Stacy L. Sylvester- MSc, CCS, CRC, CPC

Hampton Ga. 30228

aduti6@r.postjobfree.com

Professional Summary

Nearly 30 years of experience in the medical field, which includes 25 years as a Certified Surgical Technologist (including 5 years in Education & Management).

20 years as a Sterile Processing Technician.

Completed Master of Science degree through Capella University September 2016 (with commencement being on 3/11/17).

Completed Bachelor of Arts degree at Georgia State University in May 2011.

Background includes Allied healthcare, post-secondary & proprietary instruction & education, and administration.

Program Director-Surgical Tech Program 5 years total, which included all aspects of administration, auditing, compliance, teaching, and training of staff. This also included personnel management. Supervised 24 students and 5 Also assisted as a coding instructors assistant and would substitute when needed as a coding instructor for about a 1year.

Core Qualifications

7 years of active coding and 5 years of auditing in the following areas:

Risk Adjustment coding/HCC in both outpatient, inpatient settings.

ICD 9 &10cm/pcs proficient.

Comprehension and utilization of the guidelines of both the ICD 9/10, CPT, HCPCS, PCS, Coding Clinics and various coding assistant devices.

Utilizes company specific guidelines as well as CMS guidelines.

Obtains and maintains up to date current coding/auditing knowledge by obtaining various CEUs, attending seminars and watching webinars.

Adheres to and maintains required levels of performance in both coding quality and productivity.

Revenue Cycle Management

Subject Matter Expert

Experience

May 2,2022-Present: Omega Healthcare/Himagines. Risk Adjustment (HCC) Auditor (FTE)

Risk Adjustment/HCC Auditor within the Inpatient setting, currently contracted with the University of New Mexico Hospital which is a teaching level 1 facility.

Auditing Inpatient Coders

Utilizing 3M and Powerchart/Cerner, Coding Clinics, Encoders and ICD 9/10

Onboarding of new Auditors as well as training.

Team Lead

Prebill auditing and rebill processes for concurrent and retrospective accounts

Excel Spreadsheet utilization

Utilization of all Microsoft Applications including Teams

ICD 10 guidelines along with company specific guide lines

Answering coder questions, advising and rebuttals.

Executing team meetings and trainings as needed

CMS Mapping Spreadsheets

Worked on very large charts 4000-5000+ pgs along with smaller ones

March 2, 2020- May 23 2022: CVS/Aetna. Coding Quality Auditor/Coder. FTE

Audited MRA Charts

Coding

Quality Analysis (QA)

Attend and participate in weekly meetings

Trainings

Obtain CEUs

Utilizing Encoders

Apply ICD-9-CM/ICD-10-CM Official Guidelines for Coding and Reporting as well as utilizing Coding Clinics as references.

Apply company specific coding policies and procedures.

Met and exceeded productivity and Quality standards

CMS Mapping Spreadsheets

Was noted as one of the companies top performers

Worked on very large charts 4000-5000+ pgs along with smaller ones

March 29, 2019-feb, 28 2020: LanceSoft/Aetna. Coding Quality Auditor/Coder (FT Contract)

Auditing MRA Charts

Coding

QA

Attend and participate in weekly meetings

Trainings

Obtain CEUs

Utilizing Encoders

Apply ICD-9-CM/ICD-10-CM Official Guidelines for Coding and Reporting as well as utilizing Coding Clinics as references.

Apply company specific coding policies and procedures.

Meet and exceed productivity and Quality standards

CMS Mapping Spreadsheets

December 2018-February 2019 GeBBS Healthcare Solutions. Auditor/Coder(contractor) & again

April 2021-Feb 2022 (Part time)

Auditing MRA Charts PACE Coding

PACE auditing/coding

Retrospective coding/auditing

Prospective coding/auditing

Concurrent coding/auditing

RADV

EPIC use

Coding

EMR utilization of various EMR platforms

Apply company specific coding policies and procedures.

