Administrative Medical Billing

Lucinda A. Porter

Silver Spring MD

240-***-****, ****************@*****.***

Active Secret

PROFESSIONAL EXPERIENCE

Administrative Medical Support Assistant who has experience in providing Administrative and clinical support to 4 services (Urology Gynecology, Gynecology Pelvic Floor Physical Therapy and Behavioral Health) scheduling patient visits, scheduling patients for preoperative services, Anesthesia Preoperative Unit and post-operative follow up appointments, maintaining the operating room calendar for Urology Gynecology. Currently serve in a fast-paced work environment, bringing my experiences in performing administrative duties, technical input and expertise to assist leadership in establish policy and promoting the highest standards of professional practice to ensure ethics and maintained, in accordance with command policies and regulations, Federal law, Joint Commission guidelines, and supply procurement to the Defense Health Agency. As a civilian employee I have over 15 plus years working for the Federal Government.

Specialized Certifications: Medical Terminology, CNA Certification

VMT Educational Center, Washington, DC

Specialized Technical Skills; ASL Sign Language, Billing, Coding, Medical Transcription and

Specialized Core Curriculum

Medical Billing, Medical Law and Ethics, Medical Coding, Pharmacology, Medical Terminology, Electronic Health Records, Health Insurance Processing, Medical Transcription

Specialized Core Curriculum

Access Basic, Access Intermediate, Keyboarding, Production, Administrative support Professional, Medical office Procedures, Medical Anatomy and Terminology Basic and Advanced.

Specialized Core Curriculum

Computerized Medical Billing, Medical Coding, Health Insurance Processing, Introduction to Electronic Health Records, Working with Electronic Health Records, Production Labs, Career Skills, Communications I.

Specialized Core Curriculum

Medical Law and Ethics, Pharmacology I and II, Computer Networking Fundamentals, Introductions to Psychology, and Medical Transcription

07/2019-Present, Administrative Medical Support Assistant, GYN/UROGYN Dept. WRNMMC, Bethesda MD

Data Analytic Methodologies familiarity with data platforms and applications such as Databricks, Jupyter, Snowflake, Redshift, Airflow

Utilizes Armed Forces Health Longitudinal Technology Application, Composite Health Care System (CHCS), and Joint Legacy Viewer for medical documentation, ordering of ancillary procedures, such as imaging, labs, and consults. Also, writing orders, and referrals, per physician’s request to provide cost-efficient, timely, and quality services throughout the continuum of care, assuring that patients receive the appropriate level of care according to pre-established standards of the Military Treatment Facility.

Expertise manipulating large data sets, interpreting medical data trends, and using a multitude of disparate data sources and tools, provides timely analysis and advice required to make effective decisions and provide for proper program planning.

Data Requirement Analytics strong analytical skills with the ability to apply business strategy to data analysis and recommendations, experience in documenting the data requirements, data strategy, and data rules standardization

Analytical Technical Skills strong analytical and technical skills to troubleshoot issues, analyze the cause, quickly come-up with the possible solutions, document the changes, and communicate organizational impact to Naval Authority

Data Anomalies explain data anomalies, develop data visualizations and reporting to drive key messaging and recommendations to medical staff

Familiarity with data exploration and data visualization tools like Tableau or Looker.

Quality Control Assurance responsible for evaluating command quality assurance program for patient safety, monitor department medical readiness, determine medical training needs

Specialized Therapeutic and Diagnostic Equipment, skilled to set up, operate, and monitor specialized medical equipment, both therapeutic and diagnostic; Ability to recognize malfunctioning equipment and take appropriate action.

Demographic Clinical, and Laboratory Extraction Tools, to assist with the generation of missing data elements summary, extracts demographic, clinical, and laboratory data from DOD electronic and paper clinical data systems.

Assists in developing, testing, and revising Projects, investigating case report forms, and data extraction tools. Communicates with data sources to request and obtain missing data elements.

Research Procedural Techniques necessary for performing research tasks; Ability to learn and become proficient in data acquisition and clinical responsibilities related to research protocols.

Coordinates Quality Improvement, patient safety activities across the Directorate for Surgical Services and in alignment with hospital-level quality and safety initiatives. Interacts with peers across MTF’s directorates to develop systems-based improvements to all health care delivery, addressing disparities to improve overall patient outcomes.

Monitors Quality Improvement Methodology and interdisciplinary teams, to end preventable harm, continuously improve patient outcomes and experience, and eliminate waste in health care.

Identifies risks and improvement opportunities for patient safety, ensuring quality and continuity of care in all areas. Arrange consultation and guidance to Directorate Patient Safety Advisors. Manages and establishes new, complex projects and other initiatives to mitigate risks and improve performance.

Internal Professional Affiliations, partners with the Directorate for Quality, Patient Safety, Infection Control, designs and presents recommendations to improve Surgical Quality program objectives. In addition, assigned special projects and hospital leadership forums.

Regulatory Safety Inspections mediate between providers and patients, perform health and safety inspections, staff management, order medical supplies and equipment, advise medical of requirements for appointments including specialty consults, x-rays, and lab work, coordinate training of medical personnel, emergency treatment,

Medical Telemetry In-Patient Surgical Ward monitor alarms, verifying, and establishing limits in accordance with individual patients. Prepare patients for examinations, treatments and surgeries and maintain records for completeness.

Academia and Core Curriculum oversight of departmental Joint Training Records for over 200 personnel actively updated and compiled within hospital guidelines resulting in zero findings on Joint Commission inspection.

Established training plan for Non-Licensed staff personnel expansion of duties and qualifications to include post anesthesia care and medication administration.

