PROFESSIONAL SUMMARY

Highly skilled healthcare professional with extensive and progressive experience in revenue cycle management, medical coding, ICD-10, physician and staff education, reimbursement issues, regulatory requirements, sales, marketing and communications.

PROFESSIONAL EXPERIENCE

Confidential

Coding Manager

• Direct communication with Third Party Coding Auditors to validate Evaluation and Management Provider coding for accuracy and utilization of coding levels.
• Collaborate with Coding Education Specialist in development of educational materials
• to support current ICD-9 / CPT coding with emphasis on support of ICD-10 requirements.
• Identify coding and reimbursement trends
• Member of ICD-10 Development/Transition Team to support Provider Documentation enhancements and education, EMR development to insure proper coding rules within the EMR

Confidential

Regional Reimbursement Manager

• Coordinate implementation of system-wide programs, policies and procedures to ensure compliance with applicable federal and state laws and regulations.
• Revenue Cycle Management education and processes to Program Directors and Hospital Departments including accurate charge capture by Daily Reconciliation Process, Monthly Collection Review to identify unpaid/underpaid claims and analyze UB-4/RA/EOB's for non/underpayments. Implemented Collections Monitoring Tool to report and track identified accounts with Hospital Billing Office. Assisted on Appeals as needed.
• Conduct compliance and ICD-9-CM/CPT/HCPCS coding education for Physicians, Healogics Staff and Facility Coding/Business Office Departments for proper coding and billing including LCD and NCD coding guidelines and CPT updates for wound debridement, hyperbaric therapy and skin substitute products. Implementation of processes to streamline query process of coding issues/lacking documentation between Wound Center and Coders ICD-10 overview of to ensure detailed dictation to improve current dictation with preparation of ICD-10 implementation.
• Provide individual and group education in the auditing of daily documentation to support medical necessity and maximize pay-for-performance revenue of debridement and skin product application codes.
• Presentation of educational reimbursement/coding/dictation meetings for Physicians, Healogics Staff and Facility departments for new and existing Healogics Centers.
• Coding/reimbursement support via 75 on site travel, 25 telephone/email/web
• Audit, compile audit findings for revisions and training.
• Develop appropriate training materials for the orientation and education of physicians and staff for documentation, coding and billing inquiries.
• Provide assistance with charge master analysis to Program Directors and appropriate hospital representatives.

Confidential

Medical Coding Specialist

• Medical Coding Specialist at Portsmouth NH Naval Shipyard Clinic and remote coding of overseas ER/Outpatient encounters.
• Utilizing DOD Military Medical Coding Guidelines for E/M auditing of Portsmouth Occupational Health, Family Practice Physicians, Internal Medicine.
• Proficient with following software: ALTHA, CHCE, CCE, IDX, EPIC, CONGOS/MEIS.
• Microsoft Office including: Outlook, Word, PowerPoint and Excel

Confidential

Reimbursement Coordinator

• Served as Reimbursement Coordinator for Pulmonary/Intensivist Department, Hospitalist Department and 4 Regional Offices supporting Family Practice and Internal Medicine.
• Support Coder for Outpatient Endoscopy Suite.
• Managed medical coding of Physician's inpatient charts/outpatient visits, E/M auditing. Physician communication/education to ensure proper documentation and coding, as well as increased income opportunities of reviewed documentation.
• Provided Office Staff with tools and education to maintain and increase encounter accuracy.
• Provided training with other clinical staff to promote correct coding, clarify information, and distribute reports.
• Gather, analyze, and report monthly/quarterly service/rejection statistics and Provider Audits.
• Contributed to increase of Critical Care revenue with Provider/Resident education, encounter form and tracking process development.
• Coded Pulmonary E/M charges for anthrax case in 2005.

Confidential

Instructor

• Medical Coding I II, Medical Reimbursement Issues
• Emphasis to prepare students for AAPC Medical Coding Examination.
• Confidential
• Owned and operated a small business for 15 years.
• Established Greenery/Salon in 1990.
• Managed production, management, sales, employee training and record keeping.
• Receptionist/Appointment scheduling and customer service.

Confidential

Tax Preparer

Interviewed Clients and collected information to prepare individual/business income tax returns.

Confidential

On-Site Interviewer

Interviewed clients, compiled information/documentation and prepared applications for the home energy program at the Bath office and satellite locations

Confidential

Sales

• Sales of Yellow Page Advertising.
• Direct contact with business owner and managers to determine their advertising needs.
• Duties included ad design, advertising proofing and confirmation with clients.