In this, role, I reviewed and processed clinic professional charge tickets and apply coding principles according to OMG procedures, government regulatory standards, and payer specific guidelines of health plans using CPT, ICD, and HCPCS Level II codes and principles. Key Accomplishments;• Educated physicians and mid-level health care providers in correct coding based on OMG’s documentation standards, transforming operations by increasing continuity and uniformity in paying claims with limited denials.• Achieved personal accuracy level of 98% of assigned workload for all services of the orthopedic, podiatry, and internal medicine departments.• Created new training platform for coding based on documentation in collaboration with the Physician Champion and senior management of coding and finance.Skills;Medical CodingCPT CodesICD CodesHCPCS Level II CodesGovernment Regulatory StandardsPayer Specific GuidelinesDocumentation StandardsTraining Platform DevelopmentOrthopedic CodingPodiatry CodingInternal Medicine Coding

Here, I performed coding and documentation audits relating to correcting physician services coding, and resolving charge review errors, coding edits, and denied claims (follow-up). Key Accomplishments;• Resolved Epic Edits to ensure correct coding of services provided, including review of documentation for correct coding and E/M leveling, diagnosis coding, bundling issues, and modifier usage.• Acknowledged by director, manager, and supervisor of the Revenue Cycle department as continuously maintaining a positive attitude and noted as an asset to the department.• Facilitated new provider onboarding, focusing on provider service auditing, in-person floor support, provider analysis and feedback as well as evaluation of coding and documentation needs specific to audit outcomes and provider level of expertise.

In this designation, I completed substantial professional fee coding for both evaluation and management series codes and surgical coding for the department of orthopedic surgery, vascular surgery, general surgery and transplant surgery. Being a teaching facility, I had the opportunity to work with the residents and fellows to educate them about their different billing and coding styles. This was an incredibly stressful work environment as they only see the sickest of the sick. It was an incredible opportunity none the less. Key Accomplishments; • Completed charge entry of reimbursement coding with applicable modifiers into IDX.• Obtained insurance authorization for outpatient procedures, documentation, and tracking of charges.• Audited charge document completion and accuracy; batching and data entry of charge documents; billing data collection and report generation to seven department of surgery clinical divisions.• Conducted minor analysis of billing and reimbursement items and/or other special projects as directed by Department of Surgery Billing Unit Supervisor or Director, including analysis of financial trends, reimbursement, coding trends, and physician documentation.Skills;Professional Fee CodingEvaluation and Management Series CodesOperative Report CodingReimbursement CodingCharge EntryModifiers ApplicationIDX (Billing Software)Insurance AuthorizationDocumentationData EntryBilling Data CollectionReport GenerationData AnalysisFinancial Trends AnalysisCoding Trends AnalysisPhysician Documentation Analysis

Here, I served as the practice’s Human Resources Director and handled various areas, including hiring, training, scheduling, evaluating, and leading staff. Furthermore, I analyzed and reviewed all super bills and surgical charges for accuracy, integrity, and completeness of coding, in addition to correcting inaccurate coding based on documentation. • Directed business aspects of clinic, ensuring work is completed, focusing on day-to-day operations, and managing front-end and back-end staff functions including office support, financial reporting, administration, claims processing, and patient care.• Coded orthopedic surgical charges into Practice Management system to include complex spine surgery, interacting with assistants, physicians, and business office staff to ensure services are recorded accurately, posted, and subsequently reimbursed, saving practice lost revenue daily.• Managed physician recruiting and hiring, completing applications for physician credentialing with multiple hospitals, provider insurance enrollment, physician marketing, and clinic-specific education.• Strategize ways to retain patients and market practice. As an ambassador, demonstrate excellent service reflected through continuous high scores in patient retention and patient satisfaction.Skills;Human Resources ManagementStaff SupervisionSuper Bill ReviewSurgical Charge ReviewCoding AccuracyPractice ManagementOrthopedic Surgical CodingCredentialingPhysician MarketingPatient RetentionPatient SatisfactionBusiness Operations ManagementFront-End and Back-End Staff ManagementFinancial ReportingClaims ProcessingStrategic PlanningRevenue ManagementHealthcare Marketing