Amanda L. Email & Phone Number

United States

San Mateo, California, United States

Phoenix, Arizona Area

• Provide client support as required to ensure positive client and staff relations.
• Develop policies, procedures and forms specific to each new client site.
• Complete staff annual evaluations and participate in disciplinary monitoring and enforcement.
• Provide initial and on-going training of staff assigned to clients to ensure staff is aware of the expectations for the position.
• Perform coding quality reviews for all staff in accordance with the CQR policy (Profee E/M & multi-specialty surgery, Outpatient Facility OBS, SDS, ED, ANC, Provider based clinics)
• Monitor, track and report, staff productivity.

• Review coded charts to ensure accuracy of ICD-9-CM, CPT, HCPCS codes and reported units and modifiers
• Provide recommendations when coding issues are identified
• Abstract and level Evaluation and Management services
• Determine coding and acuity levels for Emergency Department services
• Assign CPT codes to a variety of Operating Room services
• Provide recommendations to system issues and help test new systems

• Monitor workflow through the areas of coding and abstracting.
• Monitor and ensure quality of work through the coding area.
• Assign ICD-9-CM code numbers to each diagnosis and procedure documented in the patient’s outpatient medical record.
• Code outpatient medical records using ICD-9-CM and CPT-4 coding rules and guidelines as well as 3M coding software.
• Enter and validate charges for outpatient departments utilizing charge capture tools and validate diagnoses with the medical documentation provided.
• Compare charges on accounts with the procedures coded and identify any discrepancies.

• Code, protocol, and enter anesthesia charges
• Submit anesthesia claims to insurance carriers for payment
• Clear claim holds and scrubs to ensure appropriate reporting
• Train temporary employees on anesthesia registration and charge entry
• Register anesthesia patients (demographic and insurance information)
• Provide support to Customer Service regarding anesthesia claims and patient questions

• Facilitate claim payment system changes relating to business decisions and quarterly/annual coding updates.
• Follow claims processing issues as they relate to provider contracts, member contracts, type of service provided, reimbursement policies and procedures, and industry standards to facilitate corrections.
• Research claim denials and incorrect payments.
• Train new Provider Claims Research Coordinators.
• Review, revise, and provide recommendations on policies and procedures.
• Subject matter expert for claim payment system.

• Answer department phones and type correspondence letters.
• Create spreadsheets for projects and data entry into Access.
• Copying, faxing, filing, and mail distribution.
• Complete simple claim payment audits.

Master Of Science (M.S.), Health/Health Care Administration/Management

Bachelor Of Science - Bs, Human Physiology

Activities and Societies: Specializing in Health and Human Services

Bachelor'S Degree, Lyman Briggs Physiology

Bachelor Of Science - Bs, Human Physiology