Ebony Rivers
Melissa,Tx
Summary
Confident Clinical Documentation Specialist with expert team leadership, adept at driving enhancements in documentation by fostering collaborative relationships with healthcare providers. Analytical and detail-oriented, with a robust capability in EHR review and critical decision-making. Demonstrates a consistent track record of optimizing workflows and processes to increase efficiency and reduce costs.
Overview
15
15
years of professional experience
1
1
Certification
Work History
Clinical Documentation Specialist
John Peter Smith Hospital
01.2020 - Current
- Analyze the clinical status of patient, current treatment plan, and past medical history to identify potential gaps in clinical documentation.
- Proactively solicits clarification from physicians to ensure points of clarification have been recorded in the patient’s chart.
- Reconcile DRG mismatches with Inpatient coders and maintained >90% accuracy.
Remote Contract Inpatient Coder
JBK Consulting
09.2010 - Current
- Assign ICD 10 CM/PCS codes to inpatient charts after detailed review for various services including Surgery, Medicine, OB/Gyn, Orthopedics, Psychiatry etc
- Abide by ICD 10 Official Guidelines for Coding and Reporting
- Initiate physician queries for clinical and documentation clarification.
- Maximized reimbursement rates by expertly navigating complex payer requirements and accurately selecting the appropriate codes for each patient encounter.
- Collaborated closely with clinical documentation specialists to identify opportunities for improved documentation that would lead to more accurate coding outcomes.
- Maintained compliance with industry standards and regulatory guidelines through continuous education on updates to ICD-10-CM/PCS codes and Coding Clinic guidance.
- Contributed to revenue optimization through diligent assignment of appropriate diagnostic and procedural codes.
- Upheld ethical standards in all aspects of work responsibilities through strict adherence to AHIMA Code of Ethics and professional practice guidelines.
- Demonstrated expertise in various code sets including CPT, HCPCS Level II, ICD-10-CM/PCS codes while maintaining certification as an Inpatient Coder.
Clinical Documentation Manager
Mount Sinai Hospital
01.2018 - 01.2020
- Co-led the establishment and growth of a new Clinical Documentation department, collaborating closely with a cross-functional team to design and implement strategic initiatives that improved operational efficiency and compliance.
- Assist the Medical Director with provider engagement. Educate the practice manager and leadership on the CDI program.
- Accomplished multiple tasks within established timeframes.
- Managed and motivated employees to be productive and engaged in work.
- Maximized performance by monitoring daily activities and mentoring team members.
- Facilitates improvement in the overall quality, completeness, and accuracy of medical record documentation through concurrent auditing and evaluation of the medical records.
- Enhanced coding accuracy by implementing regular training sessions and performance evaluations for coding staff.
- Conducted internal audits of coded records to identify potential compliance issues or areas requiring additional training for coders.
- Streamlined workflow processes by identifying areas of improvement and implementing necessary changes.
Clinical Documentation Supervisor
Mount Sinai Hospital
06.2016 - 01.2018
- Oversaw daily operations of the department, ensuring smooth workflow and timely completion of tasks.
- Applied strong leadership talents and problem-solving skills to maintain team efficiency and organize workflows.
- Monitored workflow to improve employee time management and increase productivity.
- Managed and motivated employees to be productive and engaged in work.
- Accomplished multiple tasks within established timeframes.
- Reduced errors in medical coding by developing and maintaining a thorough understanding of current regulations, industry trends, and best practices.
- Resourcefully used various coding books, procedure manuals, and online encoders.
- Review ambulatory records for HCC opportunities.
- Proactively solicits clarification from physicians to ensure points of clarification have been recorded in the patient’s chart.
- Review and approve staff time off requests.
- Monitor workflow and provide staff education as needed.
Clinical Documentation Specialist I
Mount Sinai Hospital
08.2012 - 06.2016
- Facilitated interdisciplinary collaboration between physicians, nurses, case managers, coders, and other relevant stakeholders regarding the appropriate representation of patient severity levels within EHRs.
- Analyzed data from audits to identify areas for improvement in clinical documentation processes, implementing targeted interventions for positive change.
- Proactively solicits clarification from physicians to ensure points of clarification have been recorded in the patient’s chart
- Expedited accurate clinical documentation completion by promptly responding to queries from healthcare providers and support staff, offering timely guidance and support.
- Reduced risk exposure by promptly addressing any identified discrepancies or inconsistencies within patient records.
- Maintained strong knowledge of medical terminology, diseases and conditions and procedures.
Inpatient Coding Supervisor
St. Luke’s-Roosevelt Hospital
10.2009 - 07.2012
- Monitor workflow to ensure timely coding and completion of inpatient/outpatient discharges
- Review physician queries for validity before submission
- Provide educational in-service to coding staff relating to accuracy of coding, documentation, DRG assignment and physician query
- Assist with in-service of medical staff for documentation improvement/coding improvement
- Prepare statistical reports, physician profile reports
- Review/Validate record to ensure Major Co-morbidities (MCC), Co-morbid (CC), Severity of Illness (SOI) are captured and most appropriate DRG is assigned
- Respond to all patient accounts inquiries for coding/DRG related issues
- Respond to IPRO denial letters
- Abide by the ICD-9-CM Official Guideline for Coding and Reporting, utilize Coding Clinics and CPT Assistant resources.
Education
AAS - Health Information Technology
SUNY Alfred State College
Alfred, NY05.2024
Medical Assistant Certificate/Harlem Training Initiative - Medical Assisting
Touro College
New York, NY06.1996
High School Diploma -
A. Philip Randolph HS
New York06.1995
Skills
- 3M 360 Encoder
- 3M Reporter
- Epic
- Winstrat
- Eagle
- Prism
- IP-Smart
- Microsoft Office
- Microsoft Excel
- Documentation compliance
- Process Improvements
- Training and mentoring
References
Available upon request
Affiliations
- AHIMA
- National Society of Leadership and Success
Certification
Certified Coding Specialist (CCS)
Certified Clinical Documentation Specialist (CDIP)
Timeline
Clinical Documentation Specialist
John Peter Smith Hospital
01.2020 - Current
Clinical Documentation Manager
Mount Sinai Hospital
01.2018 - 01.2020
Clinical Documentation Supervisor
Mount Sinai Hospital
06.2016 - 01.2018
Clinical Documentation Specialist I
Mount Sinai Hospital
08.2012 - 06.2016
Remote Contract Inpatient Coder
JBK Consulting
09.2010 - Current
Inpatient Coding Supervisor
St. Luke’s-Roosevelt Hospital
10.2009 - 07.2012
AAS - Health Information Technology
SUNY Alfred State College
Medical Assistant Certificate/Harlem Training Initiative - Medical Assisting
Touro College
High School Diploma -
A. Philip Randolph HS
Certified Coding Specialist (CCS)
Certified Clinical Documentation Specialist (CDIP)
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