Timothy Sak Email & Phone Number

Towson, Md

- Coordinates individual work activities with SIU Manager and Investigators, develops and presents findings and recommendations regarding the appropriateness of diagnosis and procedure codes submitted on provider service claims and supports over-payment recovery during a discussion with medical and behavioral health care providers- Coordinates coding and payment issues with other areas and departments as required- Provides detailed written review of audit findings to management, plan representatives and State Regulatory Agencies- Reviews medical records and independently codes, abstracts and analyzes inpatient and outpatient medical records using the most current International Classification of Diseases (ICD-9/ ICD-10), Current Procedural Terminology (CPT), Health Care Common Procedure Coding System (HCPCS), Universal Billing (UB) and other codes according to federal and state statutory, regulatory and contractual requirements, AMA guidelines, other regulatory agencies and generally accepted coding practice- Verifies and validates authorization of services, written clinical documentation of services received through physical health utilization management departments and information contained in the healthcare claims systems against claims, medical records and anomalies, abnormal billing patterns and other indicators (e.g., duplicate billing, services not rendered, up-coding, unbundling, etc.) of suspected fraud and abuse

Towson, Md

- Coordinates individual work activities with SIU Manager and Investigators, develops and presents findings and recommendations regarding the appropriateness of diagnosis and procedure codes submitted on provider service claims and supports over-payment recovery during discussion with medical and behavioral health care providers- Coordinates coding and payment issues with other areas and departments as required- Provides detailed written review of audit findings to management, plan representatives and State Regulatory Agencies- Reviews medical records and independently codes, abstracts and analyzes inpatient and outpatient medical records using the most current International Classification of Diseases (ICD-9/ ICD-10), Current Procedural Terminology (CPT), Health Care Common Procedure Coding System (HCPCS), Universal Billing (UB) and other codes according to federal and state statutory, regulatory and contractual requirements, AMA guidelines, other regulatory agencies and generally accepted coding practice- Verifies and validates authorization of services, written clinical documentation of services received through physical health utilization management departments and information contained in the health care claims systems against claims, medical records and anomalies, abnormal billing patters and other indicators (e.g., duplicate billing, services not rendered, up-coding, un-bundling, etc.) of suspected fraud and abuse

Towson, Md

- Certified Coder with CPT / HCPCS / ICD-9 / ICD-10 Coding Experience- Executed weekly coder meetings and training sessions via Webex and Join.me- Managed team of 17 Remote Coders and 2 Auditors for HCC and ICD10 coding of Outpatient and Inpatient medical records- Coded and audited Evaluation and Management charts- Coded hospital and multi-specialty charts for HCC risk adjustment and HEDIS measures- Data Abstractor for HEDIS reporting- Monitored employee productivity and quality standards arranging work-force accordingly to ensure goals for Medicare Risk Adjustment (MRA) are exceeded- Member of Coding Advisory Group which audited, reviewed and advised on complex, escalated ICD10 coding matters- Created and managed correct coding resources used by all coders in daily coding tasks- Maintained at least a 95% accuracy rating- Meeting production goals as outlined by management- Present Audit reports and Coder tracking reports to management- Onboarding and training of new Coders for ongoing projects

Savannah, Ga

Managed all aspects of multi-physician medical practice and office logistics from physician-employee-patient scheduling, billing/coding/auditing of medical records and charges, insurance and physician contracting with insurance companies-independent physician associations-hospitals, purchasing, marketing, payroll. Managed ancillary facilities as a telecommute position, and in a matrix office environment.• Certified Coder with 10+ years of CPT / HCPCS / ICD-9 / ICD-10 Coding Experience • Negotiated Reimbursement contracts for Physician practice, and ancillary facilities. • Maximize effective communication and leadership between project teams in the aspects of project life cycle, risk management, and course correction implementation • Managed team of 25 employees, and 5 remote coders for HCC and ICD10 coding of inpatient, outpatient, radiology, skilled nursing and hospice charts. • Coded and audited Evaluation and Management charts • Coded hospital and multi-specialty charts for HCC risk adjustment and HEDIS measures • Data Abstractor for HEDIS reporting and NCQA accreditation • Extensive experience with Revenue Cycle Management. • Project Management with Agile and Waterfall Models• Maintained Medical Group's accreditation in NCQA 2012 to current. • Advanced proficiency in Microsoft Office including Outlook, Power Point, Excel, Access, Visio, Publisher, InfoPath and Sharepoint. • Trained study staff on GCP guidelines, ICF Process, SAE reporting, eCRF completion and Protocol specific requirements • Managed Screening and Enrollment of potential study subjects • Maintained Site Master Files • Created SOP and Source documents for all clinical trials • eCRF and paper CRF completion according to Protocol • Study Drug dispensing and accountability • Managed Project and Center resources in a cross-matrixed office setting • Managed project timelines with staff • Managed multiple projects at any given time

Grand Rapids, Mi

Grand Rapids, Mi