Crystal Shaw
Milford,Maine
Overview
16
16
years of professional experience
Work History
Physician Coding Auditor/Educator
Southern Maine Health Care
02.2022 - Current
- Education and training of providers including new provider orientations to coding, on-going training on new policies/workflows, annual code updates/ changes, etc
- Provide ongoing coding education and training to clinical and support staff
- Review documentation, develop and maintain action plans to ensure accuracy and appropriateness of documentation
- Complete audits outlined in annual Corporate Compliance Plan
- Conduct patient chart audits for documentation compliance and coding accuracy; report findings to administration, physician staff and Coding Compliance Committee
- Follow up audits as necessary with Physician services coding education
- Research coding and/or compliance problems as needed
- Stay up to date and maintain a comprehensive knowledge of coding regulation by staying abreast of NGS (National Government Services), CMS (Centers of Medicare & Medicaid Services), and the OIG (Office of the Inspector General) coding releases, regulation, and decisions.
Physician Practice Coder II
Southern Maine Health Care
08.2021 - 02.2022
- Perform outpatient E/M coding as well as procedure coding for Cardiology and Women’s Health
- Responsible for auditing all aspects of coding for accuracy
- Both in ICD-10 as well as E/M and Procedures.
Health Information Coder I
Northern Light Health (Eastern Maine Medical Center)
02.2012 - 01.2021
- Perform outpatient surgical coding for Northern Light Health
- ICD-10 and CPT coding for Northeast Cardiology Clinic
- Proficient skills in the execution of facility coding, professional coding, outpatient coding, anesthesia coding, and E/M coding
- Wide coding variety including all of the above, plus ancillary, Imaging, and Series accounts
- Responsible for entering charges and charge reconciliation
- Advanced knowledge in medical terminology, anatomy and physiology
- Responsible in staying current with the most current coding guidelines.
Insurance Billing Specialist / Medical Coding
Pines Health Services
Caribou, Me
01.2010 - 01.2012
- Reviewed office charges to make sure all services were captured and correctly coded for a Multipractice facility
- Applied ICD-9 codes to all hospital admission and discharges
- Read all surgeries and did the CPT as well as ICD-9 coding for General Surgeons, Obstetrics, and Ophthalmology
- Responsible to stay current in Medicare, Maine care, and major insurance company’s guidelines to correctly code and bill to their specification
- Assisted in educating new providers in Evaluation and Management coding.
Licensed Cosmetologist
Studio Looks Salon
Presque Isle, ME
01.2008 - 01.2009
- Provided excellent customer service to assure each client was listened to and each visit left them feeling beautiful and confident
- Flawlessly sculpted and designed hairstyles at the client’s request.
Education
Medical Coding Certificate -
Northern Maine Community College
Presque Isle, MESkills
- Thoroughly enjoy working remotely as well as with others Able to work quickly and efficiently in a fast pace environment Extremely outgoing and eager to learn new things
References
References made available upon request
Timeline
Physician Coding Auditor/Educator
Southern Maine Health Care
02.2022 - Current
Physician Practice Coder II
Southern Maine Health Care
08.2021 - 02.2022
Health Information Coder I
Northern Light Health (Eastern Maine Medical Center)
02.2012 - 01.2021
Insurance Billing Specialist / Medical Coding
Pines Health Services
01.2010 - 01.2012
Licensed Cosmetologist
Studio Looks Salon
01.2008 - 01.2009
Medical Coding Certificate -
Northern Maine Community College
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