SUMMARY OF QUALIFICATION

• Excellent interpersonal, verbal and written communication skills, superio organizational and follow-up skills, including ability to manage multiple projects and broad range of commitments to completion in a fast paced environment oversee the cost-effective operations.
• Proficient in MS Word, Excel, PowerPoint, Access and Outlook.
• Medical Office Management, Medical Terminology, Anatomy Physiology and the Disease Process, Insurance Terminology, Medical Claims Management, and Financial Reporting.
• Education - Teaching Administration: Student Learning Management, Student Data Management, Student Scheduling Management, Resource Learning Management, and Academic Department-Department Material Management.
• Strong understanding of training dynamics with Electronic Health Records, Practice and Revenue Cycle Management application systems to communicate concisely and confidently to physicians and all staff levels in any implementation processes with high level of professionalism and strong custome service skills necessary to interact positively and productively with staff.
• Electronic Health Records, Practice and Revenue Cycle Management systems: 3 M Encoder, Allscripts, Medical Manager, Medi-Soft, EPIC, IDX, SMS, Lytec, Prime Clinical, GE/Centricity and Amkai
• ICD-9-CM Coding, Application Crosswalks o General Equivalence Mapping Systems GEMS ,
• MS-DRG Conversion Project, ICD-10-CM/ PCS Coding, CPT/Category II Modifiers Coding, HCPCS/G-Codes, Medical Necessity, National Correct Coding Initiative Edits NCCI , Quality/Assurance Review and RBRVS/DRG/APC Reimbursement methodologies.
• HIPAA Regulations and 5010 Transaction Code Sets Conversion January 1, 2012, ICD-10 implementation Octobe 1, 2013, The Health Information Technology fo Economic and Clinical Health Act HITECH , American Recovery and Reinvestment Act ARRA , Office of National Coordinato fo Health Information Technology ONC , EM Implementation-Meaningful Use Incentive Programs PQRI,E-Prescribing, etc , Certification Commission fo Health Information Technology CCHIT , and Health Information Management.
• Centers fo Medicare and Medicaid Services CMS , HCC Risk Adjustment Model, Centers fo Disease Control and Prevention CDC , Department of Health Human Services HHS , American Medical Association AMA , American Hospital Association, American Health Information Management Association AHIMA , The Commission on Certification fo Health Informatics and Information Management CCHIIM and American Academy of Professional Coders AAPC
• Team Building Practices and Organizational Behavior.

EXPERIENCE

Confidential

Online Medical Billing Coding Tutor-Academic Success Associate Trainer

• Assists students in achieving completion of course learning objectives by providing regular, accurate and timely feedback to students relative to thei performance.
• Documented tutoring and advising of academically struggling students below 70 in thei course must be completed on a weekly basis. May include directing students to non-academic campus resources retention, financial aid, registrar, etc. .
• Provide Struggling Students with the best opportunity to be successful academically.
• Set up strategic initiatives that lead to bette student retention and graduation rates.
• Participates in institution's student success and retention initiatives by maintaining productive contact with students. Assists with resolution of students' concerns.
• Motivates students to actively participate in all aspects of the educational process i.e. class discussions, student survey feedback, student-to-student collaboration group tutoring, outside assignments, research, tracking thei own performance accomplishment, etc.
• Coordinate with Learne Services, Tutoring, Curriculum and Academics on Webina development of Live Labs.
• Maintains expertise in subject area in orde to provide students with current trends and to recommend improvements in curriculum and instruction.
• Effectively communicate by email, telephone and meetings with students, instructors, supervisors, othe school and corporate personnel.
• Demonstrate leadership, management, problem-solving, critical thinking, cross-cultural issues, conflict resolution, team building, self-awareness and group skills.
• Systems: Blackboard 9.1 Version-Learning, Campus-Vue-Data, Appointment Plus-Scheduling, ADP-Shift-Management, WEBEX-Live Lab: Material Topics, VPN: Cisco Connectivity, Interactive Client: Review: Live conversations, Joinme.com: One on One Student Session.

Confidential

Senio Medical Coder/Auditor/Trainer

• Training and implementation participation of Amkai EH system.
• Assisted and directed practice staff in coding, billing, and collections process with Amkai practice management issues.
• Abstract and compile data from EH fo appropriate optimal diagnosis and procedures reimbursement fo facility and/o professional charges. Conducted physician chart audits fo Compliance and Utilization Review.
• Maintain entries into tracking logs fo coding completion and any discrepancies found during review of documentation
• Maintain a thorough understanding of anatomy and physiology, medical terminology, disease processes and surgical techniques through participation in continuing education programs to effectively apply ICD9-CM, CPT-4 and HCPCS coding guidelines to surgical and outpatient diagnoses and procedures.
• Maintain a thorough understanding if medical record practices, standards, regulations, Accreditation Association fo Ambulatory Health Care AAAHC , Cente fo Medicare and Medicaid Services CMS , and the American Health Information Management Association AHIMA and/o American Academy of Professional Coders AAPC Code of Ethics

Confidential

Medical Insurance Billing/Coding Instructor

Instruction covering Medical Terminology, Anatomy Physiology, Medical Insurance, Law and Ethics, Pharmacology, and ICD-9 CM, CPT, HCPCS Coding and Medi-Soft Billing Software Program.

