Eleanor A. Tyler, CPC
Mattapan,MA
Summary
Precision-driven Medical Coder known for maintaining high productivity and efficiently completing coding tasks. Possess specialized skills in ICD-10-CM, CPT coding, and medical terminology comprehension. Excel in analytical problem-solving, time management, and adaptability, ensuring accurate and timely submission of medical claims in diverse healthcare settings.
Overview
23
23
years of professional experience
1
1
Certification
Work History
Physician Medical Coder
Boston Medical Center
Boston, MA
04.2022 - Current
- Reviews patient medical records and abstracts medical data that identifies all diagnoses and procedures
- Codes and sequences diagnoses, procedures, complications and appropriate modifiers from medical record documentation using ICD-10-CM, CPT4/ HCPCS classification systems and following the Uniform Hospital Discharge Data Set (UHDDS)
- Adheres to Official Guidelines for Coding and Reporting, Coding Clinics and other regulatory guidelines as appropriate
- Consults with the CDCI team to request appropriate physician or medical staff to clarify medical record information
- Assigns grouper codes to each record according to patient type and financial class (DRG, ASC, APG, etc)
- Works closely with other coding staff to resolve coding related issues and denial management
- Maintains productivity standards set forth in departmental policies and procedures
- Maintains knowledge of coding and professional skills, including maintaining yearly coding credentials through attendance at in-service programs, conferences, workshops, and other educational programs
- Assists in training new personnel
- Utilizes hospital’s cultural values as the basis for making and facilitating hospital’s goals and mission
- Follows established hospital infection control and safety procedures
- Performs other duties as needed
Outpatient Emergency Department Facility Medical Coder
Omega Healthcare
06.2021 - 04.2024
- 3rd Party Work Assignment: Lawrence General Hospital
- Reviews medical records and assigns ICD-10-CM and CPT codes for facility outpatient emergency department medical records
- Abstracts/ verifies additional data from medical record to assure coding accuracy
- Knowledge of ICD-10-CM classification systems, encoder software, MS-DRG and APC assignment
- Ensures medical records are coded in an accurate and timely manner, according to hospital and official ICD-10-CM coding guidelines
- Skilled in assessment of facility level codes
- Maintains productivity standards set forth in departmental policies and procedures
- Maintains knowledge of coding and professional skills, including maintaining yearly coding credentials through attendance at in-service programs, conferences, workshops, and other educational programs
- Utilizes hospital’s cultural values as the basis for making and facilitating hospital’s goals and mission
- Follows established hospital infection control and safety procedures
- Performs other duties as needed
Outpatient ER & Oncology Medical Coder
Boston Medical Center
Boston, MA
03.2016 - 10.2021
- Emergency Room Facility coding for Level 1 Trauma Hospital
- Follows the Standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA) with adherence to official coding guidelines and departmental procedures
- Assign CPT4 Codes including Trauma Activation, Bedside US, Injection and Infusion and procedures for all specialty consults
- Review patient's medical record and abstract data that identifies all diagnoses and procedures
- Assist Lynx Medical System Calculator to assign facility E/M level
- Knowledgeable in clearing 3M edits with appropriate modifier assignment
- Epic, 3M, CRRM, SDK, GRID and Logician experience
- Consults with the CDCI team to request physician queries and documentation deficiencies
- Maintains accuracy and productivity standards set forth in Departmental Policies and Procedures
- Maintains knowledge of coding and professional skills including maintaining yearly coding credentials through attendance at in-service programs, conferences, and workshops
- Adapts well to changes in the work environment
- Utilizes hospital's cultural values as the basis for decision making and to facilitate the hospital's goals and mission
- Follows established hospital infection control and safety procedures
- Performs other duties as requested by management
Professional Trauma and Surgery Coder
Boston Medical Center
Boston, MA
