Amanda Proctor Email & Phone Number

Lubbock, Tx, Us

Aliso Viejo, California, Us

Aliso Viejo, California, Us

Aliso Viejo, California, Us

Ensured requirements traceability in the team and identifies areas for improvement.Validated the completion of Integrated Testing and consults with development engineers in resolution of problems.Developed, executed, and analyzed the output from scripts that capture application and platform quality metrics.Troubleshoot errors found in the test environment with help from Development teams.Configured complex software solutions by following user guides and manuals instead of waiting to get helped by experts.Raised quality issues to the right levels of management using established channels of escalation.Performed Quality Assurance Audits on New Hires and established coders.Educated and advised staff on proper code selection, documentation, procedures, and requirementsIdentified training needs; prepared training materials and conducted coaching and training as needed.Successfully trained and onboarded up to 10 coders at a time (in total 60 coders).Created & updated training materials for new hires and onboarding training schedule and timeline.Created presentations for additional coder education.Provided support to SVP of Quality and training with the development and implementation of educational and training materials.Subject Matter Expert (SME) on HCC education and general coding questions.Working with Epic, Athena, and several other Electronic Medical Records.Reviewing and searching through medical records for embedded HCC diagnoses.Hosting WebEx, Skype meetings, and training.

Eden Prairie , Mn, Us

Optum Approved TrainerResponsible for developing, maintaining, and servicing a high-quality, marketable, and satisfied provider network within an assigned geographic area.Helping assigned providers operate successfully within our model by providing strategic planning and tools to meet goals.Making sure providers have an in-depth understanding of submission of relevant ICD -10 codes and CPTII procedural information as per coding guidelines and appropriate reimbursement requirements, patient care best practices.Utilizing analytics and identifying targeted providers for Medicare Risk Adjustment training and documentation/coding resources.Conducting detailed analysis of various reports by tracking data to develop a strategic plan to ensure performance goals are achieved.Maintaining open communication with providers including issue resolution on, eligibility, disease management, utilization management, quality, and risk adjustment program to improve documentation accuracy.Ensuring member encounter data (services and disease conditions) is being accurately documented and relevant procedural codes, as well as all relevant diagnosis codes, are captured.Reviewing selected medical documentation to determine appropriate diagnoses, procedures codes and ICD-10 conditions are coded per CMS coding guideline.

Las Vegas, Nv, Us

Responsible for participating in the implementation of the organization’s Coding Proficiency program.Performing medical chart audits for Evaluation and Management and ICD-9 coding and documentation.Conducting HCC and assigning E&M, CPT, HCPCS, ICD-9, and ICD-10 codes as applicable for specialties I.e. Primary Care and associated specialties, Cardiology, Podiatry, Urgent Care, and associated specialties, and OB/GYN.Assisting healthcare providers in identifying/resolving issues related to regulatory guidelines or HCPNV internal controls.Educating and advising staff on proper code selection, documentation, procedures, and requirementsIdentifying training needs; prepares training materials and conducts coaching and training as appropriate for clinic staff, physicians, NPs, and other staffImproving the quality of the diagnosis documentation and accuracy of the collection and coding of members’ health data.Providing support to HCC Coding Manager in developing and implementation of policies and procedures, assuring HCC Coding internal quality reviews, operational process work-flows, training for new hires.Assisting in education for providers, clinicians, and coworkers in transitioning to ICD-10. Developing training materials.Improving Clinical documentation & code compliance.Assisting project management of developing and implementing Chart review software to aid in the Total care of patients.Creating training material and trained employees on how to utilize the system, SME

Las Vegas, Nv, Us

Assigning codes as applicable for specialties such as Primary Care and associated specialties, Cardiology, Podiatry, Urgent Care and associated specialties, and OB/GYNPerforming medical chart audits to meet minimum productivity standards.Educating clinicians on specific coding issues found in senior HMO pre-audits.Submitting and follow up on query forms to clinicians based on “inferred” chart audit data.Conducting analysis and Reviewing the appropriate ICD-9, CPT, E&M, and HCPCS submitted by the provider & assigned the samePerforming abstract coding and evaluate medical records and communicate findings and recommendations to providers and support staff to ensure accurate HCC coding and documentation practices in compliance with government and payer regulations.Educating & advising staff on proper code selection, documentation, procedures, and requirementsStays abreast of industry coding and compliance issues.Participating in coding/auditing discussions to ensure best practice efforts and processes are implemented ensuring maximum reimbursement through appropriate coding.Attending Coding program monthly meetings.Performing additional duties as assigned.

Las Vegas, Nv, Us

Analyzing provider billing practices by utilizing code auditing software, provider documentation, administrative policies, regulatory codes, legislative directives, precedent, code edit criterion.Assisting in audit of medical records and verification of applied ICD-9, CPT, E&M and HCPCS codes.Helping in Auditing of Primary Care and associated specialties, Cardiology, Podiatry, Urgent Care and associated specialties, and OB/GYN.Reviewing medical records to ensure billing is consistent with medical record for appeals, adjustments and miscellaneous/unlisted code review.Evaluating cases with Medical Director to validate decisions and identify opportunities to create medical policy in the absence of guidelinesWorking with providers on any documentation needed to support applied codes and coded charts to provide corrections, etc. to finalize medical record to send to billing department.Creating medical charts, scanned in documentation into appropriate patients charts.Working closely with front/ back office personnel, and providers. Pulled providers schedules on a daily basis, to ensure proper treatment.Assisting with research of health plan coding questions.Identifying potential billing errors, abuse, fraud, and opportunities to flag potential cases which may warrant a prepayment review versus an automatic system denial or payment).Maintaining appropriate records, files, documentation, etc.

Pahrump, Nv, Us

Assigning ICD-10-CM and CPT diagnosis and procedure codes, using Encoder, for all outpatient and emergency room records; maintains a 95% accuracy rate when coding and sequencing medical (patient) records.Helping medical staff and hospital with proper nomenclature of medical terminology and proper coding and sequencing of ICD-9-CM and CPT codes.Complying with established coding productivity standards as outlined in department policies and procedures, and seeks supervisor assistance when such standards cannot be met.Maintaining and submits to the supervisor on a daily basis required productivity logs for all assigned tasks.Performing patient record coding using the EPF system 100% of the time when patient records have been scanned and indexed into the EPF system.Reviewing unbilled accounts daily to identify those pending and maintains the work current and within the deadline and assigned financial goal.Daily Gathering discharged patients’ charts from the Med Rec Clerk, and review for content completionRecording E.R. code and short stay for billing purposes.Adhering to HIPPAA guidelines and demonstrated professional conduct.Participated in mandatory meetings and completed training, and had QA standards.

Bachelor Of Arts - Ba, Psychology

Master'S Of Science, Health Leaderhip