Medical Records Health Information

GJoyce Dennison, RHIT, CPC, CPB, CRC- 856-***-**** ***********@*****.***

QUALIFICATIONS

Proficient assigning ICD 10 CM/PCS, CPT, HCPCS codes

Proficient analyzing and/or auditing medical records for ICD 10 CM/PCS and DRG MS and APR code assignments for maximum revenue reimbursement

Experienced working with CDI/Physicians’/Other clinical staff on querying to clarify documentation and clinical indicators for code assignments

Proficient with Epic, Cerner, 3M/CAC, TruCode, Vital Ware, Optum 360 Encoder, Medisoft, Codify and Meditech

Adheres to ICD-10-CM Official Guidelines for Coding for Inpatient and Outpatient and reporting NCCI edits

Proficient utilizing AHA Coding Clinic for ICD-10-/PCS AMA CPT Assistant publications,, the Medicare Claims Processing Manual, and NCCI manual and coding resources

Proficient in medical terminology, anatomy & physiology, pathophysiology, pharmacology, and medical abbreviations

Proficient using Microsoft office products (Word, Excel, Outlook, SharePoint, etc.)

Proficient Kronos, ROI, Internet research and Auditing software

Follows and adheres to AHIMA’s Standards of Ethical Coding, all applicable regulations and guidelines, and all client-specific policies

Maintains productivity and quality based on national and client-specific standards Enjoys working as a team member

Member of AHIMA- RHIT (Register Health Information Technician) and CCS (pending test completion July 2025)

Member of AAPC- CPC (Certified Professional Coder) - CRC (Certified Risk adjustment Coder) and CPB (Certified Professional Biller)

EDUCATION

2005-2007 Bachelors, Degree, Health Care Management, Franklin University, Columbus, OH

2007- 2007 Coding Certificate Program, Burlington County College, Burlington, NJ

2004 -2005 Associates Degree, Health Information Technology, Weber State University,

Ogden, UT RHIT Certification

CERTIFICATIONS

12/2022-Present- CPC (Certified Professional Coder AAPC)

2/2020-Present- CPB (Certified Professional Medical Biller AAPC)

2/2020-Present-CRC (Certified Risk Adjustment Coder)

1/2007-Present- RHIT (Register Health Information Technician AHIMA)

EXPERIENCE

12/24- Present (Part-time) - GHR Revenue Cycle Workforce, 1 Valley Square, Suite 200 Blue Bells, PA 19422, 800-***-**** (Remote)

Abstracts medical data from Epic’s medical record system using all medical records to assign ICD 10CM/PCS codes

Utilizes 3M, CAC, coding aids, ICD 10 CM/PCS and other reference materials to determine correct code assignments

Responds to billing to resolve coding related issues and denial management

Adheres to the Official Guidelines for Coding and Reporting, Coding Clinic guidelines,

Uniform Hospital Discharge Data Set (UHDDS) and other regulatory guidelines as Appropriate

Continues education requirements for coding and professional skills, including

maintaining coding credentials

Complies with HIPPA laws and regulations, follows AMA, CMS, and Medicaid services

coding guidelines

Abides by the Standards of Ethical Coding as set forth by AHIMA.

Maintains productivity and quality standards set forth in Departmental Policies and

Procedures

3/3/25 to 5/6/25- Accuity Health Care DRG Integrity Specialist, 10000 Midatlantic Drive., Ste. 400 W, Mount Laurel, NJ 08054- 646-***-**** (Remote)

Reviews per-bill charts, analyzes documentation and code assignments to validate and support the accurate DRG assignment

Reviews documentation to validate principal diagnosis, procedures, MCC/CC and APR SOI/ROI

Works with Accuity’s physicians, CDIS and management regarding documentation, polices, procedures and regulations

Completes request for any coding changes

Monitors and tracts coding changes request for completion

Attends in house training and adheres to required regulations

Adheres to the Official Guidelines for Coding and Reporting, Coding Clinic guidelines, Uniform Hospital Discharge Data Set (UHDDS) and other regulatory guidelines as Appropriate

Continues education requirements for coding and professional skills, including

maintaining coding credentials

Complies with HIPPA laws and regulations, follows AMA, CMS, and Medicaid services coding guidelines

Abides by the Standards of Ethical Coding as set forth by AHIMA.

