Vanessa Austin, Cpc, Crc Email & Phone Number

Killeen, Tx, Us

United States

*Identify annual chronic illness HCC opportunities for improving coding accuracy through chart auditing*Pre-Review / Post-Review and Concurrent Review of charts*Query provider to address documentation reassessment opportunities and to prompt higher accuracy and/or specificity*Review, analyze and code through clinical indicators, diagnostic test results, and the Doctors' clinical statements in patient charts*Validate missed coding opportunities *Ensure compliance with established coding guidelines, third party reimbursement policies, regulations and accreditation guidelines

Killeen/Temple, Texas Area

• Conduct daily 18-month look-back & prospective Risk Adjustment HCC/RxHCC reviews on all outpatient Providers and clinics for missed opportunities and suspect conditions requiring assessment within the current calendar year, tracking results via multiple Excel spreadsheets, and identifying trends and deficiencies on-demand. • Within the EHR, post Provider Notifications for suspect conditions found and/or automatic Problem List updates made for documentation-to-coding accuracy for compliance and claim integrity.• High volume utilization of multiple EHR platforms: Epic, 3M*Modal, Pulse8 to identify missed HCC capture opportunities • Research, independently, or as directed, complex coding HCC issues and keep abreast of coding and compliance changes through monthly continuing education opportunities.• Partner with the HealthPlan and Clinical Staff for special projects such as: Posting Care Coordination Notes (based on clinical markers) for Provider’s consideration of more accurate documentation. • Maintain team relationships for excellence in quality, productivity, time management and a healthy work environment.

Killeen/Temple, Texas Area

• Provide Hierarchical Condition Category (HCC / RxHCC) Risk Adjustment and/or complete code capture (CCC) coding services for a variety of national insurance agencies on both inpatient and outpatient records pursuant to contract specific guidelines and ICD-9 / ICD-10 guidelines and continual monitoring of coding clinic updates: *Medicare Risk Adjustment Coding (MRA) *Commercial Risk Adjustment Coding (CRA) *Complete Capture Coding (CCC)•Utilize the proprietary encoding (HIM) system with applicable contract guidelines, 3M Coding platform and Merck Professional Manuals to research coding clinics and capture codes with the highest integrity and efficiency, and submit completed charts for timely contract completion.•Perform quality assurance audits on both inpatient and outpatient records for contract guideline compliance on HCC RA coded records prior to submission to the client.•Attend daily, weeky and monthly CEU opportunities to continue advancing my education and skill level. **To date, I have coded over 3000 HCC/RxHCC charts in 2017 for BCBS (CCC), ArroHealth, Optum, Centauri, and MedXM (CCC) maintaining a 95% accuracy rate and exceeding productivity requirements. (09/01/2017)

Killeen/Temple, Texas Area

• Collected $1,250 in past due balances within 48-hours through direct Customer Service courtesy phone calls to the patients • Filed hundreds of timely corrected claims (HCFAs) with appropriate ICD-9/-10, CPT & HCPCS coding, linking, EHR extrapolated corrections & attachments from the EOB for TriCare, BCBS, Medicaid, Medicare, and various other medical insurance carriers.• Assisted in processing Secondary Insurance claims through verification of Primary Insurance payment via the ZirMed Clearinghouse Provider portal & mailing or faxing the claim with appropriate EOB in accordance with the insurance carrier’s specific rules• Assisted in filing Worker’s Compensation HCFAs with appropriate EHR Incident Report/Medical Records/X-Rays attached and filing pursuant to the carrier’s rules• Researched online, investigated through collaboration with experienced co-workers, and successfully discovered resolutions to historically denied reimbursement requests from TriCare, BCBS, Medicare, Medicaid and a plethora of national medical insurance carriers.• Created a Medical Insurance Billing Clerk’s Basics manual for training future interns• Trained incoming interns on Paradigm practice management software, EHR retrieval & review, insurance carrier communication & transmission procedures, and patient account reconciliation via EOB, EHR, ICD & CPT coding review. (Revenue Cycle)• Posted insurance payments, adjustments and patient responsibility amounts from a variety of EOBs and perfected the final balance sheet per insurance carrier.

