Stephon Williams, Rhit, Cpc Email & Phone Number

New York, United States

New York, New York, Us

Long Beach, California, Us

Long Beach, California, Us

Research, review, and validate payment integrity cost saving concepts for the New York health plan. Lead the NY health plan cost containment program with various stakeholders, leaders, and departments.Facilitate internal and external coding education, fostering a culture of payment integrity and accuracy. Work with operational leaders within the business to provide recommendations on opportunities for process improvements and medical cost savings. Recognized as a go to NY Medicaid subject matter expert, providing invaluable insights into policies and reimbursement intricacies.Review and validate high dollar DRG claims for validation and payment.

Long Beach, California, Us

Review and validate high dollar inpatient (DRG) and outpatient claims, to ensure accurate pricing and payment. Oversee and validate all overpayments with the health plan.Collaborate with internal teams and cross functionally to communicate findings of overpayment audits and drive corrective actions.Provide education to providers on coding & billing compliance as well as state Medicaid guidelines.Research and develop new payment integrity concepts based off of industry coding and billing guidelines.

Us

Ensured accurate payment of claims by meticulously applying policy provisions, New York State mandates and the workers' compensation fee schedule. Expertly validated, priced, and processed DRG/EAPG medical bills, maintaining precision in payment calculations. Conducted thorough investigations into claims by assessing coverage, liability, and risk exposure to make informed decisions. Utilized effective negotiation skills to establish fair and reasonable payment rates with providers and hospitals, optimizing cost control.

Syracuse, Ny, Us

Led day-to-day functions of the inpatient coding team, offering expertise in coding questions, documentation enhancement, and resource provision.Actively contributed to improving documentation practices by collaborating with healthcare professionals and offering insights to ensure accurate coding. Reviewed and audited inpatient coding performance, consistently maintaining a coding accuracy rate of 98% to uphold quality standards. Demonstrated proficiency in using the EPIC HIM/Billing system application on a daily basis, optimizing coding efficiency and accuracy.

Syracuse, Ny, Us

Lead cross-functional teams to achieve project goals within specified timelines and budget constraints.Collaborated with cross-functional teams to streamline various claims processes and enhance efficiencies.Ensure CDHP claims projects & benefit comply with relevant healthcare laws, standards, and regulations.

Generated and submitted medical bills to insurance companies, ensuring accurate and timely reimbursement for healthcare services provided. Code professional claims to insurance companies.Played a key role in implementing and facilitating the "go-live" process of the electronic medical record system, contributing to successful integration.Managed the patient portal system, overseeing it's complete functionality and usability for patients and providers. Provided education to both patients and providers on effectively navigating and utilizing the patient portal system.

Syracuse, Ny, Us

Offered vital companion services to consumers with mental disabilities, creating a supportive and nurturing environment. Instructed consumers in the art of living independently, demonstrating essential activities of daily living to enhance their self sufficiency. Played a significant role in empowering individuals to embrace their quality of life, fostering positive growth and development.

Bachelor'S Degree, Health Information Management (Him), Bps

Health Information Technology Aas, Health Services/Allied Health/Health Sciences, General

Master Of Business Administration - Mba