compliant charge capture.

●Evaluates procedure codes and diagnosis on an ongoing basis and recommends corrections and changes for continuous improvement. Conduct audits.

●Serves as a knowledge resource for coding and billing auditing functions.

●Provide routine oversight to ancillary and clinical departments related to charge capture and charge reconciliation to ensure all services rendered are captured and posted to the patient's account accurately and on a timely basis.

●Identifies potential HIM coding issues pertaining to high revenue opportunities, missing or incorrect diagnosis and procedure codes.

●Manually distribute account exceptions to the appropriate clinical departments when required for resolution within a reasonable time frame.

●Participate in testing of upgrades and system enhancements as they relate to charge capture.

●Monitor effectiveness of departmental corrective action plans regarding charge capture and charge reconciliation.

●Review new edits/rules on a monthly basis to ensure changes will apply to hospital charging practices; alert assigned account manager regarding rules that apply so they can be added to our queue.

●Create and manage special projects to improve revenue cycle outcomes.

●Identify, review and summarize results for improvements needed and successes on a quarterly basis.

●Assist clinical departments with root cause analysis and process improvement if needed.

●Provides training to ensure accurate charge capture and consistency clinical documentation; in the use of charge tools and charge entry systems.

●Promotes individual professional growth and development by meeting requirements for mandatory/continuing education and skills competency; supports department-based goals which contribute to the success of the organization; serves as preceptor, mentor and resource to less experienced staff.

CHI St. Luke’s Health PMC Hospital Houston, TX Sep 2016 – Sep 2017

Senior Chargemaster Maintenance Analyst

●Responsible for developing reporting and other analytics to identify opportunities or problems, process improvements, and other system changes that will enhance revenue cycle metrics

●Update, deletes, adds, assigns or modifies CPT, ICD & HCPCS Codes.

●Monitored maintenance of revenue integrity through Chargemaster files, fee schedules, rate setting and charge capture through annual updates, periodic audits, and ongoing review.

●Plans and performs simple ad hoc queries and analysis; Assesses facility site needs to proactively provide service and support

●Analyzes the Chargemaster and billing system to identify opportunities for optimal revenue capture and to incorporate standardized workflows

●Serves as a resource in developing and documenting routine custom billing system tests, builds, and enhancements that improve maintenance and/or prevents billing errors; and performs lower complexity analysis and coordinates workflow implementations.

●Works with the Patient Finance Services, Revenue Integrity Department, Finance, and HIM departments to analyze coding and billing processes to ensure accurate and optimal revenue capture by developing trending, modeling, and other assessment tools.

●Train staff as needed.

Right Sourcing (Texas Children’s Hospital) Houston, TX Dec 2015 – Sep 2016

Coding Compliance Specialist (Contract)

●Audits medical records to ensure compliance with the organization's coding procedures and standards. Reviews insurance payments and denials and recommends billing corrections.

●Trains staff members on the coding process.

●Maintains a working knowledge of inpatient/outpatient coding principles, coding regulations, policies and guidelines.

●Develops and maintains coding/abstracting policies and procedures to ensure compliant and consistent coding practices.

●Conducts coding research as needed.

●Ensure appropriate dissemination of information to the coding team and/or any other pertinent individuals or departments, as necessary.

●Recommends revisions to the compliance program in response to changing organizational needs or new/revised regulation, policies and guidelines.

●Participates on projects, committees and/or initiatives relative to coding, clinical documentation and/or compliance, as appropriate.

●Utilize EPIC and conducts/coordinates regular coding quality reviews and coordinates ongoing monitoring of coding accuracy and clinical documentation adequacy. Performs reviews, as appropriate and acts as coding advisor.

●Tracks and reports results of reviews.

●Coordinates resolution of identified issues, develops actions plans and conducts focused reviews. Monitors improvements based on implemented actions and provides feedback and focused education to coding associates, clinical departments and physician/clinical providers.

●Develops and provides education and training to coding team, medical staff, and other impacted departments/associates regarding clinical documentation, coding and statistical reporting of coded data.

●Creates action plans to address identified opportunities related to coding practice, compliance and clinical documentation. Performs trend analysis, monitors and reports outcomes.

●Assists in the establishment and evaluation of ongoing department competency requirements for coding staff. Assists in the management of timely associate performance reviews.