2/2023 to 2/6/2025- Hospital Coder II (Hospital Coder) Mainline Health Services, Newtown

Square, 3855 West Chester Pike, Newtown Square, PA, 19073, 484-***-****

(Remote)

Reviews patient medical records and abstracts medical data that identifies all diagnoses and procedures and codes diagnoses, procedures, and appropriate modifiers from the medical record documentation using ICD-10-CM/PCS, CPT4/HCPCS, E/M classification systems

Codes surgery and operative reports, pathology/labs, radiology, and others to identify diagnoses and procedures and Specialties covered: General, Neurology, Urology, Orthopedic, GYN/OB, Ophthalmology and Vascular

Utilizes 3M, written coding aids, CPT Assist, and other reference materials to determine correct code assignments for ICD 10 CM/PCS and CPT/HCPCS to ensure accurate coding assignments for billing

Utilizes verification of medical necessity requirements based upon NCD and LCD policie, checks for NCCI edit violations

Works with CDI to query providers to clarify documentation in the health record for documentation integrity and accurate code assignment

Responds to billing to resolve coding related issues and denial management

Adheres to the Official Guidelines for Coding and Reporting, Coding Clinic guidelines,

Uniform Hospital Discharge Data Set (UHDDS) and other regulatory guidelines as appropriate

Maintains productivity and quality standards set forth in Departmental Policies and procedures

Continues education requirements for coding and professional skills, including maintaining coding credentials

Complies with HIPPA laws and regulations, follows AMA, CMS, and Medicaid services coding guidelines

Abides by the Standards of Ethical Coding as set forth by AHIMA.

03/2020 to 11/2022- Senior Outpatient Coder (ProFee Coder), Conifer Health

Solutions/Tenet, 7624 Warren Pkwy, Frisco, TX, 75034, 469-***-**** (Remote)

Reviews patient medical records and abstracts medical data that identifies all diagnoses and procedures and codes diagnoses, procedures, and appropriate modifiers from the medical record documentation using ICD-10-CM/PCS, CPT4/HCPCS, E/M classification systems

Refers to a computerized 3M encoding system, written coding aids and other reference materials to ensure accurate coding for billing and Vital Ware

Sequences diagnoses, procedures, and complications by following ICD-10-CM/PCS, CPT-4, the Uniform Hospital Discharge Data Set (UHDDS); adheres to the Official Guidelines for Coding and Reporting, Coding Clinic guidelines and other regulatory guidelines as appropriate

Codes surgery and operative reports, pathology/labs, radiology, and others to identify diagnoses and procedures and Specialties covered: General, Neurology, Urology, Orthopedic, GYN/OB, Ophthalmology and Vascular

Consults with the CDCI team to request appropriate physician or appropriate medical staff to clarify medical record information

Assigns grouper codes to each record according to patient type and financial class (DRG, ASC, APG, etc.)

Assists the clinical documentation specialists in medical record documentation auditing as needed and works closely with other coding staff to resolve coding related issues and denial management

Maintains productivity standards set forth in Departmental Policies and procedures

Maintains knowledge of coding and professional skills, including maintaining yearly coding credentials through attendance at in-service programs, conferences, workshops, review of current literature and other educational programs

Complies with HIPPA laws and regulations, follows AMA, CMS, and Medicaid services coding guidelines. Abides by the Standards of Ethical Coding as set forth by AHIMA.

8/2018 to 03/2020- Self-employed. I continued to maintain my AHMIA RHIT certification and

completed AAPC CPB (Certified Professional Biller) certification.

05/2015 to 08/2018- Senior Medical Coder, Conifer Health Solutions/Tenet, 7624 Warren

Pkwy, Frisco, TX, 75034, 469-***-**** (Remote)

Abstracts medical data from Epic’s medical record system and identifies all diagnoses

and procedures and assigns codes from the classification systems ICD-10-CM,

CPT4/HCPCS with appropriate modifiers for billing

Utilizes 3M Encoder to determine correct code assignments for ICD 10 CM and

CPT/HCPCS and references for CPT Assist, written coding aids and other reference

materials to ensure accurate coding for billing

Utilizes Vital Ware Code Validate for verification of medical necessity requirements

based upon NCD and LCD policies and checks for NCCI edit violations to ensure a clean

claim

Queries providers to clarify documentation in the health record for documentation

integrity and accurate code assignment

Familiar with assigning grouper codes to each record according to patient type and

financial class (DRG, ASC, APG, etc)

Adheres to the Official Guidelines for Coding and Reporting, Coding Clinic guidelines,

Uniform Hospital Discharge Data Set (UHDDS); and other regulatory guidelines as

appropriate

Responds to billing to resolve coding related issues and denial management

Maintains productivity and quality standards set forth in Departmental Policies and

procedures

Continues education requirements for coding and professional skills, including

maintaining yearly coding credentials

Complies with HIPPA laws and regulations, follows AMA, CMS, and Medicaid services

coding guidelines. Abides by the Standards of Ethical Coding as set forth by AHIMA.