Meeting production as well as quality standards per assignment

Apply ICD-9-CM/ICD-10-CM Official Guidelines for Coding and Reporting as well as utilizing Coding Clinics as references.

Apply company specific coding policies and procedures.

Utilizing In Patient and Outpatient records and services

July 2017- November 2018: CSI/Optum. Senior Auditor/Coder. Contract

Worked for Optum via the CSI Companies

Utilizing Medical Records Manager (MRM)

Utilizing Microsoft excel daily as well as Outlook and Word

Coded Medicare Advantage Risk Adjustment

1st and 2nd level coding

Apply company specific coding policies and procedures.

System (EDPS)

Chart review and Chart abstraction

Accustomed to working on several projects at a time

Ensures valid signature requirements, ensures patient identification is confirmed in the system and in the chart, confirms valid patient encounters, etc

Complete the company’s compliance testing weekly as well as attends rater review sessions each week.

Attend and participate in team meetings.

Very familiar with and accustomed to working with many different types of EMRs

Utilizing Encoders

Capture all HCC diagnosis codes from patient charts and reporting the diagnosis along with their comorbidities and complications when needed.

Identify and apply the components of Risk Adjustment methodology.

Apply company specific coding policies and procedures.

Understand the importance of utilizing the Index and Tabular for correct coding.

Apply ICD-9-CM/ICD-10-CM Official Guidelines for Coding and Reporting as well as utilizing Coding Clinics as references.

Meeting production as well as quality standards per assignment

Attend all of the organization’s mandatory trainings

Works all assigned overtime hours per month

Map all common diagnosis to their correct HCC/RxHCC

January 1999-January 2017 Worked as a surgical technologist (with the last 5 years being in Education/Administration).

Assisted surgeons with various surgical procedures in hospitals, outpatient clinics and doctor offices (entire career).

Worked as the program director of two colleges heading the Surgical Technologist programs. Performed all duties of the program director with all of the administration duties that where a apart of the position, as well as in the role of the instructor taught all classes and lab procedures as well as administered and proctored all test.

Educational Background

AAPC- Certified Medical Auditor Course-2018

Compliant Coding Systems- Certified Risk Adjustment course-2017

CodeMasters-Inpatient Coding/Certified Coding Specialist course-2017

Capella University-January 2014-September 2016- Master of Science degree.

Absolute Medical Coding Institute (PMCC) May 2016-September 2016- Certificate of Completion in Medical Coding.

Georgia State University- January 2008-May 2011-Bachelor of Arts degree.

Georgia Medical Institute-August 1997-January 1999- Diploma in Surgical Technology and nationally Certified.

Skills

Medical Coding/Auditing

EPIC

3M

Power chart/Cerner system

Risk Adjustment

PACE Coding

PACE auditing

Retrospective coding/auditing

Prospective coding/auditing

Concurrent coding/auditing

Compliance Auditing

Chart Review

Chart Abstraction

RADV

All HCC Models including RxHCCs also

EDPS

IVA

HCC coder/Find- A -Code

Strong analytical, negotiating, and management skills.

Good interpersonal skills and the ability to function as a team member as well as leader

Supervisory skills

Team Lead

Clinical settings

Microsoft Office Outlook, Excel and Word

Abstract codes and diagnosis

Medical Records Management (MRM)

Program management

Personnel management/staffing

Teaching/lecture

Online lecture & instruction

Compliance, policy & procedures

Administration

Set up & implemented curriculum

Employee trainings

Instructor & student evaluations

Mentoring

Coordinator

Contract negotiations

Setup & execute meetings and conference calls

Customer service

Allied service

Test proctoring

Surgical procedures

Certifications, Affiliation, and Specialized Training

AHIMA- Certified Coding Specialist (CCS)-current member

AAPC-Certified Professional Coder (CPC)-current member

AAPC-Certified Risk Adjustment Coder (CRC)-current member

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