Theraesa Jones-Cleveland

Program Manager at SOUTH POINTE HOSPITAL
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Contact Information
us****@****om
(386) 825-5501
Location
Cleveland, Ohio, United States, US
Languages
  • English -

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Bio

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Credentials

  • Certified Professional Coder
    American Association of Certified Coders

Experience

    • United States
    • Medical Practices
    • 1 - 100 Employee
    • Program Manager
      • Oct 2020 - Present
    • United States
    • Hospitals and Health Care
    • 700 & Above Employee
    • Resident/Fellowship Education Coordinator
      • Apr 2016 - Oct 2020

      •Coordinates the daily operations of the Residency Office.•Provides support for, and assists the Residency Program Director in the design, implementation and management of administrative/academic operations for the Residency Program.•Coordinates the activities of the Residency Office.•Acts as adviser/consultant to the Chief Resident when needed.•Coordinates and monitors all aspects of the Residency Review Committee's re-accreditation for the Residency Training Program.•Handles both internal and RRC program reviews.•Tracks, documents and reports on educational activities for residents, for the purpose of meeting board certification requirements, meeting national program accreditation requirements, verifying medical licensure and hospital privileges documents, the proper payment from government reimbursement agencies, admission to the National Board of Examination, and complying with policies and procedures of Cleveland Clinic Florida and The Cleveland Clinic Foundation, Division of Education. Coordinates the daily operations of the Residency Office.•Interprets and communicates policies and procedures of Cleveland Clinic Florida and The Cleveland Clinic Foundation as it pertains to Graduate Medical Education.•Oversees and directs annual orientation and graduation activities for the Program's Residents.•Administers, proctors and tracks results of yearly in-training exams.•Coordinates the annual clinical competence exam, tracks and analyzes the results of annual Board Certifying Exams, if applicable to program.•Plans, implements and oversees the recruitment process, including responding to ail inquiries for application materials, maintaining computer database, screening applications, organizing and actively participating in residency interviewing and selection, submission of final rank to NRMP (National Resident Matching Program), developing, implementing and managing recruitment activities and the writing and revision of recruitment materials. Show less

    • Lead Reimbursement Specialist
      • May 2010 - Aug 2016

       Performs coding and reimbursements duties associated with the clinical activity of the site.  Assures appropriate compliance policies and reports quarterly.  Educates physicians on coding updates and audits. Implements policies and protocols.  Supervises, mentors and evaluates all site financial personnel Involved in the hiring, performance reviews and corrective actions of financial personnel

    • Reimbursement Specialist
      • Nov 2005 - May 2010

       Consults with physicians and provides feedback regarding documentation of E&M services. Clarifies discrepancies between documentation and code selection. Appropriately handles denials for coded services (i.e. Appeal, adjust or correct) Meets productivity and quality standards related to audits, denial work, charge entry and concurrent chart reviews Maintains knowledge base by review of payer, monthly newsletters, quarterly “Coding Clinic” and other information sources.

    • Professional Fee Coder
      • Jul 2004 - Nov 2005

       Reviews, interprets and verifies evaluation and management (E&M) and other CPT-4 procedural codes according to the physician’s documented progress notes and orders located in the medical record according to correct coding principles. Utilizes ICD-9 coding books and/or encoder to accurately code diagnosis based on the physicians documented diagnosis. Identifies and codes global services and/or appropriate concurrent services according to coding guidelines. Identifies unbundled and bundled services/procedures and applies correct modifiers. Show less

Education

  • Colorado Technical University
    Bachelor's degree, Health/Health Care Administration/Management
    2018 - 2020
  • Virgina College Online
    Health/Health Care Administration/Management
    2008 - 2009

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