Brandy Burnell, Mshi, Rhia, Chc, Ccs-P Email & Phone Number

Cincinnati, Oh

Responsible for developing and implementing the Professional Billing Compliance Program at a large academic medical center with over 1,000 billing providers. Oversee auditing and monitoring functions performed by the Professional Billing Compliance Auditor role. Prepare, conduct, and analyze an annual risk assessment. Utilize feedback to develop an annual audit plan. Develop auditing and monitoring tools, policies, and standard procedures to enhance efficient and effective organizational compliance with federal, state, local, and other laws and statutes related to billing compliance. Prepare, distribute, and present reports of auditing, monitoring, and other compliance activities to organizational leadership, including executive directors, medical directors, and board committee members. Provide guidance to inquiries regarding coding, billing, and documentation guidelines, rules, and regulations. Assist investigations of reported and/or suspected noncompliance.

Nationwide

Coding Quality Review and EducationRespond to consulting and education needs related to coding quality, compliance assessments, external payer reviews, coding education, interim coding management and coding workflow operations reviews.Offer meaningful information to meet customer expectations including identifying and proposing solutions for customer issues.Prepare data files and maintain all protected health information in accordance with HIPAA regulations and company privacy and security policies.Provide feedback to customers on their compliance risks, exposures, and problematic practices.Promote connectivity between the customer and the CARE organization through ongoing communication.Perform analysis of codified data including trending/forecasting and selection of audit samples for review.Plan and deliver education sessions for coding teams and the customer organization leadership.

Cincinnati, Oh

Perform coding and documentation audits of hospital and physician services billed by CCHMC, and provide feedback to audited divisions and departments based on the audit results.Develop and provide education and training to staff and providers regarding appropriate medical record documentation and accurate coding.Facilitate and coordinate corrective and preventive action plans developed and implemented by departments and divisions as a result of audit findings. Serve as a communication and educational resource to administration, department heads, physicians, and other staff regarding the documentation of clinical services and coding rules and regulations.Maintain currency of CMS, State of Ohio, coding and other guidelines, rules, and regulations.

Berea, Ky

Analyzed medical record documentation and applied official guidelines and regulations to accurately assign ICD-9-CM diagnosis and CPT procedure codes to outpatient ancillary, emergency department, observation, and outpatient surgery accounts. Communicated and collaborated with the Business Office and Patient Access departments to correct billing errors, ensure timely filing of bills, and develop proactive processes to prevent future errors.Acted as a system super user for the Meditech Abstracting module for other HIM department staff. This included assisting with system operations and compiling customized reports.Assisted with training and development of new coding staff members.Participated in Quality Improvement and Joint Commission committees as needed.

Berea, Ky

Coded and abstracted outpatient lab, radiology, and therapy charts. Screened outpatient Medicare visits upon registration for medical necessity determination and issued Advanced Beneficiary Notice when necessary. Obtained pre-authorization for radiology and surgical procedures. This included interactions with both the physician and insurance company. Reviewed and corrected accounts for NCCI edits.Reviewed charges applied by the ancillary departments for appropriateness, and corrected inaccuracies. Registered patients for scheduled outpatient services.

Berea, Ky

Scanned, reviewed, and indexed medical records into document imaging system. Assisted in development and implementation of document imaging system update. Monitored hardware and performed routine maintenance. Contacted systems engineer as necessary for problem resolution.Assisted in other department functions as necessary, including release of information and qualitative medical record analysis.

Master'S Degree, Health Informatics

Bachelor Of Science (Bs), Health Services Administration