Janice Compton, Cmc, Chts-Pw Email & Phone Number

Austin/Houston, Texas Area

Established and support revenue cycle enhancements for multiple disciplines in the medical community. Medical billing proficiency in Physical and Occupational Therapy, Home Health, Genetic Testing, Medical Devices, Chiropractic, Pain Management, Radiology, Return to Work Programs, Biologics, Pharmacy and Laboratory testing for drug testing, wellness and DNA. Management of focused reviews to confirm compliance with documentation and billing rules and regulations set forth by CMS, Medicare Administrative Contractor, federal and state regulations which included policies and procedures. The revenue cycle team was responsible for the collection and billing, diagnosis assignment, verification and treatment plan compliance with established guidelines. Key Achievements:  Provided feedback and recommendations to clients on areas in need of improvement and opportunities to maximize profitability. Management oversight and performance of all billing submissions, electronic and paper, to ensure Payer compliance.  Assigned appropriate personnel based on the hospitals discharge diagnosis to ensure the highest level of quality care was provided to each patient. Consulted and supported documentation and preparation for Medicare on-site surveys.

Certified Medical Coding Consultant - Management oversight of medical chart audits to confirm compliance with documentation and billing rules and regulations set forth by CMS, Medicare Administrative Contractor, federal and state laws and regulations.

Prospective and retrospective inpatient and outpatient documentation audits to confirm compliance with documentation and billing rules and regulations set forth by CMS, Medicare Administrative Contractor, federal and state laws and regulations including institutional policies and procedures. Maintains a comprehensive knowledge of ICD, CPT and HCPCS coding principles, governmental regulations and third party guidelines regarding documentation and billing compliance.

Results-oriented professional with 20+ years of experience in diverse areas of healthcare management, medical billing/coding, reimbursement management, and claims administration. Adept in revenue cycle management and collections. Exposure to working with ICD-9 codes, medical terminology, and healthcare insurance protocols. Skilled in streamlining business processes, introducing process improvements, increasing profitability, and enhancing productivity levels. Exceptional leadership talents relating to staff training and professional development associated with medical coding.

Research, analysis, instruction and development of training materials regarding appropriate billing practices for all payor types to support continued employee education.

Development, of a national medical bill review system specializing in the workers' compensation product line implementing effective work units and streamlined workflow process resulting in increased department revenue.