Debra Green
Coding Compliance Specialist at UASI- Claim this Profile
Click to upgrade to our gold package
for the full feature experience.
Topline Score
Bio
Credentials
-
Registered Health Information Administrator (RHIA)
AHIMANov, 1991- Nov, 2024
Experience
-
UASI
-
United States
-
Hospitals and Health Care
-
200 - 300 Employee
-
Coding Compliance Specialist
-
2021 - Present
• Performed audits of SMART database pre-bill inpatient accounts for a major multi-hospital health system. • Identified and advanced the quality of the clinical documentation through ongoing feedback with the coding personnel. • Initiated queries to obtain the most accurate documentation and DRG. This promoted the best outcomes for the organization as well as accurate reimbursement for benchmarking. • Performed audits of SMART database pre-bill inpatient accounts for a major multi-hospital health system. • Identified and advanced the quality of the clinical documentation through ongoing feedback with the coding personnel. • Initiated queries to obtain the most accurate documentation and DRG. This promoted the best outcomes for the organization as well as accurate reimbursement for benchmarking.
-
-
-
R1 RCM
-
United States
-
Hospitals and Health Care
-
700 & Above Employee
-
Inpatient Coding Appeals Specialist
-
2018 - 2021
• Conducted and performed appeal process function for coding and DRG denials from variety of external review agencies to ensure regulatory compliance and reduce revenue loss for hospitals within requested timeframes.• Reviewed medical record documentation for multiple hospitals to determine accuracy of coding as well as MSDRGs and APRDRGs.• Prepared and drafted appeal letters, cover letters, and no appeal letters for multiple hospitals, with each to include appropriate coding guidelines • Updated PAS portal as appeal and no appeal processes completed. Show less
-
-
Inpatient Coding Auditor
-
2017 - 2018
• Conducted audits of SMART database pre-bill inpatient accounts and recommended appropriate changes.• Analyzed and completed PFS requests, including insurance denials and coding corrections. • Reviewed RAC and Omni denials and assisted RCO auditor in determining agreement with external audit denials.• Submitted PEPPER reports of selected MS-DRGs (each verified for coding and MS-DRG accuracy).• Performed internal medical record reviews for documentation and reimbursement purposes. Show less
-
-
-
St.Vincent Health
-
United States
-
Hospitals and Health Care
-
700 & Above Employee
-
Inpatient Coding Auditor
-
2012 - 2017
• Audited SMART database pre-bill inpatient accounts and recommended appropriate changes.• Analyzed and completed PFS requests, including insurance denials and coding corrections.• Reviewed RAC and OMNI denials and assisted RCO auditor in determining agreement with external audit denials.• Submitted PEPPER reports of selected MSDRGs (each verified for coding and MSDRG accuracy)
-
-
CDI Analyst
-
2011 - 2012
• Completed CDI dashboard monthly for CDI director. • Performed ongoing medical record reviews to evaluate quality and completeness of clinical documentation.• Provided CDI coders with assistance by addressing key coding questions.
-
-
Inpatient Coder/Abstractor (HIM)
-
2005 - 2011
Audited SMART database inpatient accounts and recommended appropriate changes. Analyzed medical records to accurately code and abstract each to ensure compliance with coding guidelines. Performed interim coding per PFS requests. Conducted second reviews on selected accounts to assist with accurate coding. Coded and abstracted inpatient, observation, and outpatient surgery accounts for critical access hospitals. Analyzed and completed PFS requests, including insurance denials and coding verifications. Show less
-
-
-
St.Vincent Indianapolis Hospital
-
United States
-
Hospitals and Health Care
-
400 - 500 Employee
-
Inpatient Coder/Abstractor (Family Life Center)
-
2002 - 2005
Coded and abstracted inpatient obstetrics, newborn, and newborn intensive care unit accounts. Updated coding manual to increase overall coding accuracy. Analyzed medical records to verify inclusion of appropriate documentation and signatures. Communicated coding and documentation issues to medical director.
-
-
Administrative Specialist (Quality Management)
-
1998 - 2002
Updated monthly quality indicators and distributed pertinent data to all service lines. Created reports from HDM reporting system for external and internal studies. Submitted quality indicators and UB92 data to IHHA within designated timeframes. Analyzed duplicate/inaccurate UB92 data, using IHHA-defined criteria to determine correct bill to include in IHHA database. Performed chart reviews of emergency room, radiology, and transfusion records to enhance performance improvement process. Prepared quality and medical staff dashboards for several committees as well as hospital board. Maintained multiple Microsoft Access databases. Show less
-
-
Data Analyst (HIS)
-
1992 - 1998
Performed quality monitoring of coded and abstracted patient data. Coded inpatient, emergency room, and ambulatory surgery records. Reviewed all denied Medicare A records for appropriate documentation. Submitted quality indicators to Daughters of Charity National Health Systems. Created reports from CADCARS reporting system for external and internal studies.
-
-
Education
-
1990 - 1991
Indiana University School of Medicine
Bachelor of Science - BS, Health Information/Medical Records Administration/Administrator -
1985 - 1987
Ivy Tech Community College
Associate of Science - AS, Accounting
Community
