Brandi Mack
Kansas City,USA
Summary
Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.
Overview
18
18
years of professional experience
1
1
Certification
Work History
CPC-Certified Professional Coder/CRC-Certified Risk Adjustment Coder
University of Kansas Hospital Auth.
01.2016 - Current
- Responsible for abstracting all E/M, CPT, HCPCS, ICD-10-CM, modifiers, units from the medical record documentation
- Reviews outpatient/inpatient EHR for appropriate documentation and signatures, and reviews interface charges prior to billing
- Reviews departmental reporting structures and requests modifications as needed, i.e
- Adding billing areas, providers, etc
- Monitors CPT, ICD-10, and HCPCS code changes
- Codes diagnosis for Primary Care/Medical/Non-Surgical accounts using ICD-10 nomenclature
- Codes physician's procedures for Primary Care/Medical/Non-Surgical accounts using CPT codes
- Interface charges are then released through the billing system
- Reviews coding by physicians and suggest possible modification of codes to maximize reimbursement
- Reviews reimbursement from third-party payers to ensure payment through proper use of codes
- Identifies and resolves potentially troublesome service/billing areas such as continuity of care, discharge summaries, admission history and physicals and consultations
- Maintains and processes claim edits to assure timely billing
- Works requests for additional information and correspondence from insurance companies
- Works to achieve minimum bill days from discharge/service date inpatient/outpatient account
- Communicates pertinent information on appropriate documentation to physicians and staff
- Maintains knowledge of requirements for appropriate charge generation
- Identifies and codes for all diagnoses documented supported within clinical documentation
- Captures unspecified diagnoses used and determine if documentation supports a more specific diagnosis
- Maintains a thorough understanding of anatomy and physiology, medical terminology, disease processes and surgical techniques through participation in continuing education programs to effectively apply ICD-10-CM and CPT coding guidelines to inpatient and outpatient diagnoses and procedures
- Manually entering charges for North Kansas City Hospital, ensuring healthcare providers meet specific documentation requirements that are essential in proper recordkeeping and claim reimbursement
- Proficient in computers applications-Epic, Cerner/PowerChart, IDX, Encoder Pro
Charge Entry/Medical Billing Rep
University of Kansas Hospital Auth. (KUPI)
03.2015 - 01.2016
- Demonstrated knowledge and ability to assign ICD-10 & CPT codes to the highest specificity ensuring that diagnostic codes and documentation accurately reflect and support the visit encounter
- Charge Entry-Manually entering in charges for North Kansas City Hospital
- Inpatient and Outpatient-E&M Coding/Charge Posting
- Reviews coding by physicians and suggest possible modification of codes to maximize reimbursement
- Reviews reimbursement from third-party payers to ensure payment through proper use of codes
- Compare account charges with documentation to ensure it is correct for final claim submission
- Ensures healthcare providers meet specific documentation requirements that are essential in proper recordkeeping and claim reimbursement
- Identifies and resolves potentially troublesome service/billing areas such as continuity of care, discharge summaries, admission history and physicals and consultations
- Works denied claims-Works requests for additional information and correspondence from insurance companies
- Proficient in computers applications-Epic, Cerner/PowerChart, IDX, Encoder Pro
- Manually entering in charges for North Kansas City Hospital, ensuring healthcare providers meet specific documentation requirements that are essential in proper recordkeeping and claim reimbursement
Patient Services Rep-Scheduling-North/South
University of Kansas Hospital
05.2007 - 03.2015
- Scheduling of activities, including patient appointments, Telehealth visits, surgeries, procedures and/or ancillary services using extensive knowledge of appointment types, locations, providers and specialties
- Responsible for registration of patient prior to visit and/or upon arrival, including entering demographics, insurance verification, scanning and document preparation, updating documentation and processing of referrals
- Collecting copays and point of service paperwork when working in front desk role
- Provides patient support for the MyChart EMR System
- Explains facility policies and ensures patient and/or relative understands and signs the consent and insurance forms at the appropriate time
- Responsible for check in/out and phone reception as needed
- Entering Lab Orders for Cancer/Hematology Patients, assuring the correct ICD-9 codes are correctly entered, to assure proper billing
Education
Associate in Art Degree -
Donnelly College
Kansas City, KS05.1996
Skills
- ICD-10-CM, CPT,HCPCS proficiency
- Clinical documentation review
- Healthcare reimbursement
- Teamwork and collaboration
- Data entry
- Claims processing
- Epic, Cerner, Encoder Pro/3M Encoder
Certification
- AAPC-Certified Professional Coder, CPC, 08/01/17
- AAPC-Certified Risk Adjustment Coder, CRC, 08/01/24
Timeline
CPC-Certified Professional Coder/CRC-Certified Risk Adjustment Coder
University of Kansas Hospital Auth.
01.2016 - Current
Charge Entry/Medical Billing Rep
University of Kansas Hospital Auth. (KUPI)
03.2015 - 01.2016
Patient Services Rep-Scheduling-North/South
University of Kansas Hospital
05.2007 - 03.2015
- AAPC-Certified Professional Coder, CPC, 08/01/17
- AAPC-Certified Risk Adjustment Coder, CRC, 08/01/24
Associate in Art Degree -
Donnelly College
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