Anita B. Dabney
Houston,TX
Summary
Certified Professional Medical Coder (CPC) with 8 years' of experience seeking further professional exposure and development that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills.
Overview
18
18
years of professional experience
1
1
Certification
Work History
Sr. Clinical Coding Specialist
The University of Texas MD Anderson Cancer Center
01.2017 - Current
- Applied official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services to assign diagnostic codes
- Organize and prioritize all work to ensure that records are coded in time frame that will be in line with department policies
- Participate in ongoing education, including in-service training to maintain and improve competence
- Assign appropriate modifiers, sequence and follow correct coding initiative guidelines, as indicated through Local Coverage Determination, as well as National
- Analyzes medical records to abstract clinical data by assigning codes from patient records in accordance with coding classification systems of ICD-10-CM and/or CPT
- Demonstrate ability to efficiently complete work assignments and have interaction with coding leadership team to review and discuss documentation and coding concerns
- Query physicians when code assignments are not straightforward or documentation is inadequate or unclear for coding purposes
- Responsible for resolving any coding denials and claim edits that are identified by billing department.
Charge Capture Specialist/Clinical Coding Specialist
The University of Texas MD Anderson Cancer Center
02.2015 - 01.2017
- Responsible for reviewing and processing of all technical charges and making charge corrections in CARE system regarding over and/or undercharges
- Review medical reports to make sure claim was submitted with proper CPT & ICD-9codes pertaining to patient's services.
- Review daily suspense and recirculating error reports generated daily and make appropriate adjustments to patient accounts
- Review outpatient surgery report for overlapping charges and move those charges to appropriate account
- Communicate regularly with clinical staff as questions arise regarding accuracy and compliance of charge entry; demonstrate good working relationship with various departments
- Verified accuracy of accounts payable payments, resulting in 98% reduction in payment errors and check reissues
Patient Access Specialist
The University of Texas MD Anderson Cancer Center
12.2006 - 02.2015
- Accountable for providing financial counseling options to patients including cost estimates, payment plans, discounts, and patient financial assistance; utilizing medical overrides and account reviews appropriate
- Consistently and accurately utilizes medical acceptance criteria to screen and schedule appointments for new patients to ensure optimal efficiency in clinic operations
- Review patient's medical reports and provide ICD-9, CPT and J codes for services being rendered and billed to secure authorization
- Use technical expertise to obtain insurance information, verify benefits and secure authorizations
- Use excellent oral communication and listening skills to communicate with patient, referral source, MDACC physician and MDACC clinical staff regarding obstacles to access or financial clearance
- Completely and accurately document communications with payers, patients, and treatment team.
- Collected and validated patient demographics and insurance information
Appeals and Grievance Coordinator
Heritage Health Systems/ Select Care of Texas, L.L.C
08.2005 - 12.2006
- Responsible for implementing, supporting and maintaining Appeals &Grievances department resolution of members problems in a timely, accurate, and courteous manner
- Review medical reports to make sure claim was submitted with proper CPT & ICD-9codes pertaining to patient's grievance
- Accurately address and resolve member appeals and grievance requests, in addition, research and present to Quality Improvement Compliance Committee (QICC) all appeal inquiries, and member service stats
- Perform state and federal reporting, as well as any internal ad hoc or routine reporting, trending and analysis of inquiries, and appeals and grievances
- Assist in development of quality improvement plans and policies and procedures to eliminate Medicare imposed corrective action plans
- Minimized substandard performance by reinforcing quality standards and eliminating practices that drive downstream complaints
- Performed audits and deep document reviews to verify compliance with applicable laws
Education
Some College (No Degree) -
North Harris Community College System
Houston, TXSkills
- 3M Encoder
- Epic
- E&M coding
- Professional coding
- Neurosurgery
- Dental Surgery
- Emergency care
- Abstract Coding
- NCCI Claim Edits
- Remote Coding
Certification
- CPC - Certified Professional Coder
Timeline
Sr. Clinical Coding Specialist
The University of Texas MD Anderson Cancer Center
01.2017 - Current
Charge Capture Specialist/Clinical Coding Specialist
The University of Texas MD Anderson Cancer Center
02.2015 - 01.2017
Patient Access Specialist
The University of Texas MD Anderson Cancer Center
12.2006 - 02.2015
Appeals and Grievance Coordinator
Heritage Health Systems/ Select Care of Texas, L.L.C
08.2005 - 12.2006
Some College (No Degree) -
North Harris Community College System