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MRA Auditor

Location:
United States
Salary:
open
Posted:
August 02, 2012

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Resume:

Darlene J. Williams, RHIT

*** ******* ***. ******* **** Il. 60409

Home Phone 708-***-**** Cell Phone 708-***-****

*********@*****.***

Education:

• Bachelor in Health Information Management Administration Present

DeVry University, Chicago, IL. - Online

• Certificate in Implementation Suppor t Specialists

Moraine Valley Community College, Palos Hills, IL. 2012

• Associates in Health Information Technology 2009

RHIT Certified

Northwestern Business College, Hickory Hills, IL.

• Certificate in Medical Office Assistance 2001

College of Office Technology, Chicago, IL

Experience:

Advocate Medical Group Oak Brook, IL 2010-Present

MRA Auditor

• Verify and ensure the accuracy, completeness, specificity and appropriateness of diagnosis codes based on services rendered

• Interpret documents in EMR such as, encounter forms, medical records, physician documentation, lab reports, dictated reports, and operation instruction to identify all appropriate coding based on CMS HCC categories

• Knowledge of medical and insurance reimbursement, HCC, ICD-9-CM, CPT coding, disease processes, and medical terminology

• Demonstrate analytical and problem solving ability regarding barriers to receiving and validating accurate HCC information

• Provide group and physician education regarding HCC documentation and coding guide lines

• Work independently as well as meet deadlines and goals

• Maintain effective and professional communication skills

• Support and participate in process and quality improvement initiatives

• Interview people to obtain basic information, write correspondence proficiently, and ability to interact with all levels of health care team professionally

St. Joseph Hospital Chicago, IL

Outpatient Coder(PRN) 2009-2011

• Coding/ Abstracting of outpatient ancillary testing, clinic visit, APC Assignment

• Ensure all codes are assigned to patients on the unbilled (A/R) list

• Use of Star Application

• Use of Physician Portal

• Use of 3M Encoder

Advocate Ravenswood Medical Group Chicago, IL

Revenue Cycle Lead 2007-2010

• Coordinates and ensures that all charges for assigned practices are posted to IDX in a timely

manner

• Reconciliation of patient accounts on a daily basis in an efficient and accurate manner

• Reports compliance matters to practice manager, medical director, and the supervisor of the revenue cycle department

• Follows up with provider for assurance of accurate code assignment and documentation

• Ensures accurate data entry of all ICD-9-CM, CPT and HCPC codes and modifiers in IDX

• Use of Encoder Pro

• PCS work file

• Insurance Verification

Advocate Health Center, Burbank, IL.

Patient Service Representative Coordinator 2004-2007

• Coordinates the technical functions of the PSR/HIM department to ensure daily processes are completed

• Follows up with provider for assurance of accurate code assignment and documentation

• Conducts Medical Record audits to ensure that charts are adequately prepared for the doctors appointments

• Conducts monthly PSR audits to regulate each associates work file and maintain accurate charge entry

• Maintain edits in PSR's work files

• Maintain weekly cash control for the center

• Provide leadership to department staff and assist the supervisor as needed

Patient Service Representative 2003-2004

• Systematically organized incoming patients documentation to ensure doctor accessibility

• Inputed patient demographic information in to customized medical database(IDX)

• Answered incoming calls to resolve questions regarding patients appointments

• Notated messages from patients to ensure all needed information is submitted

• Inputed charges and diagnosis in computer from encounter forms

• Collected co-pay or balances from patients during check-in

• Prepared deposits for each PSR for the day

Advocate Health Center-Irving &Western, Chicago, IL

Health Information Associate 2002-2003

• Ensured patient confidentiality is maintained at all times

• Maintained and updated patient records to adequately prepare doctors for appointments

• Systematically organized incoming patients documentation to ensure doctor accessibility

• Inputed patient demographic information in to customized medical database(IDX)

• Answered incoming calls to resolve questions regarding patient medical records

• Reviewed messages from patients to ensure all needed information is submitted

Intern/Externship:

Infant Wellfare Society, Chicago, IL

Intern/Externship 2007

• Created and maintained medical and lab charts

• Data entry in medical database

• Medical billing and coding

• Chart and billing audits

Family Health Society, Chicago Heights, IL

Intern/Externship 2001

• Created and maintained medical and lab charts

• Admitted patients for appointments

• Assisted lab when needed

• Data entry in medical database

• Medical billing and coding

Accredits:

• RHIT Certified

• Certificate in Implementation Suppor t Specialists

• Certificate in Medical Office Assistance

Skills: Charge entry; EMR, Computer literate in IDX system, Encoder Pro, Cache system, Star System, 3M Encoder, Physician Portal, Windows 98, Office XP, Access, Power Point, Excel, and Internet;



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