OBJECTIVE: To obtain a position in a challenging field where my experience and ability will offer an opportunity for learning and growth.
Overview
15
15
years of professional experience
Work History
Senior Outpatient Auditor
Northwell Health
Long Island, NY
07.2022 - Current
Conduct monthly audits on outpatient coders to ensure accuracy of diagnoses and procedure codes assigned.
Provide educational support and guidance on the proper use of CPT and HCPCS codes as needed.
Built effective working relationships with internal departments by providing input on coding challenges faced by the organization.
Participate in meetings focused on developing best practices around outpatient coding processes.
Educate healthcare staff on coding standards and changes in coding guidelines.
Support external audits by providing coded data and documentation, as requested.
Perform preliminary audits for new hire coders throughout the Northwell Health system for various sites and multi-specialties as it relates to complex coding for Compliance and Reimbursement purposes for Pre-bill review and monthly post bill. Advise on the impact of coding decisions on reimbursement and compliance.
Auditor/Denial and Appeals Specialist- Ambulatory
Northwell Health- Centralized Coding
Lynbrook, NY
10.2015 - 07.2022
Provided instruction to internal ASU coding staff for errors encountered in ASU denials.
Re-trained/educated ASU coders remotely to ensure quality and understanding of coding guidelines for errors encountered in monthly audits, and respond to rebuttals from coders in a timely manner, providing additional education when necessary.
Analyzed ambulatory denials and fixed any coding errors to ensure accurate reimbursement.
Assigned CPT-4 codes to ASU downgrades and distributed work for Cardiac Downgrades Remote/Onsite Medical Records Coder.
Coded and abstracted ambulatory, endoscopy, and ER encounters as needed.
Outpatient Coding Specialist
Ochsner Health System
New Orleans, LA
02.2019 - 04.2021
Assigned appropriate ICD-10 codes based on diagnosis, procedures, services rendered and other information in the patient record.
Assigned appropriate facility and professional CPT codes for multiple specialties.
Assigned E/M levels for various professional specialties.
Educated providers on correct documentation requirements that support medical necessity criteria.
Tracked provider compliance with regulatory requirements through ongoing monitoring activities.
Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements.
Remote Ambulatory Coder
Lenox Hill- Northwell Health
New York, NY
09.2011 - 10.2015
Coded and abstracted Ambulatory and Endoscopy encounters, while maintaining 95% accuracy.
Assisted in coding Ambulatory encounters for Manhattan Eye and Ear Infirmary.
Completed 5-9 Ambulatory/Endo charts per hour.
Reviewed Ambulatory coding discrepancies for Lenox Hill and MEETH for Patient Accounts.
Queried Physicians for documentation accuracy to ensure compliance with coding guidelines.
Assisted in training new ASU coders to ensure quality and understanding of coding guidelines.
Remote Physician Coder
Brooklyn Family Multi-Practice
Brooklyn, NY
09.2011 - 09.2015
Assigned diagnostic and procedural codes in accordance with coding principles and established guidelines.
Analyzed provider documentation to assign or verify the appropriate Evaluation & Management (E&M) CPT code.
Verified and/or requested documentation to support compliance.
Monitored, researched and corrected claim denials within health plan requirements and documented any trends with which to follow-up.
Physician ER Coder
Continuum Health Partners, Inc
New York, NY
05.2010 - 09.2011
Emergency Room Coding for Physicians (Long Island College Hospital).
Engaged in selection of E/M codes and diagnosis codes for claims.
Assigned procedure codes according to CPT description and documentation.
Coded 150+ claims per day using ICD-9-CM and CPT-4 codes.
Assisted in coding for Kings Highway Hospital (Beth Israel).
Coder
The New York Eye & Ear Infirmary
New York, NY
09.2009 - 12.2010
Clinical and Ambulatory Coding for ENT and EYE Services for Hospital Reimbursement
Reimbursement research and compliance with federal and state regulations.
Usage of ICD-9, CM and CPT classification systems.
Analyzed and reviewed records for completeness.
Education
ICD 10 Certificate -
AAPC
12.2015
CPC Certification -
AAPC
12.2008
Certificate in Out Patient Coding -
Roxbury Institute
06.2008
Certificate in DRG Coding -
Roxbury Institute
09.2008
Skills
3M, 3M 360, Optum 360 Ecac, Epic, Invision, HDM, E-Abstract, Alpha Systems, Sunrise, Huron Healthcare, Health Matics, EM-STAT, Microsoft Excel, Microsoft Power Point, Microsoft Word, and allstandard office Equiptment
CPT, ICD-10, ICD-9, Quality, Production Coding, Coding Instruction, Research, Proficiency in General Surgery, ENT, Eye, GYN, Ortho, Plastics, Urology, Vascular, GI/Endo, Respitory, and Integumentary