April Mitchell
UofL HEALTH Peace and South Hospital
Louisa,KY
1
Certification
20
years of professional experience
I currently hold my RHIT Certification. To further my career in information health technology and revenue cycle management.
Work History
HIM Operations Supervisor
1 Year 9 Months- Effectively managing all daily operations of the health information management department to ensure accuracy, compliance, and efficiency.
- Effective supervision and coordination of a medical records department require a structured approach to staffing, workflow management, documentation accuracy, and strict adherence to Joint Commission standards.
- Streamlined team operations to maintain high-quality data standards, ensure compliance with legal and regulatory requirements, and adapt workflow processes for enhanced productivity and accuracy.
- A working knowledge of CMS, Joint Commission, HIPAA/HITECH, and facility policies ensures safe, compliant, and high-quality care while protecting patient information.
- Educated healthcare providers, including physicians and nurse practitioners, on medical documentation standards and interoperability, aligning practices with current best practices and CMS/Medicare guidelines.
- Effectively responding to inquiries from staff, patients’ physicians, and internal or external customers requires clear communication, professionalism, and proactive problem-solving while fostering a positive customer service environment.
- Responded to inquiries from staff, physicians, and customers, utilizing clear communication and proactive problem-solving to foster a positive customer service environment.
- The task of preparing overseas schedules, approving work schedules, and reconciling timecards are key functions in payroll and workforce management, ensuring accurate employee compensation and compliance with labor regulations.
Denials Management
1 Year- Medical billing denials management is the process of investigating, analyzing, resolving, and preventing denied insurance claims for medical services provided by a physician.
- Developed appeal letters to effectively overturn denials related to coverage, authorization, non-covered services, contract issues, and timely filing limits.
- Develop appeal letters to substantiate overturning denial, i.e. coverage, authorization, non-covered services, contract issues, timely filing limits, etc.
- Submit reconsideration and appeals online and over the phone for reimbursement through vendor sites.
- Corrected billing claims to meet compliance standards and add modifiers in accordance with billing practices
- Tracks and trends progress and outcomes of denial and appeal processes and compiles reports for Revenue Cycle leadership. Find and point out trends and errors with billing.
- Tracks and trends progress and outcomes of denial and appeal processes and compile reports for Revenue Cycle leadership. Find and point out trends and errors with billing.
Claims Analyst
11 Years- Conducted audits of claims to detect discrepancies and ensure coding accuracy (upcoding, downcoding, unbundling).
- Identify duplicate claims or claims lacking documentation. Validate payer-specific compliance, ensuring claim submission meets contractual or regulatory standards.
- Investigate and resolve suspended claims, verify diagnosis codes are code correctly (ICD-10).
- Compiled and analyzed claims data to track trends and identify irregularities for improved claims processing.
- Interpret medical reports to apply appropriate ICD-10, CPT- and HCPCS codes to submit
- Communicated with hospital departments to resolve rejections and address unbillable charges.
- Added covering diagnosis to Medicare denials to support appeals. to Medicare denials local coverage denials, and National Coverage Denials.
Reimbursement specialist
5 Years 3 Months- Determining whether a medical claim is payable or if additional information is needed involves a structured assessment that integrates policy rules, provider contract terms, and legal/regulatory requirements. Below is a comprehensive framework.
- Effective claims project management involves creating a structured documentation system, using tracking tools to monitor progress, and establishing clear resolution workflows to ensure timely and accurate claim handling.
- Effectively overseeing advanced claim inquiries involves providing guidance, ensuring compliance, and supporting staff to resolve complex claims efficiently and accurately.
- Effective communication with clients or patients involves clear explanation, active listening, confirming understanding, addressing concerns, and referring to a specialist when necessary.
- Acting as a liaison between multiple departments requires strong communication, organizational, and problem-solving skills to ensure smooth collaboration and effective workflows.
- To address commercial insurance payment and contract issues effectively, a multi-step, systematic approach is recommended, combining verification, analytics, and proactive engagement.
Education
Associate of Science - Health Information Management
Associate of Applied Science - Health Information Management
Skills
Claims management
Data management
CMS regulatory rules
Medicaid guidelines
Claims edits
Epic-EHMR system/ Cerner EHMR
Scanning/imaging
Word
Excel
Database
Remote work experience
Workforce management
Team leadership
Quick learner
Problem solver
Experience
Remote work
Accomplishments
I have completed leadership academy and I have used this in my current role as leader.
Affiliations
AHIMA member
Certification
RHIT Certification, Completion of UofL Leadership Academy
Timeline
HIM Operations Supervisor
UofL HEALTH Peace and South Hospital
01.2025 - CurrentRead More
Denials Management
COMMONWEALTH PAIN AND ASSOCIATES
01.2024 - 01.2025Read More
Claims Analyst
BAPTIST HEALTHCARE SYSTEM
01.2013 - 01.2024Read More
Reimbursement specialist
Baptist Health Hospital
01.2007 - 04.2012Read More
RHIT Certification with AHIMA
Associate of Applied Science from Health Information Management
Read More
AAS HEALTH INFORMATION TECH JEFFERSON COUNTY TECHNICAL COLLEGE
Associate of Science from Health Information Management
Read More
Internship
- Signature Healthcare
- HIM department
- Erika Mahlbacher
- Supervisor
Personal Information
Title: HIM Operations Supervisor