Agnes Colella
Lake Zurich,IL
Summary
Dynamic Coding Compliance Auditor with extensive experience at Mount Sinai Hospital, recognized for identifying coding inaccuracies and enhancing charge capture opportunities. Proven expertise in CPT coding and effective communication, leading to significant financial recoveries and streamlined audit processes. A dedicated professional committed to improving compliance and operational efficiency in healthcare settings. Proactive and versatile professional with a dedication to quickly adapting to new challenges. Strong problem-solving abilities and a proven track record of fostering strong relationships with clients and team members. Focused on supporting team success and achieving positive results.
Overview
22
22
years of professional experience
1
1
Certification
Work History
CODING COMPLIANCE AUDITOR, COMPLIANCE & BUSINESS ETHICS
MOUNT SINAI HOSPITAL
Chicago, IL
12.2021 - 03.2025
- Perform audit and education for 300+ providers including residents and NPPs.
- Assisted on investigational audit
- Identify coding inaccuracies and charge capture opportunities.
- Create and publish monthly newsletter to highlight coding updates.
- Present monthly compliance audit report to SMG Coding and Compliance Committee.
PHYSICIAN CODING AUDITOR. REVENUE FINANCIAL DEPARTMENT
NORTHWEST COMMUNITY HEALTHCARE
Arlington Heights, IL
04.2015 - 07.2021
- Audited outside coders and recovered financial losses for high profile surgery group.
- Presented E/M usage with CMS E/M bell curve for different specialty providers.
- EPIC WQ review on documentation for high level services prior to submission.
- Assisted revenue cycle department whilst answering coding and billing questions and issue resolution.
- Performed annual/follow-up audit and education annually.
- Developed and provided annual CPT coding changes/updates.
Consultant Compliance Audit Manager, Compliance Department
CROWE HORWATH
Oak Brook, IL
07.2014 - 04.2015
- Developed a work plan to assess client needs from documentation and coding concerns.
- Completed audits for different hospital clients and provided meaningful audit findings.
- Facilitated and spearheaded documentation initiatives and education among client hospitals, physicians, APPs, and national healthcare provider teams.
Manager- Compliance Assessment and Monitoring
RUSH UNIVERSITY MEDICAL CENTER
CHICAGO, IL
11.2009 - 06.2014
- Retained a potential financial loss of $200,000+ on Medicaid audit stemming from outside consultants’ inaccurate review.
- Undertake and streamline coding/billing on specialty project (e.g., chemotherapy) for all hospitals and affiliates.
- Quality check of compliance analysts audit results on E/M levels and identify patterns and areas of concern to determine if education/ follow-up is needed and what correction action plan should be in place.
- Collaborate with the Assistant Director of Compliance on developing and executing the annual Corporate Compliance Assessment and Monitoring work plan and findings to the executive management teams.
- Analyze reports to determine audit samples.
Manager- Compliance Assessment and Monitoring- Hospital Corporate Compliance Audit
RUSH UNIVERSITY MEDICAL CENTER
CHICAGO, IL
05.2009 - 06.2014
- Liaison to CDM department on assistance for CPT/HCPCS/coding updates.
- Identified, assessed, and consulted on the Annual Compliance Hospital Audit Plan based on the OIG workplan.
- Performed Specialty Clinical Research Billing Audit project 50% ahead of schedule.
- Liaison to resolving coding billing denials, edits, and charge capture on CPT/HCPCS services.
Manager -Coding and Business Operations -Revenue Cycle Department
NORTHSHORE UNIVERSITY HEALTHCARE SYSTEM
Skokie, IL
10.2006 - 04.2008
- Partnered with Billing manager on resolving coding denials/discrepancy.
- Provide Education on Evaluation and Management (E&M), CPT/ICD/HCPCS) class to staff and providers.
- Teamed with CDM department on identifying coding updates for coding and billing and inform of charge capture opportunities.
Manager- Hospital Coding and Billing Compliance
NORTHSHORE UNIVERSITY HEALTHCARE SYSTEM
Skokie, IL
04.2006 - 10.2006
- Collaborated with Administrative VP of Coding Compliance with Coding and Billing issues from Hospital Service lines.
- Liaison for Hospital coding and billing staff.
- Assisted providers with educational materials. (e.g., templates coding references)
- Conducted coding training sessions for physicians, NPPs, and departmental and billing staff.
Senior Analyst- Physician Medical Group
NORTHSHORE UNIVERSITY HEALTHCARE SYSTEM
Skokie, IL
05.2003 - 04.2006
- Conducted retrospective and prospective audits for multi-specialties within the medical group to physicians, NPPs and residents (ICD-9, CPT, and E/M auditing) based on CMS guidelines.
- Kept up to date on all CMS, OIG and Compliance rules and regulations.
- Developed progress note templates for specialties.
- Led initiative to publish Coding Newsletter.
- Utilize CMS LCD to identify medical necessity on billing questions.
- Responsible for annual encounter review of all medical group departments.
- Presented E/M usage with CMS E/ M bell curve for different specialty providers.
Education
Bachelor of Science - Management Information Systems
National Louis University
Chicago, ILAssociate Degree - Registered Health Information Technician
Oakton Community College
Des Plaines, ILCertified Coding Specialist -
Oakton Community College
Des Plaines, ILSkills
- Electronic health records management
- MD auditing and coding
- EPIC and IDX proficiency
- Data management with 3M and Mosaic
- NextGen and Meditech expertise
- Clinical documentation improvement
- Encoder Pro and Optum 360 skills
- Template creation and report analysis
- Data visualization and pivot tables
- Lead EPIC experience
- Effective communication skills
- Problem-solving strategies
- Team collaboration
- Revenue Charge capture methods
- Audit and Education
Certification
- Certified Healthcare Data Analyst
- Certified 360 Data Analyst
- AHIMA –Approved ICD-10-CM/PCS Trainer
- Certified Coding Specialist (CCS)
- Registered Health Information Technician (RHIT)
Associations
- Member of American Health Information Management Association (AHIMA)
- Member of Illinois Health Information Management Association (ILHIMA)
- Member of Chicago Area Health Information Management Association (CAHIMA)
Timeline
CODING COMPLIANCE AUDITOR, COMPLIANCE & BUSINESS ETHICS
MOUNT SINAI HOSPITAL
12.2021 - 03.2025
PHYSICIAN CODING AUDITOR. REVENUE FINANCIAL DEPARTMENT
NORTHWEST COMMUNITY HEALTHCARE
04.2015 - 07.2021
Consultant Compliance Audit Manager, Compliance Department
CROWE HORWATH
07.2014 - 04.2015
Manager- Compliance Assessment and Monitoring
RUSH UNIVERSITY MEDICAL CENTER
11.2009 - 06.2014
Manager- Compliance Assessment and Monitoring- Hospital Corporate Compliance Audit
RUSH UNIVERSITY MEDICAL CENTER
05.2009 - 06.2014
Manager -Coding and Business Operations -Revenue Cycle Department
NORTHSHORE UNIVERSITY HEALTHCARE SYSTEM
10.2006 - 04.2008
Manager- Hospital Coding and Billing Compliance
NORTHSHORE UNIVERSITY HEALTHCARE SYSTEM
04.2006 - 10.2006
Senior Analyst- Physician Medical Group
NORTHSHORE UNIVERSITY HEALTHCARE SYSTEM
05.2003 - 04.2006
Bachelor of Science - Management Information Systems
National Louis University
Associate Degree - Registered Health Information Technician
Oakton Community College
Certified Coding Specialist -
Oakton Community College
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