Agnes Rochelle Pouchie
Lake Charles,LA
Summary
A detailed-minded individual with a proven record of accomplishments in the areas of: training, consulting in business environments, accounting, customer relations, scheduling, staff supervision and general office operations. Strong organizational abilities combined with excellent interpersonal, communication and leadership skills that allow me to work effectively with other people at all levels. Knowledgeable Coding Manager with robust background in coding analysis and problem-solving. Proven success in streamlining code efficiency and contributing to significant project milestones. Demonstrated analytical skills and proficiency in programming languages to enhance team performance. Analytical professional prepared to excel in coding analysis with strong foundation in software development. Known for optimizing code and improving system functionality while collaborating effectively with team members. Reliable and adaptable, ensuring timely project delivery and continuous improvement.
Overview
16
16
years of professional experience
Work History
Coding Analyst/ Coding Manager
Conifer Health Solutions
01.2016 - 03.2023
- Trained new coders on site specifics and accessing client’s IT systems
- Oriented new coders
- Performed preliminary and routine audits on coding staff at each site managed
- Audits 100% of all new coder’s work on a pre-bill basis
- Sends audit results to appropriate personnel at client site and internally as required
- Developed site-specific procedures for each Medical Center based on policies and procedures received from the Medical Center, along with other information communicated verbally and/or via e-mail
- Communicated requests for new projects received from Medical Center to Account Executive and Assistant Director of Coding Services prior to starting
- Responded to questions from coding staff, with applicable references, as appropriate
- Identified coding risks and/or client issues/problems proactively and make appropriate recommendations to the Assistant Director of Coding Services and/or Account Executive
- Reviewed candidates submitted via MHIS Pass Sheet from recruiter
- Select qualified candidates and interview according to the Interview Process
- Completed weekly activity status report and submit by email to assigned email-Manager Activity Logs every Monday by 2 p.m
- Eastern Standard Time
- Actively participated in weekly remote coding update conference calls
- Demonstrated effective time management skills by completing assignments within time constraints, budget, and calendar schedules
- Communicates professionally and effectively with clients, coding staff, and Corporate staff
- Completed work assignments independently
- Kept current with new laws, regulations, and guidelines related to coding
- Seek guidance from the Assistant Director of Coding Services to complete any assigned task requiring further clarification
- Engaged in professional development activities to maintain professional certification(s)
- Performed other duties as assigned/necessary
- Support and provide coding and compliance training to physicians, clinical personnel, billing, and/or other client staff, establish effective communication with physicians, clinical staff, and help hospital staff to address documentation, coding and reimbursement issues
- Use knowledge of coding and compliance guidelines to identify potential billing/ reimbursement issues
- Participate in special audits and system administration as necessary
- Audit multi-specialty professional charges and assist with account denials
- Managed coders at each medical center, including communicating and resolving issues identified by the HIM staff
Profee Auditor (Gastroenterology, Otolaryngology, Urology, Ophthalmology, Orthopedic, Podiatry, and Neurology)/ Denial Analyst
Ochsner Health
01.2014 - 08.2016
- Analyze, evaluate, and review client medical records to ensure accuracy of code assignment
- Code professional fee charts as needed by the client
- Deliver expertise in professional fee coding
- Prepare daily coding logs, as requested by client
- Demonstrate proficiency in coding including both ICD-10 and CPT while maintaining a 95% accuracy or above
- Follow and adhere to AHIMA’s Standards of Ethical Coding, all applicable regulations and guidelines, and all client-specific policies
- Maintain productivity based on national standards and/or client-specific standards
- Work as a team player in a dynamic environment on multiple projects
- Other duties as assigned based on company needs and client projects
- Responsible for tracking/communicating commercial and governmental payer changes; and escalating payer rules for rule enforcement
- Worked with Operations leadership to proactively recommend opportunities for improvement in order to reduce denial risks
- Identified and investigated denials that were potentially due to coding compliance issues and trends; performed thorough and complete investigation, and reported/coordinated any significant findings to the Content Management Team for rule enforcement
- Contributed to the achievement of the Content Management Department goals and objectives as well as adhere to departmental policies, procedures, and performance
- Provided support to the Content Management Director to identify and manage projects requirements effectively
- In conjunction with Operation Management/Client Services/Professional Services, analyzed and identified reimbursement risks, billing guidelines compliance, assisted in the development of rules, strategies, and solutions to alleviate revenue loss due to commercial and government payer changes
- Research Payer and coding websites to stay up-to-date on coding issues, coding changes, and Payer Electronic Data Interchange change that affected clean claim submission and reimbursement
