Denise Applefeld
Myrtle Beach,SC
Summary
Professional with strong background in customer interactions and service solutions. Highly skilled in conflict resolution, communication, and problem-solving, ensuring customer satisfaction and loyalty. Effective team collaborator, adaptable to changing needs, and consistently focused on achieving results through efficient and empathetic service. Known for reliability and proactive approach to meeting customer and organizational goals.
Overview
39
39
years of professional experience
1
1
Certification
Work History
CODING COMPLIANCE AUDITOR
University of Maryland Medical Systems
11.2020 - 12.2023
- Company Overview: Health Information Management, Hunt Valley, MD
- Remotely reviewed inpatient medical records for complete and accurate coding as well as accurate APR-DRG assignment
- Reviewed records audited by outside vendor for accuracy, and issued any rebuttals for these audits as necessary
- Managed the outside auditing program that included keeping the calendar, making sure all audits were performed within the scheduled time, creating audit batches in 3M 360, and working with the vendor to reconcile any rebutted accounts
- Issued queries to clinicians as necessary while auditing records, to ensure complete, compliant documentation
- Entered audit information into a 3M 360 database
- Performed any focus audits as requested by management
- Health Information Management, Hunt Valley, MD
CLINICAL DOCUMENTATION SPECIALIST
University of Maryland Medical Systems
04.2020 - 11.2020
- Company Overview: Health Information Management, Hunt Valley, MD
- Reviewed inpatient Medical-Surgical records at St
- Joseph Medical Center for complete documentation
- Issued queried to clinicians as appropriate while reviewing records
- Coded and grouped each case reviewed using the 3M HDM system
- Entered all review information into a MIDAS database
- Worked with the inpatient coding staff to reconcile the APR assignment on all cases reviewed
- Reviewed cases for Patient Quality Indicators
- Reviewed cases to assign the appropriate Present on Admission (POA) indicators
- Issued clinical-based queries to support exclusions for MHAC cases as appropriate
- Met with the medical staff to discuss documentation issues as necessary
- Attended MHAC meetings as well as medical staff quality meetings
- Health Information Management, Hunt Valley, MD
MANAGER OF CODING AUDITS
University of Maryland Medical Systems
04.2019 - 04.2020
- Company Overview: Health Information Management, Hunt Valley, MD
- Organize all coding auditing functions across seven facilities within UMMS HIM Shared Services
- Standardize all auditing functions to ensure effective and efficient operations
- Manage all external audits to ensure compliance with coding guidelines and facility policies and to meet HSCRC data submission timelines
- Track and report monthly coding quality accuracy for all coding staff
- Collaborate with Coding Management on staff training and recommendations for coder Performance Improvement Plans
- Work with CDI staff to ensure compliance with all guidelines as well as to identify opportunities in documentation improvement
- Report monthly facility coding performance, coding trends, educational opportunities and action plans to Senior leadership
- Manage a staff of six remote auditors
- Health Information Management, Hunt Valley, MD
MANAGER OF CLINICAL DOCUMENTATION INTEGRITY
University of Maryland Medical Center Midtown Campus
01.2005 - 04.2019
- Company Overview: Baltimore, MD
- Implemented a hospital-wide Clinical Documentation Improvement (CDI) Program in January 2005
- Manage CDI program consisting of three RN Clinical Documentation Specialists (CDS)
- Conduct CDS staff chart audits for both APR-DRG assignment and documentation integrity
- Develop and present quarterly Grand Rounds educational sessions to the Residents and Hospitalist physician groups
- Developed a physician on-boarding program for CDI and, in conjunction with Credentialing, on-board all new medical staff members to the CDI Program
