Audit and educate staff regarding Medicare's HCC model. Training and coordinating transition to ICD-10 for staff and providers.

On-board and train all new coders with follow-up training for all new accounts. I regularly perform quality assurance audits on all coders, providing management with concise reports and accuracy percentages. In conjunction with Managing Director, design and develop training plans to meet training needs of coders to achieve higher level of accuracy and further develop coding skills. Monitor changes in laws, regulations, and coding/documentation standards. Provide coder education and serve as a coding resource. Participate in interviewing, selecting, training, evaluating, motivating and mentoring coders. Provide assistance to coders by reviewing difficult records and perform secondary review as needed. Assist with projects and assignments (coding and related work) as needed, Train coders on all new software and applicable systems. Create a desk procedure at the onset of each new project, assignment or client. Maintain and update desk procedures as needed. In addition to the above responsibilities, this role may include such other responsibilities and duties as assigned, based on departmental or company needs and responsibilities

Supervisor of coding auditors/educators for the Specialty Department's within Kaiser. The auditors provide auditing and feedback to Kaiser Physicians on a regularly scheduled basis. Along with two other supervisors I organized and provided on boarding of new consultants hired with in the coding education department. I assigned and tracked audits in Mdaudit, the electronic auditing system used at Kaiser. I supervised the auditors working with multi-specialty departments such as Allergy, General Surgery, Dermatology, Pulmonology and Cardiology. Managed and supervised remote auditors for the specialty departments as well as managing and supervising the consultants who did the provider education on site. Reviewed and provided QA feedback to the auditors and answered any questions they may have had. I was responsible for the daily supervision of employees as well as process time cards and help with issue resolution.

I worked as part of a team to develop coding education for Kaiser Providers in Primary Care and Specialty Care. Developed and presented power point presentations for group training. Conducted audits and gave feedback to providers with regards to the overall accuracy rates. Suggested ways to improve coding accuracy and made them aware of governmental guidelines as well as Kaiser coding and compliance guidelines. Developed and implemented a coding orientation for any new hires or consultants coming on. This included a Desk Reference manual, On-Site Reference manual, sample audits with results and how to audit following Medicare part C guidelines. This position was later transitioned into the Coding Education Supervisor position.

Provided coding education to the members of University Physicians (MD's, NP's PA's), the doctors that practice at University Hospital. Developed group presentations in all areas including Internal Medicine, Pulmonology, ENT, Cardiology, and Nephrology and worked one on one new providers regarding correct coding and CMS coding guidelines. Audits were performed to rate provider accuracy with coding, and documentation. Feedback was then given to the providers to help improve their coding ability and knowledge. Information was submitted on behalf of the providers for credentialing and to ensure all of their billing numbers were in place and ready before their scheduled start date.

I worked a second coding job in the evenings as an instructor. Taught basic concepts for ICD-9 as well as CPT coding. Training materials I developed included nightly lessons, class room practice sheets, homework assignments and test. Helped with some career counseling and resume building.

In Patient Chart Abstractor; Job duties included the daily abstraction of in patient charges for the pulmonary/critical care, renal and anesthesia departments. My job included the abstraction notes for patients in the surgical critical care unit the burn/trauma unit and the intermediate critical care unit, as well as coverage for the medicine doctors on the 7th and 6th floors. I worked directly with the Chief of the pulmonary transplant team to ensure that all encounters were captured and coded correctly. Including all admits, discharges subsequent visits and any procedures done at bedside as well as in the clinic. Regular analysis of monthly denial reports were done to assess if the codes submitted were accurate, and if needed charge corrections were sent to the insurance carrier. Acted as a team lead to help relay information, answer questions and organize cross coverage when other were out. Lead round table discussions concerning current coding issues and also discussed the best way to develop work flow patterns.

Perform code review of claims submitted by providers for auto injuries making sure the CPT and ICD codes were correct for the documentation. Following the review of the claims a denial or reimbursement was issued. If the claim was denied I worked with the provider or his staff to help resolve the issue.

Answer the coding hotline for societies such as the ACS (American College of Surgeons), AACU (American Academy of Clinical Urologist), and many other specialty associations and colleges. Helped providers and their staff with difficult CPT and ICD coding issues. All questions were answered live and if research was need we supplied a response with in 48 hours.