Confidential

Medical Office Manage

• Daily management of operations assuring compliance with institutional goals, policies and procedures.
• Observe daily operation to assess and implement short and long-range goals to ensure efficient functioning of assigned locations and physician satisfaction with the practice environment.
• Participate in the development of site budgets. Recommend and review purchases to assure cost efficiency.
• Implement policies and procedures to enhance operating performance and custome services. Participate in the development and implementation of business development, execution of contract development, credentialing and marketing plans.
• Manage and oversee direct reports to include: hiring, corrective action and termination decisions, performance evaluation and monitoring, coaching and development, professional development opportunities.
• Interview/hire qualified individuals fo approved positions. Orient, train, GE/Centricity training and reorient staff to ensure efficiency and competency. Deploy resources as appropriate to support operations. Conduct staff meetings. Work as a part of the team, when needed, to support smooth operations.

Confidential

CFO's Patient Financial Assistant/Trainer

• Ensure personnel are properly trained on GE/Centricity, informed and kept current on all procedures, routines and regulations pertaining to department. Counsel and praise employees in an effective manne utilizing interaction management skills and training to achieve desired goals of work unit, department and medical facility.
• Responsible fo supervision of collection activities and assisting in daily department operations to assure effective billing and collection of accounts receivable in the area of system data entry and pricing.

Confidential

Medical/Dental Office Management Instructor

• Instruction of Administrative Medical Assisting: Oral and Written Communication, Records Management, Collecting Fees, Healthcare Coverage and Medical Office Management, Anatomy and Physiology and Medical Terminology.
• Instruction of Medical Billing Software Programs: Medical Manage and Medi-Soft

Confidential

Admission Financial Coordinato - Transplants Department

Monitored and maintained Cardiac, Renal and Pancreatic organ transplants fo all billing and authorization questions from all departments including billing services, medical staff, physicians and transplant patients.

Confidential

Medical Regional Director's Administrative Assistant Regional Patient Accounts Department

• Successfully supported the Directo and department leadership team during and following seven medical centers large-scale EPIC Practice Management implementation transition process, resulting in total re-organization of the region. Assisted with writing and publication of policies and procedures and training of staff to enhance performance and productivity ratings.
• Efficiently managed the Director's complex schedule of fifty employees maximizing use of available time and achieving overall satisfaction. Responsible fo conducting audits of all department operational practices, including billing, collections, cash posting and registration.
• Responsible fo conducting audits of all department operational practices, including billing, collections, cash posting and registration.
• Coordinated bi-regional meetings fo up to fifty employees.
• Demonstrated the ability to efficiently track data fo seven medical centers and report findings via financial and statistical methodologies.
• Develop policies and procedures that document the operational implementation of provide contracts in the area of system data entry and pricing.
• Assisted with writing and publication of policies and procedures and training of staff, to enhance performance and productivity ratings.
• Supported peers and introduced changes that enhanced assistance to the Directo and staff. Effective use of interpersonal skills enabled me to successfully manage the department, again.

Confidential

Specialized Case Management

Independently reorganized fou medical centers priorities and workflow by implementing Medi-Cal EDI system and maintain audit policies and procedures to ensure the integrity of data entered into the operations databases.

Confidential

Medical Coder/Analyst -Medical Records / Business Departments

• Review medical records to identify diagnoses/procedures: Independently organizes and prioritizes all work to ensure that records are coded in timeframes that will assure compliance with regulatory requirements.
• Demonstrates a comprehensive, expert level of knowledge of all procedures concerning the sequencing of diagnoses, procedures such as but not limited to those outlined in ICD 9 CM, Uniform Hospital Discharge Data Set, and Medicare Guidelines. Demonstrates knowledge of anatomy and physiology to interpret general medical classifications fo coding discharge data including the most complicated encounters/cases.
• Codes all diagnostic and operative information from the medical record using ICD 9 CM and CPT coding classification systems and independently quality checks own work. Selects the DRG fo each inpatient case. Optimizes hospital payment legitimately and ethically by utilizing approved coding guidelines and conventions. Reviews DRG discrepancies from the fiscal intermediary to ensure the appropriate pe case DRG assignment. Verifies and abstracts, all medical data from thei record to complete a data abstract on each hospital encounter. Corrects data as appropriate. Ensures that all data abstracted is consistent with guidelines outlined by JCAHO, OSHPD and HCFA, regional and local policy.
• Interacts with physicians to clarify and accurately document patient diagnostic and procedural information. Enters patient information into the computerized inpatient and outpatient medical record databases, ensuring the accuracy and integrity of the medical record abstract data prio to transmitting case to Government Reimbursement fo billing. Ensures timely record availability by meeting established coding and abstracting productivity standards. Independently conducts medical record documentation auditing to monito physician compliance with regulatory requirements i.e., Physician Review Project.
• Maintains and complies with policies and procedures fo confidentiality of all patient records. Demonstrates knowledge of security of systems by not sharing compute logons.