• Audits and evaluates records to determine documentation consistency and adequacy to support coding levels assigned by providers. Ensures that the final diagnosis is consistent with documentation and reflects the care and treatment rendered. Reviews selected records for compliance with established regulatory and third-party documentation requirements.• Abide by AAPC and established regulatory standards of Ethical Coding when performing validation reviews and provide feedback to Professional Coding Manager of any potential compliance issues related to coding and physician documentation.• Analyzes provider documentation to assure the appropriate Evaluation & Management (E&M) coding levels are assigned using the correct and appropriate CPT code.• Provide guidance and education to Coders on validation findings to support compliant coding and increase knowledge and skills.• Conduct regular educational sessions with Coders on newly published coding guidelines or billing regulations to assure coding staff possess accurate information and follow new requirements.• Meet with providers to provide feedback and training to strengths/weaknesses identified in audit/review activities. Continue to monitor provider performance and perform additional reviews, instruction and guidance as needed to meet minimum coding accuracy standards.• Serve as an educational resource to hospital-based physicians and staff for ongoing educational needs.• Develop curriculum and training materials for coding staff.• Revise and provide recommendations of best practice standards for coding policies and procedures.• Assist in review and assessment of audit findings from third parties that provide coding validation audits. Formulate and write appeals when appropriate and/or educate Coder(s) when required.• Provide coding support and answer coding questions for Patient Financial Services and other departments.• Maintain knowledge of coding and reimbursement rules and regulations.

• Provide individuals with foundation skills to becoming a coder, instructing Foundation in Medicine course 12-week program, identify medical terminology, anatomy, and pathophysiology for a wide range of topics, applying it to interpreting a medical record• Provide individuals basic knowledge to become a Certified Professional Coder (CPC), Certified Professional Biller (CPB), instructing 16-week program on topics and concepts of coding and billing• Executing a 16-week program via Zoom classroom program of studies• Provide coaching, time management, and real-world coding insight relating to course material• Fostered independent critical thinking • Facilitated and encouraged an open and positive learning environment

• Provided individuals basic knowledge to become a Certified Professional Coder (CPC)• Developed course syllabus and execute 3 month in class program of study; including, but not limited to supplemental learning material, take home worksheets, proficiency exams and proctored certification exam• Developed a 2 day boot camp for preparation to sit for the Certified Professional Coder (CPC) proctored certification exam, CEUs offered • Fostered independent critical thinking • Facilitated and encouraged an open and positive learning environment

• Was interim manager starting April 2020• Responsible for talent management for outpatient and professional external audits• Oversight of personnel, project management, inventory control, audit activity, financial goals, operational effectiveness• Identify potential fraud and abuse, document billing errors and trends.• Assures compliance to BCBSMA and billing guidelines. Consult as a subject matter expert with internal and external professionals in reference to coding, billing, and accurate assignment of Current Procedural Terminology (CPT) codes.• Interfaces with provider leaders, resolves conflicts and develops proactive approaches for future coding discrepancies.• Monitor existing, emerging issues and trends, and assesses levels of risk.• Coaches/counsels direct reports to maximize performance, job progression, and leads positive change.• Meet deadlines to ensure all tasks are performed to bring audits and projects to a timely closure.• Actively participate in internal and external meetings, training activities.• Represent the department on a cross functional workgroups and projects as needed.• Promotes innovation solutions and pursues new opportunities for cost avoidance savings.• Performs other work-related duties as assigned or requested.

