Staci Bell, Cpc-H,Coc,Cemc Email & Phone Number

Fresno, Tx, Us

Responsible for Internal clinical pre pay auditing and investigations for employers and individuals, according compliance and regulatory guidelines, patients insurance, CM-1500 and coding guidelines. Identify trends in overpayment, overuse, and fraud. Specialties include: Inpatient, E/M, ED W/ I&I, consults, anesthesia, laboratory, radiology, pain management, chemo, genetics, surgeries, ortho, PT, OT, SP, pathology, general surgery, neuro, OBGYN, pulmonary, modifier, intraop monitoring, injections, optomology, DME and dermatology in relations to optum ops payment integrity. Examine, assess, and document business operations and procedures to ensure data integrity, data security and process optimization. Investigate, recover, and resolve all types of claims as well as recovery and resolution for health plans, commercial customers, and government entities (i.e. Medicare and Retirement, Community and State, Employer and Individual). Investigate and pursue recoveries and payables on subrogation claims and file management. Initiate phone calls to members, providers, and other insurance companies to gather coordination of benefits information. Process recovery on claims. Ensure adherence to state and federal compliance policies, reimbursement policies, and contract compliance. Use pertinent data and facts to identify and solve a range of problems within area of expertise. Performs Quality Audits focused on medical coding principles and guidelines, as well as operational performance and processes as needed. Extract precise information from documentation, test results, and reports to audit and ensure appropriate codes were assigned. Audit and test ongoing operational processes to assure continued compliance with all requirements regarding coding procedures, practices, and internal processing guidelines. Certified coach-train and mentor all new hires

Plano, Texas, Us

I do inpatient rehabilitation coding and ED diagnosis with simple procedures and Injections and infusions.For Inpatients recovering from strokes, brain and spinal cord injuries, amputations, complex orthopedic injuries, neurological, renal, myopaties, respiratory and much more. Code IRF admit and discharge records using current ICD 10 within timeframe set by the hospital, works with the PPS coordinator assigning impairment codes and UB coding on discharge.Assigns codes for all diagnostic and operative information from the medical record using ICD-10-CM, CPT, HCPCS level 2 coding classification systems. . Reviews DRG discrepancies from the fiscal intermediary to ensure the appropriate per case DRG assignment. Verifies and abstracts all medical data from the record to complete a data abstract on hospital encounters. Corrects data as appropriate per query. Ensures that all data abstracted and/or coded are consistent with guidelines outlined by JCAHO, OSHPD and CMS, regional and local policy. Reviews appropriate provider documentation to determine principal diagnosis, co-morbidities and complications, secondary conditions and surgical procedures. Assigns present on admission (POA) value for inpatient diagnoses.For ED I coded all diagnosis related to patient care, abstracting all information from multiple systems. I capture all bedside procedures, infusion and injection. Enter all charges into the system after coding.

New Orleans, Louisiana, Us

Code evaluation and management for internal medicine, family practice, ancillary, urgent care, transitional care (TC), health risk adjustments (HRA/HCC) researching and coding, home health, teaching facility coding, anesthesia, radiology, Obgyn etc...Perform chart reviews, E/M auditing, and HCC auditing.Work denials.

Nephrology/Dialysis facility coding and spectra labs.Research and resolve general coding issues; communicating with cross-divisional teams and/or vendors as necessary. Code labs, assign the appropriate diagnostic and/or procedural code(s) to patient health information documents. Corrects and identify data errors or inconsistencies, ensure provider documentation is complete and supports the diagnoses and procedures coded. Reports incorrect documentation or codes in the electronic patient record.Performed ICD 9 to ICD 10 transitions and special projects.

Responsible for clinical coding and billing of outpatient services as well as surgical cases Uses ICD-9, CPT-4 and HCPCS to assign correct coding for patient clinic visit and procedures Collect, post, and manage patient account payments, submit claims to insurance Review delinquent accounts and call for collection purposes Ensure healthcare facilities are reimbursed for all procedures Investigate rejected claim to see why denial was issued and send appeals when neededE/M auditing.

Responsible for Same Day Surgery for Pain Management, Outpatient and Inpatient Rehab coding Performs coding on all diagnoses, procedures, and related services according to applicable coding guidelines for outpatient clinic, inpatient rehab and specialty accountsUses ICD-9-CM, CPT-4, and HCPCS code sets to appropriately assign and sequence codes identified within the outpatient medical record while maintaining confidentiality of patient records and proceduresApplies the most accurate codes for reimbursement purposes, statistical analysis outcomes, financial and strategic planning, evaluation of quality of care, and communication to support the patient’s treatment by abstracting all EHRsReviews and prepares for correction Outpatient Coder Editor (OCE) errors, Medically Unlikely Edits (MUE) errors and National Correct Coding Initiative (NCCI) editsReviews assignment of CPT-4 codes and resolves Local Coverage Determination (LCD) errors as it relates to the diagnosis codesLean Six Sigma Green Belt participation Remote experience

I PERFORMED E/M LEVEL CODING FOR ALL HCA HOSPITALS USING 1995 GUIDELINES.RESPONSIBLE FOR ASSIGNING CPT CODE FOR ALL ER/ED VISITS.CHARGED/BILLED FOR ALL SUPPLIES AND SERVICES INCLUDING BUT NOT LIMITED TO INJECTIONS, INFUSION, IV's, MINOR/MAJOR PROCEDURES AND CRITICAL CARE VISITS.PERFORMED ABSTRACTING EHR/EMR's TO SUCCESSFULLY CODE PATIENTS ACCOUNTS ACCORDING TO CPT GUIDELINES AND HCA POINT MATRIX FOR OVER 7 HCA HOSPITALS EMERGENCY ROOMS. RESPONSIBLE FOR 200 PLUS ACCOUNTS DAILY.PERFORMED DATA ENTRY FOR ALL CODES COLLECTED.

Associate'S Degree, Health Information/Medical Records Technology/Technician

Certificate Of Technology In Medical Coding, Medical Insurance Coding Specialist/Coder