MCO Billing and Coding Auditor

• Nov 2019 - Present

Perform audits on assigned MCO's to ensure correct coding and the correct fee schedule for pricing is being used for billing and charges. Ensure all documentations requirements are being met per Medicare guidelines. DME, E/M, Surgery Coding, CPT, ICD 10, PCS, Physician coding and billing review. Perform audits on assigned MCO's to ensure correct coding and the correct fee schedule for pricing is being used for billing and charges. Ensure all documentations requirements are being met per Medicare guidelines. DME, E/M, Surgery Coding, CPT, ICD 10, PCS, Physician coding and billing review.

Team Lead Inpatient coding and auditing

• Feb 2017 - Present

Perform quarterly audits and educate new coders in training. Review and work with Quality team and CDA for PSI/HAC reviews, documentation issues and denials. Contact person for billing and quality outcome specialists to resolve pre and post denials. Perform quarterly audits and educate new coders in training. Review and work with Quality team and CDA for PSI/HAC reviews, documentation issues and denials. Contact person for billing and quality outcome specialists to resolve pre and post denials.

Senior Coder ASC, CPT

• Nov 2011 - Present

Senior Coder for our ambulatory centers. Work LCD, NCD and CCI edits. I also help with analysis and other tasks with our Health Information Department when time allows. We use Epic, 3M and SharePoint. Senior Coder for our ambulatory centers. Work LCD, NCD and CCI edits. I also help with analysis and other tasks with our Health Information Department when time allows. We use Epic, 3M and SharePoint.

Medical Necessity Coder

• Oct 2009 - Jul 2011