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Click here or scroll down to respond to this candidateCandidate's Name , CPCOrmond Beach, Fl Street Address
PHONE NUMBER AVAILABLEEMAIL AVAILABLEAttentive Medical Billing /Coding Hospitalist Coordinator with 18+ years of experience in medical billing, coding/auditing Risk Adjustment, reimbursements, and payments. Proven ability in handling legal medical record requirements and adept in efficiently managing complex billing and coding processes. Coding knowledge and experience with Outpatient Services, Ambulatory Services, selecting and verifying inpatient diagnosis codes for daily Hospitalist visits. Strong understanding of medical terminology, anatomy, and physiology. Charge entry experience.Professional ExperienceFlorida Health Care Plans, Inc Daytona Beach, FLMedical Billing/Hospitalist Coordinator March 2006- November 2023Audited office and hospital batches for accuracy by adhering to billing compliance guidelines, resulting in increased billing accuracy.Initiated batch corrections and resolutions by closely monitoring and addressing discrepancies, leading to a reduction in billing errors charge entries dailyCoded diagnoses to specificity by maintaining an updated monthly spreadsheet, enhancing accuracyFlorida Health Care Plans, Inc Daytona Beach, FLSpecial Projects Coordinator/Hospitalist Coordinator March 2006 - November 2023Collected hospital data, coded and processed payments and billed in real time.Support 4 full-time HCP Hospitalists by coding diagnoses numerically, improving billing efficiencyAudited dictations from FHCP hospitalists by identifying HCCs within 30 days of discharge, increasing accuracy for current and prior years to ascertain STAR status. Also billed HCCs found but not billed.Florida Health Care Plans, Inc Daytona Beach, FLProgram Management Medical Coder/Auditor/Analyst II April 2010 - December 2012Conducted audits and resolved risk adjustment suspect review issues by researching and managing documentation, improving Medicare STAR compliance.Conducted Physician office audits (off site) and kept physicians informed of coding guidelines.Reviewed physician documentation for unsubmitted HCCs by interacting with Physicians and staff.Demonstrated attention to detail abilities by auditing Medicare PEs for coding guidelines compliance and maintaining proper documentation.Florida Health Care Plans, Inc Daytona Beach, FLPhysician Office Medical Coder and Biller March 2006 - March 2009Supported operations for a facility with 6 primary care and 2 pain management physicians by auditing and coding office encounters/procedures (helped with Orthopedic, Ophthalmology, and Endocrinology coding.Documented and billed hospital and nursing home encounters by confirming completeness, improving billing turnaround and maintaining accurate documentation.Collaborated with physicians by performing real-time coding during patient visits, enhancing accuracy, and ensuring comprehensive documentationAdditional ExperienceBay Medical Center APC Coordinator (Ambulatory Payment Classification)*Audited from Hospital Charge Master for Emergency Room Daily charges.Verified charges, procedures and diagnosis codes.Identified incorrect E&M levels, queried physicians and sent to Coding Department correction.Technical SkillsAS400AllscriptsCitrixEpicElectronic Health Records (EHR) SystemsMicrosoft Office WordExcelEducation & CertificationsCertified Professional Coder (CPC)/ICD 10 in Medical Billing & Coding, AAPC #01049211 |
