Coding Analyst Information Technology
Resume:
Kristine Englin
Batavia, IL *****
Career Objective: Highly qualified healthcare professional who possesses an associate degree in Health Information Technology, RHIT eligible, seeking a position with a company who values professional growth for employees.
Sr Investigator/Coding Analyst/Auditor
UHG/Optum
January 2022 through the present
• Audit chart notes and investigate fraud, waste, and abuse complaints for the VA/CCN
• Function as a resource person for coding, billing, and compliance questions. Payment Integrity Investigative Coding Analyst/Auditor MPF/Contract position for UHG/Optum
August 2021 through the present
• Audit chart notes and investigate fraud, waste, and abuse complaints for the VA/CCN
• Function as a resource person for coding and billing questions. Auditor/Coding Analyst
NANI (Nephrology Associates of Northern Illinois)
September 2019 to July 2021
• Audited chart notes and presented findings to physicians.
• Created education and training materials.
• Functioned as a resource person for charge capture personnel
• Coding operative reports as necessary
Special Investigation Unit (SIU) Coding Analyst
Molina HealthCare - SIU, Illinois, US
May 2018 to June 2019
• Analyzed suspected cases of fraud, waste, and abuse with research of various state regulations and guidelines in association with the Molina Healthcare insurance plan line of business such as Medicare, Medicaid, and dual programs.
• Created documentation and presented findings for medical review based upon analysis of said cases.
• After medical review prepared documentation for state based regulatory action follow-up. Addison Group
February 2017 to August 2017
Certified Professional Coder- contract position, Centegra Health Care Group
• Established a monthly onboarding process for credentialing services.
• Created an auditing and compliance program including creating various spreadsheets, teaching tools and educational materials, as necessary.
• Audited EM services and procedures for multi-specialty physicians.
• Educated physicians and residents regarding results of audits, nonteaching documentation requirements, PATH documentation requirements and proper billing procedures.
• Taught fellow co-workers regarding compliance and auditing process. Researched and problem solved regarding various coding and reimbursement issues.
• Coded various specialties as needed for month-end.
• Functioned as a resource for charge capture personnel. Physician Coding Specialist
Edward HealthCare Services
February 2014 to July 2016
• Auditing E&M services and teaching physicians primary job responsibility, • Coding, teaching and resource for fellow co-workers and charge capture specialists, as necessary.
• Coded various specialties as needed for month-end. Compliance Auditor for Phoenix Physician Services
January 2011 to February 2014
• Audited EM services and procedures for multi-specialty physicians.
• Educated physicians and residents regarding results of audits, PATH documentation requirements and proper billing procedures.
• Created teaching materials including specialized billing and documentation forms for physicians. Coding Analyst Phoenix Physician Services
Billing company for Mount Sinai Hospital - Chicago, IL January 2008 to January 2008
• Audited EM services and procedures for multi-specialty physicians.
• Coded multi-specialties such as Emergency Room Records, Radiology, Urology, General Surgery, Neurovascular, Cardiology, Anesthesia, Gastroenterology, Plastics, ENT, and Interventional Radiology. Revenue Cycle Solutions
December 2006 to January 2008
Oakbrook, Illinois • Audited insurance claims and medical records to resolve outstanding accounts. balances through the denials and appeals process.
Patient Access Specialist
Delnor Community Hospital - Geneva, IL
2005 to 2006
Registered patients, collected co-pays as necessary, verified necessary documentation in the chart. Transcriptionist
Global Transcription - Aurora, IL
2003 to 2005
On site position involving rehabilitation notes, oncology, radiology, clinic notes, cardiology, gastroenterology, designed and set-up account specifics. Editor, Lead Transcriptionist at Transolutions
Proofer
1997 to 2003
At home position proofed and edited reports for other transcriptions on various accounts, transcribed as Necessary, filled in blanks, functioned as a liaison/resource person for various accounts. Medical Transcriptionist
Provena Mercy Center Hospital
1983 to 1997
Transcribed all reports related to an in-house integrated hospital word processing department in an acute care hospital acting supervisor and trainer as need arose. Medical Records Clerk
Provena Mercy Center Hospital
1982 to 1982
Pulled charts, made copies, assembled, and analyzed charts for deficiencies, verified chart count with census, helped with medical record projects, prepared charts for copy and release of information, abstracted charts, prepared birth certificates.
Education
Associate degree in Health Information Technology
Hutchinson Community College December 2013
Skills
CPC, Auditing, Patient Registration, Compliance, education Certifications/Licenses
CPC, CPMA, CRC, CMRS
Present
Additional Information
Job experience in medical records, transcription, reimbursement, registration, insurance, coding, auditing, teaching, as well as fraud, waste, and abuse. Clinical experience through an RN program and EMT-A training.
ADDITIONAL SKILLS:
Fraud, waste, and abuse analysis.
Certified Risk Adjustment Coding
Excellent Evaluation and Management teaching skills with selection of proper office level visits including the proper selection of ICD-10 diagnosis codes to ensure proper reimbursement. Compliance as it applies to the medical record.
Knowledge of EOB as it applies to appeals and denials. Auditing skills, internal and external.
Typing speed at 65+wpm.
Extensive knowledge of internet research tools as it applies to the healthcare field. Knowledge of Epic, Nebo, Meditech, Medisoft, NextGen Knowledge of Patient Keeper
Knowledge of Word and Excel, Power Point, Access.
Knowledge of Quadra Med Affinity.
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