Houston Independent School District Houston, Texas Nov 2014 – Mar 2015

Sourcing Analyst (Contract)

●Research and gathers internal and external data by commodity categories in the Procurement department for use in reports and strategic sourcing activities to support strategic sourcing events.

●Demonstrate proficiency in procurement guidelines and ensure current and continued compliance with all regulatory requirements, policies, and procedures.

●Prepare and presents comprehensive analytical results to HISD management and internal customers.

●Provide any other analytical support required by the strategic sourcing team.

●Perform other job-related duties as assigned.

●Provided analytical support to HISD strategic sourcing teams within Procurement Services including information gathering, market research, economic modeling and savings assessments

●Responsible for gathering spend and market data, developing economic assessment models (Total Cost of Ownership, Lease vs. Buy, etc.) and preparing and presenting analytical results to HISD staff and Procurement Services customers

Memorial Hermann Hospital Houston, Texas

May 2013 – Nov 2014

Transplant Data Coordinator

●Coordinator Transplant patient information in UNOS (UNET) forms

●Collects and enters clinical data from paper and electronic sources into a transplant database(s).

●Interacts with clinical staff and UNOS (United Network for Organ Sharing) personnel

●to determine data collection needs; recommends key data fields, sources and processes for data collection.

●Integrates clinical data from multiple points of service.

●Monitors data to ensure that it is formatted accurately and reflective of the care elements provided.

●Prepares routine and ad hoc reports for departmental review, regulatory reporting, quality improvement and clinical research

●Obtains and evaluates transplant data for data collection and reporting

●Documents all data submission appropriately, accurately and within specified time frames.

●Performs data queries and collection related to organ donors, pre-transplant patients, and transplant recipients using appropriate data collection forms and computer software.

●Compiles and submits data at appropriate internals to the United Network for Organ Sharing (UNOS), Organ Procurement Organizations, and other registries as required for compliance with membership standards

●Participates in transplant program performance improvement activities

●Collaborates with Project Manager to facilitate implementation, and on-going maintenance of the transplant database Trans Chart

●Completes chart audits for required documentation prior to transplantation and post transplantation.

●Performs data queries and collection related to organ donors, pre-transplant patients, and transplant recipients using appropriate data collection forms and computer software

●Supports program quality outcomes by coordination and preparation of accurate information for data entry and analysis

St. Luke’s Episcopal Hospital Houston, Texas Jan 2012 – May 2013

Data Coordinator

●Coordinate data for Nursing Intraoperative Record documentation and Patient Billing practices, Compliance, Revenue Capture and the appropriate allocation to Expense Accounts for seven hospital facilities

●Research and assign Commodity Codes in Horizon Enterprise Materials Management (HEMM) and map all products within the Surgical Information System (SIS) Materials Manager

●Review and apply HCPCS codes & maintain Perioperative Charge Master by assigning simfim and HCPCS codes to appropriate items (implants, supplies, equipment, and instruments)

●Coordinate nomenclature, assigning Expense Accounts & Commodity Codes for new products & submit to Purchasing for entry into HEMM

●Document information in SIS system by entering important implant, supply, equipment, and instrument data to ensure that information interfaces to SIS, HBOC Star, and Charge master

●Work directly with Implant Management team, Central Sterile Processing personnel, Purchasing & Financial Planning to expedite the data entry of new Implants Systems & Specialty Supplies in HEMM

●Designs & Implements new workflow processes in conjunction with Supply Chain Management

●Communicate changes in billing practices to Billing Specialists such as markup rate changes, investigational device billing, chart auditing, and billing policy &/or practice changes

●Completes maintenance of 3000 + line items & the recalculating of patient charges as prices changes to support accurate billing of more than 580,000 implants and supplies monthly

Billing Specialist May 2002 – Jan 2012

●Handled billing surgery procedures for three hospital facilities by generating, checking & resolving issues for billing patients surgery

●Developed spreadsheets for tracking patient billing revenue information for surgery procedures, implants & supplies

●Maintained inquiries by entering data for documentation purposes to process charges, reconcile, and make billing adjustments

●Completed and reviewed records for completeness and to abstract and code data, using standard classification systems, and to identify and compile patient data

●Implemented thorough Charge Master maintenance, support the billing of $500,000,000.00 in revenue annually

●Trained new Billing Specialists from seven facilities for two week training sessions and offered on-going training and support for new hires.



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