Crystal M. Boots
Statesville,NC
Summary
Experienced Certified Professional Coding Manager licensed by the American Academy of Professional Coders with several years of comprehensive healthcare revenue cycle knowledge and implementation including coding, auditing, billing, reimbursements and denials with automation software experience.
Overview
17
17
years of professional experience
Work History
Client Coding Manager
CorroHealth
04.2022 - Current
- Implement and manage coding and denial management operational processes and workflows, eliminating 30k chart backlog
- Develop and maintain client relationships by assessing needs and implementing processes valuable to the customers' revenue cycle goals
- Manage daily production and quality goals of coding & quality staff
- Manage pre-bill audits and feedback, identify coder training needs
- Automation software client support and troubleshooting
- Support Automation Engineering Team with client specific rule development
- Provide staff and client training for coding and reporting solutions
Client Coding Supervisor
CorroHealth
08.2019 - 04.2022
- Manage daily coding production and quality standards while maintaining service level agreement metrics and delivery expectations
- Monitor client reporting and communicate root cause of deliverable outliers
- Supervise coding staff, completing all necessary HR functions
- Assist direct reports with accurate application of diagnosis and procedure codes utilizing ICD-10- CM, ICD-10-PCS, CPT, and HCPCS and assist with proper interpretation of coding guidelines
- Implement and test system changes
Client Coding Team Lead
CorroHealth
09.2017 - 08.2019
- Audit facility and professional medical coding
- Conduct regular educational training meetings with coding staff
- Create and maintain production and quality reports for coders and auditors
- Create training documents and update daily coding guidelines
- Claim denial appeal submission, process workflow and root cause analysis
- Support management team in daily reporting and workflow management
Client Account Coder
CorroHealth
12.2014 - 08.2017
- CPT, HCPCS & ICD-10 Coding
- Maintain 95% or better coding accuracy on all charts
- Consistently exceeded production requirements
- Report documentation deficiency trends to management team
Independent Healthcare A/R Business Consultant
Piedmont HealthCare
06.2013 - 06.2013
- Review internal processes and controls for Business Services Departments for upcoming external audit
- Create and update departmental processes and controls
- Create Process Flow Maps for individual department functions
- Write and update formal policies and procedures for each department function
Business Services Supervisor
Piedmont HealthCare
10.2007 - 03.2013
- Supervised Accounts Receivable Management Department, overseeing payment entry, refund, denial management and contract/payment variance processes and staff for a multi-specialty, 130+ provider healthcare organization
- Achieved departmental goals and objectives by creating and implementing new processes and standards for all patient account related functions
- Trained employees to recognize coding and billing errors to reduce claim denial volumes and payor overpayment requests
- Reconciled all payments and refunds with monthly bank deposits
- Implemented routine communication devices informing staff of insurance billing and reimbursement policies
- Assisted physicians, clinical staff and patients with billing, coding, contract and payment related questions
- Decreased A/R days and reduced full time employees from 14 to 9 in Payment Entry Department by writing and implementing electronic remittance and banking solutions, creating lean operating procedures and claim edits
- CERT and RAC audit processing
Education
Some College (No Degree) - Advanced Medical Coding & Billing
Mitchell Community College
Statesville, NC01-2012
Skills
- Medical coding, auditing & billing: ICD-10, CPT, HCPCS
- Claim denial resolution & root cause analysis
- Managed care payment variance tracking & appeals
- Patient accounts receivables
- Electronic payment posting remittance implementation and rule refinement
- Medical coding automation rule development and refinement
- Employee training and development
- Workflow development and implementation
- Electronic medical record utilization
Timeline
Client Coding Manager
CorroHealth
04.2022 - Current
Client Coding Supervisor
CorroHealth
08.2019 - 04.2022
Client Coding Team Lead
CorroHealth
09.2017 - 08.2019
Client Account Coder
CorroHealth
12.2014 - 08.2017
Independent Healthcare A/R Business Consultant
Piedmont HealthCare
06.2013 - 06.2013
Business Services Supervisor
Piedmont HealthCare
10.2007 - 03.2013
Some College (No Degree) - Advanced Medical Coding & Billing
Mitchell Community College
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