Accomplished Certified Medical Coder/Auditor with a solid history of achievement in provider relations and provider education. Motivated leader with strong organizational and prioritization abilities. Areas of expertise include over fourteen years of experience in various specialized areas of inpatient, outpatient, and emergency medical and surgical coding/auditing, as well as diagnostic imaging, pathology, and laboratory coding.
Coding Specialist
08/2012 to
Present
Orion Healthcorp –
Houston,
TX
Self-supervised telecommuting coder responsible for
abstracting and/or assigning appropriate CPT 4, HCPCS, and ICD 9/ICD 10 codes (using
Encoder and coding books) from Pathology and Radiology electronic documents and
assigning appropriate modifiers and PQRS codes when required, while maintaining
superior accuracy and production standards for multiple local and nationwide
accounts. Responsible for conducting
both client and peer audits to ensure all charges were correctly documented and
captured on previously submitted claims. Responsible for correcting denied
claims. Responsible for maintaining a high level of communication with
management regarding workflow and audit findings and with data entry regarding
corrected claims.
Quality Coding Specialist/Auditor
05/2006 to
08/2012
MD Anderson Cancer Center –
Houston,
TX
3 year onsite/3 year telecommuting coder/auditor responsible for utilizing guidelines established by
institutional compliance (following the 1995/1997 CMS documentation guidelines) to manually abstract and/or assign appropriate CPT 4, ICD 9, and HCPCS codes from electronic medical records, while maintaining department accuracy and production standards. Responsible for performing a designated number of provider audits for each provider in an assigned Provider Division and initiating consistent and ongoing training for them and other faculty regarding the coding and/or auditing rules and regulations
set forth by the American Medical Association, Centers for Medicaid and Medicare Services, as well other individual payers. Provided education on other pertinent issues related to coding as well, while communicating knowledgeably, effectively, and concisely via phone, email, and/or in person. Personal coding, auditing, and educating experience included 20+ oncology sub-specialties within the institution.
Business Office Lead
08/2005 to
05/2006
HealthSouth Diagnostics –
Houston,
TX
Utilized diagnostic imaging,
internal medicine, and orthopedic coding skills to maximize center revenue
reimbursement. Assisted corporate office with correcting aged and denied
insurance claims, and properly resubmitting claims for payment. Responsible for
daily deposits and charge posting. Practiced internal chart auditing skills to
maintain accurate billing and demographic data. Calculated/input bi-weekly
payroll. Responsible for maintaining accounts payable records.
Office Manager
05/2001 to
04/2005
Daria B Lee, MD, FCCP –
Houston,
TX
Utilized organizational, interpersonal, and problem solving skills
to assist physician with beginning a new medical practice. Worked directly with
physician to ensure functional operations of a specialty practice, and assisted
with practice based vitality decisions. Utilized procedural, inpatient, and
outpatient internal medicine and pulmonary coding skills to maximize solo
practice revenue reimbursement. Followed up, corrected, resubmitted and
appealed aged and denied insurance claims. Maintained and applied insurance and individual
payments to outstanding patient accounts. Prepared and review operational reports and schedules to ensure accuracy and efficiency. Supervised and directed clinical staff. Resolved all patient related issues.
