Coding Auditor Manager

• Mar 2022 - Present

Risk Adjustment Program Manager

• Nov 2019 - Mar 2022

Lead HCC Coder

• Nov 2015 - Nov 2019

Increased yearly revenue by more than 6.5 million. HCC coding and data mining researching and extracting potential chronic conditions from physician records, hospital records, laboratory and radiology records for Primary Care Physicians to review, treat and report. Read and analyze physicians' notes to assess them for documentation accuracy. This involves comparing physician documentation to established Diagnostic ICD 10 Guidelines to certify the appropriate category of billing. Communicated with physicians face to face and educate physicians for appropriate clinical documentation that will accurately reflect patient severity of illness. Performed compliance audits for PCP and Specialist records. Responsible for HCC coding for wound, and diabetes clinic and transitional care program claims. Development of documentation examples to aid physicians. Responsible for on-boarding and training of new medical professionals regarding medical documentation, billing, and coding and ongoing training and educational in-services to medical professionals and ancillary staff regarding updates. Developed and implemented curriculum and training materials. Lead, reinforce, and validate standard workflows and best practices. Maintained and completed numerous statistical reports utilizing Microsoft Word, Excel, and PowerPoint.

Medical Billing and Coding Program Director

• Jan 2015 - Nov 2015

Trained beginning students in front and back office procedures in medical billing and coding, reception techniques, patient flow management, patient records, medical terminology, pathophysiology, collections and customer service. Maintained and completed numerous statistical reports utilizing Microsoft Word, Excel, and PowerPoint. Facilitated training for instructors and students in the use of asynchronous courses using a Course Management System. Developed curriculum for program. Developed efficiency-enhancing workflow/process improvements that made it possible to accommodate increasing responsibilities necessitated by growing campus. Wrote and submitted proposals including program guides and training recommendations that enhanced instructors’ understanding of adult learners and technology that helped teach more effectively.

Facility Billing Manager

• Jul 2013 - Jun 2014

Reduced Accounts Receivable while maintaining over 90% net collection ratio. Billing, coding, collecting, and managing accounts for an Ambulatory Surgical Center. Responsible for the timely and accurate submission of facility and professional claims to insurance companies for reimbursement. Familiar with CPT, ICD-9 and ICD-10 coding. Medicare, Medi-Cal, Workers Compensation, HMO, PPO and Third Party Insurance Carriers. Posting of charges, CPT, ICD-9 coding, entering of patient demographics, electronic submission of claims, reviewing EOB, follow up on claims status, tracking denials, researching rejected claims, providing insurance companies with missing or corrected information, payment posting, insurance appeals and patient follow up. Preparing, reviewing and sending out patient statements. Identifying and resolving patient billing complaints.

Program Chair Health Information Technology

• Jun 2009 - Mar 2013

Repeatedly promoted during tenure at Charter College, maintained 90% student satisfaction, culminating in current responsibilities for coordinating educational functions, and overseeing a HIT/MA team of instruction professionals. Results: Developed efficiency-enhancing workflow/process improvements that made it possible to accommodate increasing responsibilities necessitated by growing campus. Wrote and submitted proposals including program guides and training recommendations that enhanced instructors’ understanding of adult learners and technology that helped teach more effectively. Maintained a personal 93% average student satisfaction rate throughout a 24 month period. (as measured by student classroom surveys every 5 week course). Organized, designed, and delivered training for a variety of classes, consecutively, in a college campus environment. Facilitated training for instructors and students in the use of asynchronous courses using a Course Management System. Trained a demographically diverse population and met organizational goals and objectives

Veterinary Technician

• Jul 2008 - Jun 2009

Functioned as a member of a 24 hour emergency veterinary medical team that oversaw the efficiency of a demanding business, which was deadline- oriented and highly structured. Provided outstanding customer service, ensured consistent and continued customer satisfaction that ended with a positive pet-owner outcome. Facilitated education, continued understanding, and care of animals after medical treatment had been delivered. Results: Anesthesia monitoring and recovery. Rotations in all areas of facility including Oncology, Physical Therapy, MRI/CT, General post-surgical care. Administration of medications; orally, topically, injections, subcutaneous fluids.