07.2013 - 03.2016
- Trauma and Surgery Professional coding for Level 1 Trauma Hospital
- With the use of Patient Keeper assigned Evaluation /Management visit levels and trauma/ surgical CPT4 Codes such as Critical Care, wound debridement, tracheostomy, central lines, chest tubes and catheterizations
- Reviewed patient's medical record to abstract diagnoses and procedures
- Reviewed and resolved rejections/denials relating to Trauma Charges
- Educated Trauma physicians with CPT/ICD-9 updates as they occurred
- Ensured coding updates were implemented both at a division level and within the billing process
Professional Medical Coding Specialist
Massachusetts General Hospital
Boston, MA
05.2006 - 04.2011
- Reviewed online medical record systems to collect, analyze, assign and sequence codes for diagnoses, procedures, complications, and co-morbidities for each inpatient and/or outpatient case according to ICD-9 and/ or CPT coding classification system
- Obtained 95% accuracy
- Interacted with billing managers and other professional staff regarding coding documentation and other issues to assure correct coding
- Other responsibilities included: Coding for different specialties such as OB/GYN, Rehabilitation Medicine, Cardiology, Infectious Medicine and many more areas
- Corrected coding work file edits by accessing the TES and PCS system-based programs
- Coded and cleared all inpatient charges daily via the web-based Patient Keeper system
- Assisted other coders with problem-solving documentation and coding issues
Credentialing & Grand Rounds Coordinator
Boston Medical Center
Boston, MA
03.2005 - 05.2006
- Coordinated the appointment & reappointment credentialing process for all physicians, certified nurses, midwives and nurse practitioners within the OB/GYN department as well as affiliated hospitals
- Assured the physicians were active providers with the hospital's contracted managed care & health plans, & agencies
- Assured all physicians, nurse midwives & nurse practitioners maintained updated licenses such as DEA certification, ACLS
- Coordinated Grand Rounds programs, various department conferences & lunches
- Maintained monthly/yearly database and schedule of speakers & topics
- Coordinated all audiovisual needs for each speaker for Grand Rounds & Case Review
- Produced and maintained evaluation forms for required CME accreditation
Medical Billing & Coding Coordinator
Boston Medical Center
Boston, MA
01.2002 - 03.2005
- Liaison for secretaries and physicians within the practice regarding gathering and capturing charge information
- Assured that all charges & reports were transmitted and printed daily
- Gathered missing information to complete the processing of charges in a timely manner
- Obtained insurance eligibility for medical necessity
- Reviewed and communicated appropriate ICD-9 & CPT codes to physicians
- Performed billing reconciliation between the practice and billing service
- Trained and educated staff regarding billing updates
Education
Coding & Medical Terminology -
Roxbury Community College
Boston, MA12.2004
Associate Degree - Business Administration
Mount Ida College
Newton, MA05.1992
Skills
- CPC (AAPC Certified)
- Facility Medical Coding & Billing
- ICD-10
- 3M
- 3M 360
- Epic
- IDX
- Excel
- Word
Certification
CPC, 09/01/05, Present, AAPC, 01035060
Assessments
- Electronic Medical Records Knowledge, Highly Proficient, 08/01/19, https://share.indeedassessments.com/share_assignment/1geyvpjfrxpqflve
- Medical Terminology, Proficient, 08/01/19, https://share.indeedassessments.com/share_assignment/gh-4iix0mzzfwge
- Medical Billing, Proficient, 09/01/19, https://share.indeedassessments.com/share_assignment/hojb16wyp1lw7p-o
Timeline
Physician Medical Coder
Boston Medical Center
04.2022 - Current
Outpatient Emergency Department Facility Medical Coder
Omega Healthcare
06.2021 - 04.2024
Outpatient ER & Oncology Medical Coder
Boston Medical Center
03.2016 - 10.2021
Professional Trauma and Surgery Coder
Boston Medical Center
07.2013 - 03.2016
Professional Medical Coding Specialist
Massachusetts General Hospital
05.2006 - 04.2011
Credentialing & Grand Rounds Coordinator
Boston Medical Center
03.2005 - 05.2006
Medical Billing & Coding Coordinator
Boston Medical Center
01.2002 - 03.2005
Coding & Medical Terminology -
Roxbury Community College
Associate Degree - Business Administration
Mount Ida College
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