01/2013-06/2016 -Adjunct Instructor (PART-TIME), Coding, Camden Community College, 200 N. Broadway, Camden, NJ, 08102, 856-***-****

Online Instructor for ICD 10-CM & ICD-10-PCS & CPT

Responsible for course material and updating the course syllabus

Develops lesson plans

Assess student learning through varying methods (i.e. quizzes, testes, papers, group work or presentations)

Incorporate a variety of teaching methods in class to all levels of student capacity

Provide academic and professional guidance for students

Respond promptly to student emails with 48 hours of receipt

Submit grades on a weekly basis

Maintain computer literacy skills including working knowledge of Word, Excel, PowerPoint, and Outlook

05/2010-05/2015 – Director Health Information and Coding, Philadelphia Nursing

Home/Fairmount Long-Term Care, 2100 West Girard Ave, Philadelphia, PA,

19130, 215-***-**** - http://fltcpnh.org/ (FACILITY CLOSED)

• Performs hiring, training, and evaluations of HIM employees

• Ensures timely accurate coding by reviewing the paper and electronic medical record for

diagnoses and procedures and assigning codes from the classification systems ICD-10-

CM, CPT4/HCPCS with appropriate modifiers for billing

• Utilizes 3M Encoder to determine correct code assignments for ICD 10 CM and

CPT/HCPCS and references CPT Assist, written coding aids and other reference materials

to ensure accurate coding for billing

• Completes required audits and reviews data for quality and optimum reimbursement

• Reviews and Updates the HIM policies, procedures, standards, and objectives

• Assisted in the transition of paper medical records to Electronic Medical Records

• Continues education requirements for coding and professional skills, including

maintaining yearly coding credentials

• Complies with HIPPA laws and regulations, follows AMA, CMS, and Medicaid services

coding guidelines. Abides by the Standards of Ethical Coding 02as set forth by AHIMA.

05/2008-02/2010 -Supervisor Record Processing Coordinator, Cape Regional Medical Center,

2 Stone Harbor Blvd, Cape May Court House, NJ, 609-***-****

• Coordinates the schedule for the HIM department, assigns duties, and processes

payroll

• Assist in new employee orientation, cross training, and conducts yearly employee

evaluations

• Assist in the timely processing of inpatient and outpatient discharged medical

records for coding and scanning

• Monitors the location of all medical records

• Assist in creating and revising, procedures, and job duties

• Monitors tumor registry completion of staging forms

• Conducts and reports the incomplete records for completion of physician's

deficiencies and communicates with Physicians for follow up and to resolve issues

• Conducts audits for Ongoing Record Review for Joint Commission monitoring

• Coordinates chart reviews for PRO, insurance payers, and government agencies.

Participates in performance improvement requirement

• Works with Human Resources on staff management

• Manages coding queries, unbilled list, tumor registry inquires, release of information,

incomplete charts, and the storage and retrieval of medical records and manage

timely distribution of transcribed report Familiar with ICD-9-CM, CPT, HCPCS and patient chart auditing.

08/2005-05/2008 – Medical Records Analyst/ Health Information Technician,

Inspira Health/South Jersey Health Care, 1505 W Sherman Ave., Vineland, NJ

856-***-****

• Analyze medical records for documentation, deficiencies, and chart order

• Follow hospitals regulations for record completeness and discharge analysis

• Completed training for ER coding.

04/2003-08/2005 - Medical Biller/Accounting Patient Business Service, South Jersey

Health Care, 1505 W Sherman Ave., Vineland, NJ -856-***-****

• Prepare and submit clean claims to insurance companies either electronically or by

paper

• Review superbill reports and work claim rejections

• Assess insurance reimbursement for individual accounts to ensure maximum

reimbursement from payers

• Take appropriate follow-up actions on accounts to resolve claims and ensure payment

on the first follow-up call or appeal

• Perform collection activities, such as insurance status calls to ensure timely

reimbursement, appeals, and account reviews

• Task provider staff when additional information is required for claims submissions

• Request and prepare adjustments and refund requests based on contracts, applicable

modifiers, or appeal denials.

Contact this candidate