Technical Facilitation conduct in-service trainings and staff education courses on proper blood draw practices, IV placement, medication administration, and proper use of departmental software and troubleshooting techniques. Trained and oriented over 30 personnel to workspaces and Standard Operating Practices.

Sensitive Departmental Medical Equipment templating and managing clinic schedule to assure patients are seen in a timely manner in accordance with priority. Maintenance and upkeep of departmental equipment totaling over $3M.

Joint Commission Inspections conducted mock Joint Commission inspections to maintain an environment of safety for patients and staff. Perform surgical assistance by scrubbing procedures to include biopsy excisions, and implants

Patient Logistical Operations assist and facilitate work orders or outstanding work orders that has not been completed, also correspond with the direct members of the facilities team.

April 2017-July 2019, Administrative Medical Support Assistant, Labor and Delivery, WRNMMC, Bethesda, MD

Clinical Medical Support provided clinical support, scheduling patient visits, and orienting patients and their families of hospital wide systems. Schedules appropriate patient appointments manually in scheduling system CHCS/AHLTA.

Scheduling provides patient information via telephone, in-person, and to professional staff in response to inquiries regarding appointments in Labor and Delivery. Schedule patient appointments for x-ray and laboratory needs.

Patient Verification Assessments utilizes data systems WMNSi, and Vocera to schedule staffing and patient admission and discharge. Maintains and monitors patient appointment schedules for the clinic using CHCS and AHLTA.

Auxiliary Specialty Clinic Assistance procures outside medical records, radiology studies, and/or biopsy slides and submit to the respective departments to review, coordinates arrangements for patient transportation when needed.

Assist and facilitate work orders or outstanding work orders that has not been completed, also correspond with the direct members of the facilities team.

Maryland Birth Registry tasked with administering the birth certificate documentation/Birth Registry in the State of Maryland, administrative liaison between the medical staff, nursing staff, health alliance staff and the patients.

Eligibility Verification insures eligibility for care and contacts administrator for verification when necessary.

Patient Mediation monitors and communicates delays in scheduled appointments to the appropriate staff and patients. Attempts to resolve complaints and refers other complaints to supervisor. Provides information requiring clinic policies procedures and/or refers to other resources for difficult questions or concerns.

Communications orient new patients and their families by responding to their questions and directing them to examining areas for tests and/or procedures. When required coordinates and/or schedules patient appointments with other clinics or specialties. Obtains identifying information and determines the nature of the visit or call, maintains patient confidentiality. Records and relays messages and/or redirect calls as necessary. Refers urgent messages and patient results for immediate actions.

Aug 2011-April 2017, Medical Support Assistant, General Surgery/Neuroscience/Orthopedics/OB/GYN, WRNMMC, Bethesda MD

Patient Scheduling administers the day-to-day administration of the Composite Health Care System (CHCS), Patient Appointment and Scheduling (PAS) serving patients in the Health Service Area. Prepares and implements operating guides; prepares reports; oversees the overall appointment scheduling activities, communication, and data analytics processing system as it relates to PAS; liaison between customers and health clinic personnel utilizing the system.

Data System Analytics technical manager of PAS responsible for the central management of the scheduling/appointing system. Develops and maintains schedules for providers and technicians. Modifies schedules and develops reports as necessary when requested.

Identifies software and hardware operational problems, and forwards recommendations for improvements on the system.

Statistical Data Reports provides a variety of statistical data reports and prepares other reports, as required, reflecting health care provider productivity un-booked appointments, no shows, end of day reports, and telephone consults

Clinical Coding assigns specific codes to medical records and billing forms sequencing and determining codes to accurately reflect the resources and procedures used in the care of the patients. Considerable judgment is used to relate appropriate diagnosis and treatment procedures to interpret, analyze and select correct codes.

Regulatory Compliance ensures compliance with regulatory and third-party insurance requirements in utilizing the most recent revision of the International Classification of Diseases, Clinical Modification assignment, CPT and HCPCS coding books. Correlates operation codes with diagnosis codes to ensure the most descriptive code is selected when more than one anatomical location is involved.

Code Sequencing codes complicated medical records having diagnostic, surgical and therapeutic procedures that are identified as difficult to classify. Assures accurate coding and sequencing of diseases, injuries, manifestations, operations, and non-surgical procedures, both complicated and uncomplicated, in accordance with established guidelines and coding principles. Uses specialized procedures and methods to correct and amend records. Monitors provider documentation in AHLTA coding system.

Record Analysis assures all diagnoses and procedures are properly documented; review of medical records is performed. The review relates to adequacy of the records, proper sequencing of diagnoses and procedures and sufficient documentation to support the most recent revision of the International Classification of Diseases, Clinical Modification assignment, CPT and HCPCS assignment.

Quality Assurance Reviews conducted quality assurance reviews, evaluated documents in the record and identified over or under utilization of services or resources, inadequate documentation and identifies unrecorded diagnoses.

Developed organized and maintained a comprehensive data system sufficient to meet the needs and standards of coding compliance operations and needs of the users. Performed and maintained quality control on case finding, abstracting, severity of illness, coding, and inclusion of other pertinent patient data.

Review and Analysis performed quantitative analysis of records by assembling the record in numerical and chronological order. Organized and checked medical record for completeness, accuracy, and compliance with regulatory requirements.

Ensures all required forms and documentation are present and in appropriate format and sequence. Analyzed and interpreted documentation in record, ensuring accuracy, internal consistency and correlation of recorded data and returns record to provider/area for correction/completion.

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