Wayne Lyon Email & Phone Number

Los Angeles, CA, US

• Develop strategic direction & initiatives, operations planning, program development, talent management, vision, goals & objectives, KPI, and budget for inpatient & outpatient coding within a fully integrated.
• Overall management and oversight of acute-care IP & OP coding, abstracting, DNFB/DNFC management, KPIs, auditing & monitoring, QA, QI, claim denials/rejections activities, education, training, productivity &.
• Overall management of coding technology, workflow optimization, and use of common tools including encoders, groupers, and other systems related to coding & abstracting. Identification of new coding-related.
• Establish strong partnerships with internal and external stakeholders such as CDI, Risk, Quality, Compliance, Providers, Revenue Integrity, Patient Access, Case Management, IT, vendors, and other departments within the.
• Detail-oriented leader with project management & change management mindset; the ability to see the big picture and think strategically combined with a deep understanding of the day-to-day operations.
• Embodies ‘Servant Leadership’ and ‘Situational Leadership’ styles and is driven by mission and inspires all those around

Los Angeles, CA, US

• Responsible for the strategic direction of the Clinical Documentation & Coding Integrity (CDCI) mid-revenue-cycle department’s goals & objectives, OIG coding compliance, data analytics, key performance indicators.
• Ensure mission-critical collaboration between Coding & Clinical Documentation Integrity (CDI) departments Re: ICD-10, DRG, PSI, HAC, etc., mitigations & reconciliations.
• Ensure quality assurance regarding coding & abstraction compliance with federal/state coding & billing laws, rules, regulations, and guidelines—the AHA Coding Clinic, ICD-10CM/PCS Official Guidelines for Coding &.
• HIM Coding & CDI Department liaison/consultant to other departments across Keck Medical center of USC.

Torrance, CA, US

• Coding operations management, specific to ICD-9-CM, MS-DRG, CPT/HCPCS/APC coding of IP/AS/ED/OP accounts & visits for UB-04 claims processing & reporting purposes.
• Developed & administered coding P&P, workflow methodologies, and procedures to ensure daily operational compliance, productivity, & efficiency. Administered payroll, scheduling, hiring, orientation, training, annual.
• Coding compliance auditing & monitoring, and education & training in all aspects of ICD-9-CM, MS-DRG, APR-DRG, HACs, CPT/HCPCS, NCCI, & APC coding & abstraction compliance with federal/state coding & billing laws.
• Managed Clinical Documentation & Coding Integrity (CDCI) related CDI program—created CDI query forms, CDI workflows, CDI P&Ps, and operations protocols Re: chart reviews to identify diagnosis & procedure documentation.
• Assists with CDI program metrics, reports, and statistics, such as chart review/query/ response rates, MS-DRG financial impact mitigations, and case-mix-Index (CMI) analysis, etc.
• Project Management (PM) lead during the ‘Cerner Revenue Cycle Conversion Project’—specific to Cerner’s HIM software modules integration with Cerner’s billing system.

Dallas, Texas, US

• Directed HIM Dept.’s operations—performing the full range of paper-based medical record and electronic health information management functions, including Joint Commission (JC), CMS’ Condition of Participation (CoP), &.
• Coding operations management, specific to ICD-9-CM, MS-DRG, CPT/HCPCS/APC coding of IP/AS/ED/OP accounts & visits.
• Develops and administers coding P&P, workflow methodologies, and procedures to ensure daily operational compliance and efficiency. Administers payroll, scheduling, hiring, orientation, training, annual evaluations.
• Coding compliance auditing & monitoring, and education & training in all aspects of ICD-9-CM, MS-DRG, APR-DRG, HACs, CPT/HCPCS, NCCI, & APC coding & abstraction compliance with federal/state coding & billing laws.
• Reports & System Query Language (SQL): Designed, created, & generated detailed, statistical, clinical, & revenue cycle reports using the Siemens Medical System (SMS) Ad-Hoc Wizard Report Writer, and IBM Product Line.
• Data Management & Integrity: Directed California Code of Regulation semi-annual inpatient & quarterly outpatient OSHPD/MIRCal patient coding & demographic data abstraction, submissions, and corrections.

San Francisco, CA, US

• HIM coding & abstracting functions specific to ICD-9-CM & CPT/HCPCS coding of inpatient (IP), ambulatory surgery (AS), emergency department (ED), and outpatient (OP) ancillary encounters with respective DRG & APC.
• Clinical Documentation Improvement (CDI) functions managed under J.A. Thomas & Associates CDI program—by performing ‘concurrent coding’ of Medicare medical records to ascertain the ‘Working DRG’ to identify physician.
• Engaged Case Management staff to prepare and administer CDI query forms; assist with the education of physicians and Case Management staff regarding clinical documentation protocols to be compliant with federal/state.
• DRG auditor/validator—performed clinical data integrity/quality reviews on inpatient records to validate ICD-9-CM codes & DRG grouping appropriateness to assure compliance with federal compliance mandates and reporting.
• OSHPD & UB-92: Abstracted and validated patient-level administrative clinical and demographic data to satisfy federal UHDDS requirements and California OSHPD state mandates; ensured OSHPD data integrity and performed.

Randolph AFB, TX, US

• United States Air Force (USAF) enlisted active-duty sergeant served & supported in defense of the U.S. Constitution and the United States of America.
• Support Services for First Sergeant and squadron Commander: Orderly Room functions related to Squadron Strength Management; Security Clearance; Squadron Manning; Awards & Recognitions; Retention; Enlisted and Officer.
• Military Hospital & Clinic Administration: AFC 90650 Certified Medical Administrative Specialist—squadron orderly room functions and processes, aero-medical evacuation, and performed healthcare administrative functions.
• Military Hospital HIM Administrative Functions: Assembled, analyzed, consolidated, filed, and maintain military medical records. Reviewed, analyzed, screened/re-check medical record documentation to ensure completion.
• Military Hospital Clinical Coding Functions: ICD-9-CM and CPT/HCPCS coding of OP & IP medical and surgical records—abstracting data & ensuring USAF personnel & dependents healthcare patient-level administrative data.
• Military Hospital Patient Access Functions: Performs routine administrative functions related to admitting, scheduling, and other patient access; discharging functions; transferring of patients throughout the United.

Torrance, CA, US

• HIM coding & abstracting functions specific to ICD-9-CM & CPT/HCPCS coding of inpatient (IP), ambulatory surgery (AS), emergency department (ED), and outpatient (OP) ancillary encounters with respective DRG & APC.
• Retrospective physician CDI querying functions related to omitted, inadequate, vague, ambiguous, incomplete, incongruent, or unclear clinical documentation.
• OSHPD & UB-92: Abstracted and validated patient-level administrative clinical and demographic data to satisfy federal UHDDS requirements and California OSHPD state mandates; ensured OSHPD data integrity and performed.

Master'S Degree, Health Care Administration (Mha)

Bachelor Of Science (B.S.), Health Information Management (Him)

Associate Of Applied Science (A.A.S.), Health Information Technology (Hit)