Cally Ferguson
Saint Louis,MI
Summary
Coding Operations Lead and RHIT-certified specialist with extensive experience in medical coding and compliance. Focused on enhancing coding accuracy and operational efficiency through mentorship and quality audits. Strong analytical skills foster effective team leadership and continuous improvement in healthcare data management.
Overview
1
1
Certification
16
16
years of professional experience
Work History
Coding Operations Lead / Clinical Lead
Reveleer
09.2024 - Current
- Supervised daily operations of coding team to achieve productivity and quality benchmarks.
- Maintained 98% coding accuracy across all projects.
- Conducted compliance audits to verify adherence to coding guidelines and project requirements.
- Monitored team performance using IQA scores and production metrics to identify areas for improvement.
- Provided mentorship and education to coders, improving accuracy to 95% and overall efficiency.
- Led cross-functional teams in implementing process improvement initiatives.
- Streamlined operational workflows to enhance efficiency in healthcare data management.
Clinical Auditor
UnitedHealthcare
01.2024 - 09.2024
- Conducted detailed audits of medical records to validate coding accuracy and compliance.
- Prepared comprehensive reports summarizing audit findings and recommending actionable improvements to enhance compliance and coding accuracy.
- Monitored regulatory changes to ensure ongoing adherence to Medicare and Optum guidelines, minimizing compliance risks.
- Educated coding staff on guideline updates while identifying missed opportunities to improve coding practices.
- Interpreted outpatient documentation to assign precise diagnoses and procedures.
- Trained junior auditors on auditing standards and best practices for enhanced performance.
- Ensured timely completion of all assigned tasks within established deadlines.
- Maintained high standards for data integrity and accuracy in records.
Senior Medical Coder
UnitedHealthcare
08.2015 - 01.2024
- Assigned ICD-10-CM codes per official coding guidelines.
- Reviewed outpatient medical records to ensure accurate code assignment.
- Utilized EMR systems and coding tools, including 3M encoder, for efficiency.
- Identified coding discrepancies and recommended corrective actions.
- Maintained compliance with CMS and AMA standards throughout coding processes.
- Conducted audits of coded data to verify accuracy and compliance with established standards.
- Provided feedback on process improvements related to medical record documentation.
Provider Educator
MidMichigan Physicians Group
03.2010 - 08.2015
- Educated providers and staff on documentation and coding practices to ensure compliance and accuracy.
- Trained new coders in ICD-10 and CPT code usage, improving coding accuracy and reducing errors.
- Analyzed physician documentation for correct code assignments per guidelines.
- Conducted audits of coding practices, ensuring compliance with regulatory standards.
- Reviewed medical records to identify diagnoses, procedures, and services, facilitating accurate coding and reimbursement.
- Resolved coding discrepancies through effective communication with insurance companies.
- Supported optimization of medical records and improvements in workflow efficiency.
- Mentored coders and medical staff to foster professional growth and accuracy.
Education
Associate Degree - Health Information Technology
Herzing University
Wisconsin04-2011
Skills
- ICD-10-CM and CPT coding
- HCPCS coding
- Coding audits and compliance
- Quality assurance
- Record review
- Denial management
- Workflow optimization and reporting
- Data reporting tools utilization
- Coder training
- Productivity management of coders
- Project management and deadlines
- Process improvement
- Analytical problem-solving skills
- Cross-functional collaboration
- Leadership development
Certification
- Registered Health Information Technician (RHIT) 09/2013
Personal Information
Title: Coding Operations Lead | Clinical Auditor
Timeline
Coding Operations Lead / Clinical Lead
Reveleer
09.2024 - Current
Clinical Auditor
UnitedHealthcare
01.2024 - 09.2024
Senior Medical Coder
UnitedHealthcare
08.2015 - 01.2024
Provider Educator
MidMichigan Physicians Group
03.2010 - 08.2015
Associate Degree - Health Information Technology
Herzing University