Killeen/Temple, Texas Area

Completed Practical Career Coursework in:• Organizing, analyzing and technically evaluating health insurance claim forms• Properly coding diseases, surgeries, medical procedures & therapies to ensure proper billing• ICD-9/-10 & crossover coding; CPT & HCPCS coding• Medical Terminology; Anatomy and Physiology; Medical Office Procedures; Pharmacology• Medical Office Procedures• Practice Management and EHR Management software• HIPAA compliance• HITECH compliance

Harker Heights, Tx

• Greeted patients and visitors, responded to questions/concerns and directed them to appropriate location for services. Provided on-going communication with clinical staff regarding patient status.• Collected and entered into Paragon all necessary demographic, clinical, billing and insurance information from patients or responsible parties.• Explained processes and forms to patients prior to securing signatures and ensures that all documents are properly signed and witnessed as required. Determined and accepted required payments, including co-pays and deductibles. Verified eligibility/co-pays via TMHP, completed UB-04 data for inpatients. • Ensured medical necessity compliance by obtaining necessary data, reviewing compliance system, communicating information to patient or guarantor and obtaining necessary signatures. • Protected financial integrity of the facility by collecting patient liability, establishing payment arrangements, discussing payment options and screening for eligibility. Verified insurance eligibility and benefits and ensures all notifications and authorizations are completed within the required time frames.

Killeen, Tx

Financial◾Researched, negotiated and procured a 4-plex apartment building and a single-family home for investment purposes◾Maintained accurate records of all property transactions (i.e., rent rolls, delinquency reports, move-in/move-outs, etc.), escrow, invoicing, vendor & contractor payments.◾Prepared annual budgets and income projections ◾Ensured that all rents and late fees/check charges are collected, posted and deposited ◾Generated necessary legal action, documents and processes in accordance with State and local guidelines◾Provided constant vendor/contractor communications concerning scheduling, billing, vendor relations and certificates of insurance.◾Ensured that A/P invoices were paid timely, handled petty cash and all fundsLeasing◾Researched market competition for fair rents◾Continually monitored and analyzed budgets, renewal information, marketing data, etc., to remain current and competitive in the multi-family housing marketAdministrative◾Created all leases and corresponding paperwork for leasing in accordance with the Texas Apartment Association regulatory guidelines◾ Ensured proper response and handling of all on-site emergencies with staff, residents, buildings, etc. to minimize liabilities (i.e., criminal activity on community, employee/resident injuries, fires, floods, freezes, etc.).Personnel Management◾Ensured efficiency of staff through ongoing training, instruction, counseling and leadership.◾Planned weekly/daily staff schedules and assignments. ◾Coordinated maintenance schedule and assignments with Maintenance Director and vendorsMaintenance◾Maintained property appearance and ensured repairs were completed on timely basis through regular inspections◾Assured quality ready apartments◾Ensured that all service requests are recorded and communicated appropriately to maintenance.◾Ensured that unsafe conditions were corrected in a timely manner and in accordance with all local, State and Federal housing guidelines

Fort Hood, Texas

• Provided extensive case management, through database development, for the 6,400 homes of Fort Hood Family Housing by securing and coordinating multiple contractors to facilitate the initial installation, continuous maintenance and technological upgrades of 6400 electric meters and 12 data collector units over a mandated three-year phased installation timeline that substantially contributed to the case management standard operating procedures for all military bases nationwide. • Developed and presented multiple training power point presentations, newsletters, and educational outreach brochures for the residents, corporate overseers, and Department of the Army (DA) regarding implementation of the DA's utility conservation program that resulted in a 17% reduction in electricity consumption at Fort Hood Family Housing over a 3-year period. • Collected and compared comprehensive data, assessed data and formulated reporting of the data to all relative entities which resulted in the prioritization of education needs, resource outreach, and collaboration that led to the continued reduction in utility consumption. • Interpreted and applied annual comparison financial data for management of a $6M budget with a high priority objective of obtaining a 1% reduction annually that resulted in a 50% reduction in the annual utility budget in 6-years allowing for reallocation of budgeted funds to the design and construction division to enhance the quality of the existing homes and the building of more new homes on Fort Hood.