- In conjunction with the Quality Department, participate as a CDI representative in any HSCRC QBR initiatives including the MHAC program, the Readmission Reduction program, the PQI program and the Sepsis Workgroup
- Conduct educational sessions for the Coding and CDI staff on various coding and documentation topics and on any new HSCRC Coding or Quality based reimbursement initiatives
- Participate on various hospital and UMMS system committees as a Coding and/ or CDI representative
- Develop and present monthly CDI program metrics to HIM leadership, physician leadership and hospital leadership
- Developed and manage a physician documentation award program
- Work with various hospital departments, the President of the Medical Staff and the Physician Advisor to optimize electronic medical record documentation
- Baltimore, MD
CASE MIX MANAGER
University of Maryland Medical Center Midtown Campus
04.2004 - 01.2005
- Company Overview: Baltimore, MD
- Developed an internal coding auditing program
- Implemented the APR-DRG reimbursement system in July 2005
- Conducted ICD-9-CM coding audits for APR-DRG assignment
- Organized physician education sessions related to any documentation issues that were identified during auditing
- Conducted educational sessions for the coding staff on audit findings, pertinent coding/documentation topics and on any HSCRC initiatives
- Completed monthly Case Mix reporting for HIM leadership as well as hospital administration
- Baltimore, MD
DISTRICT MANAGER/ MANAGER, CONSULTING DIVISION/ SENIOR HIM CONSULTANT/ HIM CONSULTANT
SourceCorp / Lexicode/ Code-a Lex Corp
10.1985 - 04.2004
- Company Overview: Ballentine, SC
- Served as the District Manager for the Baltimore/Washington area, overseeing all client sites and functions as well as performing multiple marketing duties
- Performed nationwide coding and auditing at various client sites
- Compiled administrative reports and conducted post-audit education for hospital coding staff, registration staff, and scheduling staff
- Conducted post-audit exit conferences with all clients, including hospital leadership and administrative staff, to go over audit findings and follow-up plans
- Performed coding, auditing, and interim coding management at various client and outsourced client sites
- Conducted nationwide Federal compliance and investigative audits, in conjunction with several National accounting firms
- Ballentine, SC
MEDICAL RECORD CODER/ANALYST
Rex Hospital
12.1984 - 10.1985
- Company Overview: Raleigh, NC
- Assigned ICD-9-CM codes and CPT codes to inpatient and outpatient hospital records
- Assembled and analyzed inpatient discharges
- Raleigh, NC
Education
AA - MEDICAL RECORD TECHNOLOGY
Broome Community College
Binghamton, NYSkills
- Strong computer skills
- Client Relations
- Team Development
- Data Analytics
- Customer Service
- Problem-solving abilities
- Active Listening
- Critical Thinking
- Data Entry
- Customer Relations
Certification
- Registered Health Information Technician (RHIT), AHIMA
- Certified Coding Specialist (CCS), AHIMA
- Certified Clinical Documentation Specialist (CCDS), ACDIS
Credentials
- RHIT
- CCS
- CCDS
Professionalmemberships
- AHIMA, 1983
- MDHIMA, 2002, present
- ACDIS, 11/01/07, present
- MDACDIS, 2007, 2005, 2005-2008, 2008-2009
Timeline
CODING COMPLIANCE AUDITOR
University of Maryland Medical Systems
11.2020 - 12.2023
CLINICAL DOCUMENTATION SPECIALIST
University of Maryland Medical Systems
04.2020 - 11.2020
MANAGER OF CODING AUDITS
University of Maryland Medical Systems
04.2019 - 04.2020
MANAGER OF CLINICAL DOCUMENTATION INTEGRITY
University of Maryland Medical Center Midtown Campus
01.2005 - 04.2019
CASE MIX MANAGER
University of Maryland Medical Center Midtown Campus
04.2004 - 01.2005
DISTRICT MANAGER/ MANAGER, CONSULTING DIVISION/ SENIOR HIM CONSULTANT/ HIM CONSULTANT
SourceCorp / Lexicode/ Code-a Lex Corp
10.1985 - 04.2004
MEDICAL RECORD CODER/ANALYST
Rex Hospital
12.1984 - 10.1985
- Registered Health Information Technician (RHIT), AHIMA
- Certified Coding Specialist (CCS), AHIMA
- Certified Clinical Documentation Specialist (CCDS), ACDIS
AA - MEDICAL RECORD TECHNOLOGY
Broome Community College
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