Patricia S.
Exam Advisory Board Member at National Center for Competency Testing (NCCT)- Claim this Profile
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English -
Topline Score
Bio
Credentials
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Certified Coding Specialist
AHIMAApr, 2017- Oct, 2024 -
National Certified Insurance and Coding Specialist
National Center for Competency Testing (NCCT)Feb, 2016- Oct, 2024 -
CPC- Certified Professional Coder
AAPC -
CPC-I-Certified Professional Coder Instructor
AAPC -
Certified Coding Specialist- Physician Based
AHIMA
Experience
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National Center for Competency Testing (NCCT)
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Higher Education
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1 - 100 Employee
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Exam Advisory Board Member
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Dec 2016 - Present
Proficiently provide onsite exam review of exam questions, CPT, HCPCS, ICD-10, and compliance and governance. Review of content and regulations with other committee members. Onsite travel to Kansas City periodically to meet with committee members.
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Course Writer
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Jan 2016 - Present
- Writing and preparing Continuing Education Curriculum for HealthCare Professional.- Submission of Articles regarding Medical Billing and Coding.- Preparation of Test questions; Answer Keys and various coding scenarios for completion for Licensed members to maintain certification.
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Molloy University
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United States
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Higher Education
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700 & Above Employee
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Adjunct Instructor
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Oct 2016 - Nov 2018
- Utilized appropriate teaching strategies, methods of presentation, and techniques to motivate students to meet lesson plan requirement. - Monitored student work and progress and provided feedback to students and facility director. - Develops schemes of work lesson plans and test that are in accordance with established curriculum. - Assign and grade classwork; course work; tests and assignments. - Taught AHIMA approved curriculum. - Utilized appropriate teaching strategies, methods of presentation, and techniques to motivate students to meet lesson plan requirement. - Monitored student work and progress and provided feedback to students and facility director. - Develops schemes of work lesson plans and test that are in accordance with established curriculum. - Assign and grade classwork; course work; tests and assignments. - Taught AHIMA approved curriculum.
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Anthem, Inc.
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United States
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Hospitals and Health Care
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700 & Above Employee
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Clinical Documentation Specialist
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Apr 2017 - Jul 2018
- Conducts onsite and remote retrospective medical reviews to assess medical record documentation and monitor submitted diagnostic codes on encounters for Medicare Risk adjustment. - Provides clinically based concurrent and retrospective review of outpatient medical records to evaluate the utilization and documentation of acute care services. - Communicates with physicians or other providers to validate observations and appropriately prompts for documentation if necessary, either verbally or electronically. - Responsible for the marketing start-up venture with Anthem/IPA collaboration with practice visits with senior IPA leadership. - Educates physicians and other key healthcare providers regarding clinical documentation improvement and the need for accurate and complete documentation in the health record. - Facilitates improvement in the overall quality and completeness of medical record documentation through the query process along with formal and informal education. -Collaborates with physicians, ancillary office staff, and case managers reviewing outpatient medical records to ensure correct Hierarchical Condition Category (HCC) payment methodology. Show less
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Developmental Disabilities Institute (DDI)
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United States
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Individual and Family Services
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300 - 400 Employee
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Accounts Receivable Manager
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Oct 2006 - Apr 2017
• Supervised and increased effectiveness and efficiency of operational systems and processes/policies to support organization’s mission; specifically supported management reporting information • Oversight of monthly revenue of 100 million dollars for an non-profit agency that provides services for an Article 28 and Article 16 clinic; OPWDD (Day-Habilitation; IRA; Respite; ICF; CRP), and SED (Pre-school; EI; School Age) program. • Played a significant role in long term strategic plans towards operational excellence; developed and implemented organizational strategies and policies. • Planned, organized coordinated, and implemented three major computer system conversions. • Maintained existing contracts and negotiated new contracts with HMO and third party insurance carrier contracts with managed care executives; Formulated and Chaired monthly contract review committee. • Reconciled and Analyzed Monthly APG per visits per provider based on APG revenue entry for Article 28 and Article 16 clinic services; recorded monthly revenue. • Reviewed coding documentation on a monthly basis and participated with chart audits to ensure correct coding standards for Medicare, Medicaid, and NCCI edits. • Handled, EHR implementation, Template setup, reporting configuration for the practice (locked progress notes, visit dashboard analysis, HMO capitation reimbursement analysis). • Team Champion for agency for the implementation of ICD-10; coordinated training, roll out, and follow through within each program department within the agency to ensure proper protocols followed. • Bad debt review, reconciliation, and analysis. Reconciled units and revenue on the G/L and ensured subsidiary system balanced to G/L. • Served on IT committee board for a multi-facility merger of 100 physicians from an article 28 and 16 clinic facility to a FQHC; Prepared and demonstrated E.H.R. system and usage; provided feedback to committee on the Pros and Cons of various E.H.R. software applications. Show less
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ACLD
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United States
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Hospitals and Health Care
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200 - 300 Employee
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Accounts Receivable Supervisor
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Sep 1998 - Oct 2006
•Rapidly progressed from Administrator of Accounts Receivable to Supervisor of Accounts Receivable responsible for staff of 6 people and intake and front end department providing billing services to 23 clinicians. • Completely reorganized/reengineered 6 month-old chaotic department; streamlined all areas and drastically reduced extensive delinquency backlog. • Formulated billing and collection policies and procedures; trained all employees on operation of system. • Established and efficiently managed 5 million operating budget; for an article 28 clinic. • Handled the supervision and oversight of the billing and registration department. • Yearly update and implementation of the procedure fee schedule as it relates to relative value. • Maintained Month/ End Year End reconciliation and balancing from software system to general ledger. • Monthly report preparation and distribution of 23 clinicians and their productivity per patient. Part of Bi-Weekly corporate compliance committee to ensure Medicare, Medicaid, and HIPAA regulations maintained within the clinic. • Bi-Weekly meetings with Director to develop and implement strategies to reduce coding errors. • Facilitated correspondence and handled negotiations with Software Company for upgrades, custom programming, and various software, and hardware issues. • Quarterly reporting of bad debt and plan implemented to decrease bad debt. • Handled the credentialing and recertification of clinicians for Medicare certification, and NPI registration. • Assisted in the yearly implementation and preparation of visit and budget projection. • Analysis of income generated from procedures performed to help assist in the growth of profitable services. Assist internal and external auditors on a yearly basis to complete audit. Show less
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Education
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1994 - 1995
Molloy College
Post-Secondary Education, Certificate As Certified Coding Specialist; Hospital and Physician Billing; Medical Administrative A -
2017 - 2021
NYSED
NYSED Provisional license- Adult Education, Insurance Billing and Coding -
2012 - 2016
Tabernacle Bible College
Bachelor's Degree, Religious Arts
Community
