Sandy Mcmaster Email & Phone Number

Selected Contributions:•Maximized reimbursement by ensuring accurate ICD-9-CM, HCPC and CPT coding and conducting regular charge capture and quality audits as compared to chart documentation. •Ensured records and billing met medical necessity and compliance guidelines for all insurance providers including Medicare. •rovided up to date compliance, medical necessity and MUE information to billing team and patient accounts. •Responsible for RAC audits on several specific oncology drugs which we passed due to my timely and accurate updating of the CDM•Ran statistical reports from the oncology EMR to compare to hospital system for timeliness and accuracy of coding, billing and documentation.•Business office superuser for the oncology EMR Varian system. •rovided ongoing training to staff on intricacies of insurance submissions, coding and intake procedures to minimize rejections for referral- or registration-related reasons.Specialties: Radiation Oncology and Medical Oncology billing and financial statistics

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  Supervisor, Business Services

  Edward Hospital Cancer Center

  Jan 2001 - Jul 2011

  Audit CPT, HCPC and ICD-9-CM codes of outpatient Radiation and Medical Oncology patient records accuracy and medical necessity. Review medical documentation and consult with healthcare providers when documentation is inadequate/unclear for coding purposes. Work collaboratively with oncology billers, patient accounts department, medical records and nurse auditors to ensure accurate charging, compliant billing and to resolve claim denials and medical-necessity issues. Audit daily radiation and… Show more Audit CPT, HCPC and ICD-9-CM codes of outpatient Radiation and Medical Oncology patient records accuracy and medical necessity. Review medical documentation and consult with healthcare providers when documentation is inadequate/unclear for coding purposes. Work collaboratively with oncology billers, patient accounts department, medical records and nurse auditors to ensure accurate charging, compliant billing and to resolve claim denials and medical-necessity issues. Audit daily radiation and medical oncology charge capture for accuracy and timeliness. Maintained CDM for radiation and medical oncology including all oncology drugs. Responsible for insurance coverage and benefit verification and pre-authorization of oncology and imaging services.Created and maintained weekly and monthly statistics by diagnosis, by accelerator capacity, by drugs purchased, used and wasted, by patient visits and procedures. Monitored work load units to ensure proper staffing. Responsible for patient registration accuracy, privacy and security through constant and consistent education of the front desk staff. Scheduled business office and front desk staff time off requests, delivered annual reviews and reviewed time cards Show less