Angela Hembrough
Springfield,IL
Summary
Detail-oriented Coding Quality Reviewer with a proven track record in ensuring coding accuracy and compliance. Expertise in medical terminology and electronic health records enhances productivity and quality. Many years of experience with inpatient coding and auditing with high quality percentages.
Overview
22
22
years of professional experience
1
1
Certification
Work History
Coding Quality Reviewer
HCA/Parallon
Nashville, TN
08.2022 - Current
- Conduct systematic pre-bill focus, random, and business quality assessments to ensure coding accuracy and compliance.
- Conduct thorough reviews of ICD-10-CM/PCS codes, ensuring alignment with official coding guidelines and ethical standards set by AHIMA.
- Identify trends in coding errors, provide detailed feedback to coders, and assist in developing educational materials to improve documentation and coding quality.
- Act as a coding resource for questions,resolve coding-related edits and assist in root cause analysis for quality issues.
- Maintain or exceed 95% accuracy and productivity.
Inpatient Coding Consultant
AQuity Solutions
Cary, NC
03.2009 - 08.2022
- Conducted thorough examinations of medical records to extract and code relevant diagnoses and procedures(ICD-9 CM ICD-10-CM/PCS), enhancing data integrity and reporting accuracy.
- Assigned appropriate DRG for optimal reimbursement and ensured accuracy in medical documentation, following AHIMA standards.
- Engaged with physicians to resolve ambiguities and conflicts in documentation, enhancing compliance and clarity.
- Conducted thorough daily chart reviews, successfully meeting 95% accuracy standards and optimizing productivity.
- Applied detailed knowledge of anatomy, physiology, surgical technology, and pharmacology to ensure precise and effective medical interventions.
Inpatient Coding Consultant
Kforce Inc
Tampa, FL
11.2007 - 03.2009
- Assigned diagnostic and procedural codes (ICD-9 CM) to inpatient charts of moderate to high complexity.
- Analyzed patient histories,examination findings, an treatment plans to extract relevant data.
- Determined the appropriate Medicare Severity-Diagnosis-Related Groups (MS-DRGs) or All Patient Refined-DRGs (APR-DRGs) to ensure accurate reimbursement.
- Communicated with physicians and CDI (Clinical Documentation Improvement) teams to clarify missing or ambiguous documentation.
- Adhered to AHIMA coding guidelines,CMS regulations, and HIPPA confidentiality policies.
- Worked within electronic health systems, encoder software, and computer-assisted software.
Coding Compliance Auditor
Memorial Medical Center
Springfield, IL
05.2004 - 11.2007
- Performed regular audits based on the compliance work plan to identify risks and ensure adherence to regulations.
- Researched and monitored compliance with federal and state regulations,including HIPPA and Medicare billing requirements.
- Prepared detailed written audit outlining findings, risks, and corrective recommendations for coding accuracy.
- Educated coders on compliance policies and preformed follow up audits to ensure corrective actions are implemented.
- Performed an audit under a CIA agreement for a critical access hospital in which scope was to review all prebill inpatient accounts. Review of my work was 100% accurate.
Education
No Degree - Health Information Management
Robert Morris University
Springfield, ILHigh School Diploma -
Riverton High School
Riverton High SchoolSkills
- Proficient in medical terminology and anatomy and physiology
- Experienced with Epic, Meditech Expanse, and Oracle EHR systems
- Proficient with encoders Solventum(formerly 3M), Trucode, and Optum
- Over 26 years of inpatient medical coding expertise
- Proficient in inpatient auditing for 7 years
- Experience in coding for various healthcare settings, including ambulatory, ER, and outpatient surgery
Certification
- AHIMA Certified Coding Specialist
- June 2002
- C14474
Timeline
Coding Quality Reviewer
HCA/Parallon
08.2022 - Current
Inpatient Coding Consultant
AQuity Solutions
03.2009 - 08.2022
Inpatient Coding Consultant
Kforce Inc
11.2007 - 03.2009
Coding Compliance Auditor
Memorial Medical Center
05.2004 - 11.2007
No Degree - Health Information Management
Robert Morris University
High School Diploma -
Riverton High School