- Responsible for completion of projects or assignments as given, accurately and in a timely fashion
- Helped in understanding and interpreting payer guidelines and policies
- Independently documented denial and impact pertaining to denial analysis and strategies
Consultant/ Auditor
On Assignment
03.2012 - 06.2016
- Coded and abstracted medical data of outpatient medical records for acute care facilities to reduce backlog and increase incoming revenue through quicker turn-around time
- Worked remotely using the electronic patient file
- Used ICD-9-CM and CPT-4 coding classification systems utilizing 3M encoder to assign APC's
- Communicated with onsite staff and performed other assignments as required to maintain client retention and satisfaction
- Self-discipline and ability to work independently with little supervision is mandatory in this position
- Also audited outpatient records for accuracy and completed continuing education for coders
Adjunct Instructor
Sowela Technical Community College
01.2011 - 05.2012
- Position included hands-on training and lectures to students in medical insurance and coding to include teaching courses in medical insurance, medical law and ethics, medical billing, advanced medical coding, anatomy and physiology, and medical software training for adult students at post-secondary vocational school
Medical Coder II
Christus St. Elizabeth Hospital
04.2011 - 04.2012
- Used encoder, ICD-9-CM, CPT, HCPCS coding systems to accurately code diagnosis and procedures for all inpatients, outpatient surgery, observations, ER and other outpatient encounters
- An abstract designated data from the patients’ record and enters the information into the abstract data base and maintains 90% accuracy rate on ICD-9-CM CPT-4, and HCPCS coding
- Kept current on any changes regarding ICD-9-Cm, CPT 4 and HCPCS coding by attending workshops, in-services and reading materials provided
- Selected appropriate assignments for the coding/abstracting from work queue
- Contacted physician and/or ancillary departments when additional information is needed to accurately code the record
- Verified CPT-4 and HCPCS outpatient procedure codes/changes and work CRC report with the unbilled accounts and edits
Medical Coder II/Information Analyst/Coding Supervisor/Interim Director
West Calcasieu Cameron Hospital
03.2007 - 03.2012
- Uses encoder, ICD-9-CM, CPT, HCPCS coding systems to accurately code diagnosis and procedures for all inpatients, outpatient surgery, observations, ER and other outpatient encounters
- Abstracts designated data from the patient records and enter the information into the abstract data base and, maintains 90% accuracy rate on ICD-9-CM CPT-4, and HCPCS coding
- Kept current on any changes regarding ICD-9-Cm, CPT 4 and HCPCS coding by attending workshops, in-services and reading materials provided
- Selects appropriate assignments for the coding/abstracting from work queue
- Contact physician and/or ancillary departments when additional information is needed to accurately code the record
- Verify CPT-4 and HCPCS outpatient procedure codes/changes
- Work CRC report with the unbilled accounts and edits
- Educated staff on charge codes and unbundling
- Demonstrated physician liaison to the new medical record system, RAC Team preparedness, trained individuals on how to code
- Make sure all processes for the Electronic Record are running correctly
- Responds to walk in request for information, trains new employees, demonstrates a conscientious dress code, adhere to the confidentiality polices of the hospital
- Critic and maintain medical record system HPF
Education
Associates of Applied Science Degree - Health Information Technology
Lamar Institute of Technology
Beaumont, TX05.2006
Skills
- Medical Records Skills
- Maintaining Census
- Chart assembly
- Record Analysis
- Birth Certificates
- Admissions
- Medical Terminology
- Microcomputers App
- Physicians Liaison
- Filing
- Indexing and Registries
- Cancer Registry and Statistics
- Coding and Reimbursement Methodologies
- Technical Communication
- Anatomy and Physiology
- Quality Assessment and Performance Improvement
- Legal and Ethical Aspects of Healthcare
- McKesson
- Horizon Patient Folder
- AHIMA Ambassador for ICD 10cm/pcs Trainer
- Customer service
- Team leadership
- Time management
- Decision-making
- Verbal and written communication
- Complex Problem-solving
- Staff training and development
- Staff management
- Task delegation
- Goal setting
- Documentation and reporting
- Relationship building
- Strategic planning
- Operations management
- Project management
- Cross-functional teamwork
- Customer relationship management (CRM)
- Performance management
- Staff development
- Shift scheduling
- Policy implementation
- Conflict resolution
- Employee onboarding
- Coaching and mentoring
- Work prioritization
- Recruiting and interviewing
- Policy and procedure development
References
Available upon request
Credentials
- RHIT
- CCS
- CPC
- CPC-I
Timeline
Coding Analyst/ Coding Manager
Conifer Health Solutions
01.2016 - 03.2023
Profee Auditor (Gastroenterology, Otolaryngology, Urology, Ophthalmology, Orthopedic, Podiatry, and Neurology)/ Denial Analyst
Ochsner Health
01.2014 - 08.2016
Consultant/ Auditor
On Assignment
03.2012 - 06.2016
Medical Coder II
Christus St. Elizabeth Hospital
04.2011 - 04.2012
Adjunct Instructor
Sowela Technical Community College
01.2011 - 05.2012
Medical Coder II/Information Analyst/Coding Supervisor/Interim Director
West Calcasieu Cameron Hospital
03.2007 - 03.2012
Associates of Applied Science Degree - Health Information Technology
Lamar Institute of Technology
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