Experience

Infused Solutions, LLC

• Government Administration
• 1 - 100 Employee

• Outpatient Medical Coder

  • Dec 2014 - Present

  • Perform a comprehensive review of medical records to assure the presence of all component parts such as: patient and record identification, signatures and dates where required and other necessary data in the presence of all reports which appeared to be indicated by the nature of the treatment rendered. • Analyze provider documentation to assure the appropriate Evaluation & Management (E & M) levels were assigned using the correct CPT code. • Assign and sequence ICD-9-CM/CPT/HCPCS codes to diagnoses and procedures for documented information for the Ophthalmology Clinic. Assure the final diagnoses and operative procedures as stated by the physician were valid and complete. Abstract all necessary information from health records to identify secondary complications and co-morbid conditions. • Communicate with nursing and ancillary services personnel for needed documentation for accurate coding. Provide real-time feedback to surgical/procedural providers as it pertained to proper coding and clinical documentation of services performed. • Identify trends/problems in medical documentation and respond to departmental coding related concerns/issues and recommend possible solutions. • Process 700 claims weekly while maintaining 98% accuracy and achieving productivity goals. ICD-10 certified Show less



Symtech Corporation

• Motor Vehicle Manufacturing
• 1 - 100 Employee

• Certified Professional Coder

  • Jul 2013 - Present



Symtech CorporationWalter Reed National Military Medical Center

• Medical Records Technician

  • Jul 2013 - Present

  Retrieve patient’s healthcare information after emergency room visit entering and scanning all essential information into AHLTA. Input order request for laboratory test, radiology, and EKG request.Provide a daily job status report which reflects the number and types of jobs back logged each day, incomplete activity, and the status of special interest jobs.Analyze scanning results for content, correctness, and research extensively using CHCS, AHLTA, DEERs and other necessary programs.Performs daily scanning of PHI to electronic files in the directories of the appropriate clinic.Completes all responsibilities and duties in accordance with the Health Insurance Portability and Accountability Act (HIPAA) guidelines to include proper handling of Protected Health Information (PHI). Complies with all required HIPAA training and refresher courses.Coordinates preparation and generation of monthly reports with the department’s systems analyst. Compiles reports, spreadsheets, and records. Analyzes data and records showing trends, statistical data, and strategic data to assist management with daily and future operational improvements. Presents results and details at the monthly departmental meeting. Show less

• Medical Coder

  • Apr 2012 - Mar 2014

  Performed a comprehensive review of medical records to assure the presence of all component parts such as: patient and record identification, signatures and dates where required and other necessary data in the presence of all reports which appeared to be indicated by the nature of the treatment rendered.Analyzed provider documentation to assure the appropriate Evaluation & Management (E & M) levels were assigned using the correct CPT code. Assigned and sequenced ICD-9-CM/CPT/HCPCS codes to diagnoses and procedures for documented information. Assured the final diagnoses and operative procedures as stated by the physician were valid and complete. Abstracted all necessary information from health records to identify secondary complications and co-morbid conditions.Communicated with nursing and ancillary services personnel for needed documentation for accurate coding. Provided real-time feedback to surgical/procedural providers as it pertained to proper coding and clinical documentation of services performed. Show less



Zimmerman Associates, Inc

• Right of First Refusal Coordinator

  • Oct 2011 - Mar 2013

  Worked as the liaison in conjunction with Health Net Federal Services for coordinating authorizations entered into the Care Coordinator System (CCS) by providers of beneficiary’s medical records for specialty treatment referrals. Coordinates the review of referrals entered by the provider. Makes determination on referrals based on information provided for suitability, administrative and clinical completeness, and required tests and pre-work as required by the TRICARE policy contract and referral guidelines. Liaison for specialty clinics such as Orthopedic Spine, Cardiology, Breast Care, General Surgery, Ophthalmology, and Peripheral Vascular Surgery in the Tricare North Region recapturing care for these clinics, reviewing diagnoses and appointing referrals to appropriate medical physicians for treatment. Assisted Health Net Federal Services and contractor (Tricare) with medical claims and discrepancies as it pertains to referral billing errors and benefits coverage. Developed accessibility records for healthcare in military and civilian treatment facilities. Creates an electronic referral, using CHCS, with medical information such as diagnoses, civilian facility location and urgency of care for review and acceptance by the designated Military Treatment Facility (MTF). Upon notification of acceptance, schedules appointments for beneficiaries with the available provider based on availability. If the request is refused, makes referral on behalf of the beneficiary with a TRICARE network provider. Provides patients with the appropriate documentation for the referral to include where to return results. Provided follow-up with providers to ensure completion of referral results within required timeline. Defers referrals to the Referral Management Board for medical necessity, problematic issues, and further review, when necessary. Show less



Joint Task Force

• Training Coordinator

  • Sep 2010 - Oct 2011

  Supervised patient scheduling, registration, medical records, data entry and processing. Developed, implemented and maintained office policies and procedures while promoting excellent customer service. Conducted extensive training on the appointing process for new employees. Delivered TRICARE based content training through a variety of methods to include desktop using CHCS, Armed Forces Health Longitudinal Technology Application (AHLTA), and Micro log; one-on-one sessions and classroom instructions. The duration of training ranged from 1 to 60 days. Supervised and monitored approximately 150 calls per day, personally handling customer service issues. Provided conflict resolution and responds to grievances in a timely manner. Planned and executed formal and informal learning activities in a classroom environment and through utilization of online technology. Developed and implemented customer and standard training packages including presentations, role play, handouts, manuals, exercises and other resource materials. Utilized extensive knowledge of TRICARE services, policies and procedures to educate healthcare providers and personnel through seminars and training. Developed training and plans to ensure employee’s received required certifications, met health and safety compliance requirements, and kept abreast of new policy, laws and regulations associated with the job requirements. Facilitated productive relationship and proactive communication with providers and facility personnel. Assisted providers in troubleshooting and resolution of complex issues associated with TRICARE programs. Show less



IAP World Services

• Training Coordinator

  • Jun 2009 - Oct 2011

• Medical Appointing Agent

  • Jun 2009 - Apr 2011

  Served as the liaison for specialty clinics, responding to inquiries, scheduling appointments, and ensuring proper protocols were compliant, and clinical needs were met in accordance with acceptable standards. Interfaced with healthcare professionals and organizations regarding insurance benefits and medical policies.Examined and analyzed clinical appointments and records in order to verify accuracy and effectiveness as it pertained to specific guidelines requested by the MTF. Received and processed requests for the release of information. Screened to ensure consent requirements of HIPAA were met or if the request met the waiver criteria. Pulled records for which there were valid requests. Accessed information from multiple resources and databases to locate information, if not readily available and respond to oral and written inquiries. Show less