Barbara Martinez
Coder/Revenue Cycle Compliance Auditor
Redlands,CA
Summary
Competent medical coder and revenue cycle auditor with eight years of inpatient experience in handling a wide variety of medical coding and compliance tasks. Sophisticated and hardworking individual with excellent analytical and multitasking abilities. Expertise in accurately inputting procedure and diagnosis codes into encoder software
Overview
8
8
years of professional experience
Work History
Revenue Cycle Auditor
Adventist Health
Roseville, CA
02.2022 - Current
- Collaborate with revenue-generating departments to ensure compliance.
- Perform quality risk-based reviews on inpatient, outpatient and professional fee coding and provides documentation of recommended code changes.
- Audit to facilitate clean claims using current International Classification of Diseases (ICD), and coding or billing accuracy in accordance with federal, state guidelines and appropriate credible resources.
- Create clear and accurate audit findings and recommendations in written audit reports that will be used for creating, advising and educating coders.
- Communicate clearly (verbally and in written reports or summaries) opportunities in regard to proper clinical documentation guidelines, service selection, charge capture and timely submission, healthcare data accuracy and coding principles.
- Stay current with AHA Official Coding and Reporting Guidelines, CMS and other agency directives for ICD-10-CM/PCS and PCS coding.
- Complete online education courses and attends mandatory coding workshops and/or seminars for inpatient, coding.
- Review AHA quarterly coding update publications.
- Use experience to read and understand compliance rules and regulations from federal, state, and local levels as they pertain to coding, billing and reimbursement.
- Use Microsoft Word and other software tools to create documents and other communications
- Improve operations through consistent hard work and dedication
- Use critical thinking to break down problems, evaluate solutions and make decisions
Senior Certified Coder
Adventist Health
Roseville, CA
11.2014 - 02.2022
- Review patient records to identify diagnosis and procedure codes performed during patient’s stay in accordance with coding conventions and guidelines.
- Regularly work with sensitive and confidential information, often involving interpretation of policies and procedures to guide use, abstract and assign diagnosis codes and procedure codes from patient records to provide information required for billing and reimbursement.
- Audit medical records to ensure proper coding is completed and to ensure compliance with federal and state regulatory agencies.
- Apply strategies to improve productivity, identify trends with tasks and provide feedback to leadership
- Identify and report possible HACs, or adverse events, to Quality Department and HIM
- Provide departmental or enterprise coverage when needed
- Follow coding guidelines and legal requirements to ensure compliance with federal and state regulatory bodies
- Collaborate to provide coding feedback and education to departmental leadership regarding completeness and accurateness of documentation and physician coding practices.
Education
Bachelor of Science - Health Information Management, In Progress
Western Governors University
Salt Lake City, UT12.2024
Associate of Arts - English
Crafton Hills College
Yucaipa, CA05.2021
Certificate - Medical Coding Specialist
Loma Linda University
Loma Linda, CA06.2014
Skills
- 3M Encoder
- Spinal Fusion
- ICD-10 (International Classification of Disease Systems)
- Medical Terminology
- Anatomy and Physiology
- Pharmacology
- Word Processing Software
- Coding Error Resolution
- Compliance Verification
Timeline
Revenue Cycle Auditor
Adventist Health
02.2022 - Current
Senior Certified Coder
Adventist Health
11.2014 - 02.2022
Bachelor of Science - Health Information Management, In Progress
Western Governors University
Associate of Arts - English
Crafton Hills College
Certificate - Medical Coding Specialist
Loma Linda University
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