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Hcc Coder / Auditor Resume

Garfield Heights, OH

SUMMARY

  • Dynamic and highly analytical professional with broad - based experience in directing all aspects of health care encompassing program integrity, medical coding,, and medical group billing / finance.

AREAS OF EXPERTISE:

  • Project Management | Quality Assurance | Healthcare Operations
  • Cross-functional Collaboration | Continuous Process Improvement | Training and Leadership |Strategic Planning and Implementation | Business Development | Matrix Environment Management | HEDIS Review
  • HCC Coding and Auditing | MRA Coding and Auditing

PROFESSIONAL EXPERIENCE:

Confidential, Garfield Heights, oh

HCC Coder / Auditor

Responsibilities:

  • Certified Coder with CPT / HCPCS / ICD-9 / ICD-10 Coding Experience
  • Coded and audited Evaluation and Management charts
  • Coded hospital and multi-specialty charts for HCC risk adjustment and HEDIS measures
  • Data Abstractor for HEDIS reporting
  • Maintained at least a 95% accuracy rating
  • Meeting production goals as outlined by management

Confidential, Savannah, GA

Patient Finance Manager / Medical Coder

Responsibilities:

  • Certified Coder with CPT / HCPCS / ICD-9 / ICD-10 Coding Experience
  • Executed weekly coder meetings and training sessions via Webex and Join.me
  • Managed team of 3 Remote Coders and 2 Auditors for coding of Outpatient and Inpatient medical records.
  • Responsible for accurate and complete coding according to compliance guidelines and for assigning ICD-9/10 and CPT codes from physician documentation (General radiology, CT, MRI, Ultrasound and Cardiology).
  • Created and managed correct coding resources used by all coders in daily coding tasks
  • Maintained at least a 95% accuracy rating
  • Meeting production goals as outlined by management
  • Present Audit reports and Coder tracking reports to management

Confidential, Savannah, GA

Patient Finance Manager / Medical Coder

Responsibilities:

  • Certified Coder with CPT / HCPCS / ICD-9 / ICD-10 Coding Experience
  • Managed team of 5 local coders, and 5 remote coders for HCC and ICD10 coding of inpatient, outpatient, radiology, skilled nursing and hospice charts.
  • Coded and audited Evaluation and Management charts
  • Coded hospital and multi-specialty charts for HCC risk adjustment and HEDIS measures
  • Data Abstractor for HEDIS reporting
  • Monitored employee productivity and quality standards arranging work force accordingly to ensure goals for Medicare Risk Adjustment (MRA) are exceeded
  • Member of Coding Advisory Group which audited, reviewed, and advised on complex, escalated ICD10 coding matters
  • Created and managed correct coding resources used by all coders in daily coding tasks
  • Contributed to the creation of standard coding guidelines, time study of coding practices to plan for future production

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