Fort Hood, Texas

• Created and facilitated multiple marketing, educational and interviewing events to secure the 200 volunteer families needed to participate in the various Technologically Connected Homes' research study groups over the 3-year program duration. • Case Managed 200 families, five technology corporations and three military entities to facilitate multiple research programs including collection of data to support the installation of outreach technology in military housing resulting in the contribution to improved telemedicine.• Developed policies and procedures pursuant to each of the five corporation's research requirements for the participants to follow generating the proper random, unbiased research results. • Organized coordination of delivery, distribution, technical maintenance and property control of 200 computers and wireless modems over a three year period resulting in 100% recovery of all equipment, which was then donated back to the military families residing in Fort Hood Family Housing. • Measured, clarified and analyzed focused data as requested by each of the research partners to enhance their product development, marketing and use by the military family which enhanced their living experience at Fort Hood Family Housing.

Fort Hood, Texas

• Provided routine administrative duties as Office Manager for the operations and business office of Fort Hood Family Housing, including editing, printing, binding and distribution of a 200-page Quarterly Report to 27 different share holders, partners and agencies. • Designed a monthly internal company progress awareness newsletter to include photography, graphics, literary content and structural design that advised the share holders of recent successes, achievements and how expectations were exceeded enhancing the share holder's support in the development of new and improved housing at Fort Hood. • Developed agendas and took minutes for weekly, bi-monthly and monthly meetings and maintained timeline tracking for tasks assigned to all participants facilitating prioritization and collaboration success. • Arranged travel, event planning and accommodations for various company personnel. • Organized data and hard copy files. • Maintained office supplies inventory, provided minor IT support.

Killeen, Tx

• Case managed the Family Law Division of more than 200 active files and four attorneys • Drafted all pleadings utilized in Family Law (Divorces, Modifications, Enforcements, Foreign Judgments, Discovery, Real Estate Transactions)• Prepared all pleadings and correspondence for processing through the local District and County Courts systems of five counties• Coordinated all hearings, depositions, mediations and appointments• Developed and processed client intake forms/case management forms for family law matters• Maintained the time and billing system (TIMESUPS / PRODOC SOS) for more than 500 accounts receivable• Maintained internal office accounting, accounts payable, trust accounts, accounts receivable, weekly payroll for attorneys and employees, prepared monthly, quarterly and annual general accounting and budgeting and tax preparation in tandem with the Texas Workforce Commission and Federal Corporate Tax regulations and guidelines• Coordinated all repairs, maintenance and development of the offices, surrounding grounds and a 5-telephone NORSTAR communication system• Assisted in the development of internal office procedural systems, guidelines, forms, and fees• Assisted in training paralegals and the attorney in office procedure, reception, time and billing management, file maintenance, paralegal duties, division organization and software program utilization• Independently developed company marketing for the internet and print ads • Performed all Human Resources functions, including interviewing, hiring, termination, salary and performance reviews, implementation of medical insurance programs and retirement programs for all employees' benefit.

Fort Leavenworth, Ks

• Managed a team of four flight operations personnel, six pilots and four fuel handlers in the daily operations of military fixed-wing air traffic• Maintained a flight schedule of two local aircraft and six pilots• Maintained all administrative records pertaining to U.S. Government policies regarding an aviation unit• Organized, created and performed training exercises for the airfield• Performed basic secretarial functions• Performed monthly update on Army C12 radar software (TRACOR)

Fort Lauderdale, Fl

• Drafted pleadings, correspondence; maintained client/case data • Filed, docketed and organized documents for more than 500 cases• Maintained the Personal Injury discovery calendar for 100+ active cases• Assisted the Discovery Paralegals in research and client contact• Performed basic secretarial duties for the Chief Paralegal

Hollywood, Fl

• Received and entered into the computer system the incoming patient’s information for admittance to the hospital• Negotiated receipt of required payment from patient• Processed medical insurance submission forms • Assisted with bed assignment procedures• Provided personal customer service with family members and patients to obtain required executed documents for successful admittance • Medical terminology and hospital procedure training completed annually• High volume interaction with Physicians and Nursing Staff regarding admissions diagnosis, bed assignment and billing