Sandra Troade Email & Phone Number

United States

*Responsible for conducting quality assurance audits on all Advantasure coders (including Level 1, Level 2, CDI Reviewers and Pre-Submission Coders) *Answer coding questions for the all coders (Level 1- Pre-Submission Team) *Help interpret and utilize all coding guidelines from Advantasure’ s coding guidelines to ICD 10, Coding Clinic and CMS.Provide.

• Development of Opportunities, Query Identification and Provider Education to improve the Medical Record Documentation. *Communicates, promotes, and partners with physicians for improved clinical documentation to reduce.
• Ensure that information documented in the medical record is translated into specific codable diagnoses.

1401 NW 136th Ave Sunrise, FL 33323

• Ensure compliance with all applicable Federal, State and/or County laws and regulations related to coding and documentation guidelines for Risk Adjustment.
• Review medical records, patient medical history and physical exams, progress notes, consultation reports, diagnostic reports, operative and pathology reports, and discharge summaries to verify whether: a. The diagnosis.
• Performs on-site or electronic medical record reviews to capture of all relevant HCC diagnosis codes based on CMS Hierarchical Condition Categories (HCC) conditions that are applicable to Medicare Risk Adjustment.

*Review Medical Record information to identify all appropriate coding based on CMS HCC categories*Provider support, education and training related to revenue optimization, quality of documentation, level of service and diagnosis coding consistent with established coding guidelines and standards*Provide real time support and coordination with Primary Care.

3091 Coral Way, Miami-FL

HCC AuditorDiverse set of concurrent medical records review skills, clinical knowledge, and knowledge of coding and reimbursement regulations.Educate physicians how documentation affects diagnosis and RAF reimbursement.Ability to interpret medication administration record to look for query opportunities.Work with clinical team to develop provider.

Review medical records to assure proper coding of submitted claims.Ensure all services documented in the patient’s medical records are coded with the appropriate ICD-9-CM codes and procedures codes. Conduct a review of medical records to ensure compliance with coding and documentation guidelines.Provides proper documentation and Medicare Risk Adjustment.

Organizing and managing multiple priorities and/or projects by using appropriate methodologies and tools.Verify and ensure the accuracy, completeness, specificity and appropriateness of diagnosis codes based on services rendered.Review medical record information to identify all appropriate coding based on CMS HCC categories.Responsible in the communication.

Manage patient dental balances and benefits accordinglyEnter all dental specialist claims and balance reports from account payableBill all Dental External Specialist ClaimsRun a weekly and monthly Report for Dental External SpecialistRequest Checks to Finance Department to pay External Dental Specialist claim

Certified Documentation Improvement Expert Outpatient, Medical Insurance Coding Specialist/Coder

Certified Professional Coder Cpc, Medical Insurance Coding Specialist/Coder

Bachelor'S Degree, Health Information Management

Certified Risk Adjustment Crc

Certified Professional Medical Auditor (Cpma), Medical Insurance Coding Specialist/Coder