•• Review medical documentation to assure all services and charges are supported by clinical documentation, post payment reviews.• Identify potential fraud and abuse, document billing errors and trends.• Consult as a subject matter expert with internal and external professionals in reference to coding, billing, and accurate assignment of Current Procedural terminology (CPT) codes.• Serve as a resource to physician practices and staff for ongoing educational needs related to coding. Respond to practitioners and management questions regarding coding and reimbursement, researching, as necessary.• Educate internal and external professionals on post audit findings. Utilizing my knowledge of coding, billing, BCBSMA payment policies, CPT guidelines and conventions published by the AMA, 1995/1997 Documentation Guidelines for Evaluation and Management Services published by CMS.• Monitor existing, emerging issues and trends, keep leaders informed of risk areas and concerns that may require additional attention.• Meet deadlines to ensure all tasks are performed to bring audits and projects to a timely closure.• Actively participate in internal and external meetings, training activities.• Represent the department on a cross functional workgroups and projects as needed.• Assisting in supervising auditors for performance and education.• Develop physician education strategy in conjunction with clinical documentation improvement to promote complete and accurate clinical documentation.• Development a report performance measures to the medical staff and other departments of physician specific information regarding documentation compliance.• Collaborate extensively with physicians, nursing staff to improve quality and completeness of documentation of care provided and coded. • Performs other work-related duties as assigned or requested.

• Obtain appropriate clinical documentation through extensive interaction with physicians, nursing staff, other patient care givers • Collaborates with HIM coding staff to ensure that appropriate reimbursement is received for the level of services rendered to patients and the clinical information utilized in profiling and reporting outcomes is complete and accurate.• Facilitate appropriate and timely clinical documentation to ensure that level of services and acuity are accurately reflected in the medical record.• Utilizes extensive knowledge of documentation requirements and guidelines in accordance with government and commercial payers to improve the overall quality and completeness of clinical documentation by performing reviews using the clinical documentation guidelines.• Educate practice office physicians and staff on clinical documentation needs, changes to clinical documentation guidelines, coding and reimbursement issues.• Conduct follow up review of clinical documentation to ensure proper clinical information is documented in the patient’s record. • Generate accurate and timely status reports for physicians & leadership.• Performs other work related duties as assigned or requested.

• Utilizing my skills to accurately interpret medical records to assign correct CPT, ICD-9 codes, modifiers for billing• Analyze, sequences and validates assigned codes based on medical record documentation when coding is provided• Provide education for physicians and supportive staff• Auditing of medical records for accurate coding• Communicates with Physicians and Operations Mangers to finding solutions and implementing changes to increase productivity and department efficiency• Respect client confidentiality, company policies and procedures• Regularly communicates with patients with, but not limited to insurance issues, payments, general inquiry• Assist in the training of new employees• Self-manages and prioritizes daily work flow to achieve accurate and timely submission of claims• Flexibility to adjust daily tasks when assigned new work/project or covering for co-workers

• Provided individuals basic knowledge to assist licensed professionals in daily veterinary tasks• Developed course syllabus and execute 12 week in class program of study; including, but not limited to supplemental learning material, take home worksheets and proficiency exams• Fostered independent critical thinking • Facilitated and encouraged an open and positive learning environment

• Active role in coordinating and providing daily client care• Effective and accurate liaison between veterinarian, clients and support staff• Collected, prepared, analyzed, reported results to veterinarian and document laboratory samples• Interpreted, processed, and maintained electronic client records• Responsible for maintaining veterinarian, surgical, technician, and affiliated animal boarding schedules • Collaborated with main hospital and referral hospitals to coordinate surgeries and specialty care• Instrumental in set-up of DVMax operating system, regularly collaborated with off-site information technology professionals to trouble shoot issues with minimal interruption to operations • Oversaw all accounting operations; invoicing, collections and auditing receivables; proactively extracted monthly fiscal data from DVMax, transferred to Microsoft Excel and communicated financial data to practice owner• Established DVMax computerized inventory management system at main office and Forestdale clinic; implemented monthly inventory recalibration at local office• Responsible for administrative new hire training, supervision and evaluation• Developed comprehensive training manual for ancillary personnel• Participated in client growth business initiatives, coordinating marketing and advertisement of clinic; successfully secured minimum of 8-10 new clients per month• Maintained safe, clean and organized work environment• Responsible for handwritten holiday, welcome, thank you, and sympathy cards• Team leader for clinic’s American Red Cross Hurricane Katrina relief efforts• Fostered positive and helpful environment throughout the organization and community