Erica L. Murphy
Colchester,CT
Summary
Results-driven professional with a proven track record in delivering high-quality work and exceptional service. Renowned for excellent communication and teamwork skills, consistently contributing to the achievement of company goals. Demonstrates strong problem-solving capabilities and adaptability to new challenges, fostering valuable relationships with clients and colleagues alike. Committed to continuous learning and supporting team success through effective collaboration.
Overview
24
24
years of professional experience
1
1
Certification
Work History
Professional Revenue Auditor/Educator
Yale New Haven Health System
New Haven, CT
10.2021 - Current
- Supports planning, organizing, and completing revenue compliance audits.
- Identified lost revenue opportunities and overpayments caused by coding errors.
- Increased adherence to medical documentation standards through provider education.
- Conducts audit activities monitoring by government payors, auditors, and healthcare systems.
- Analyzing potential threats to ensure adherence with governmental and internal standards.
- Conducts thorough compliance audits in collaboration with YNHHS leadership.
- Recorded identified issues, corrective actions, and implemented improvements.
- Developed and enforced protocols for audit documentation, security, and retention.
- Coordinates sessions with appropriate leaders to review start of audits.
- Enhanced compliance by summarizing audit findings and suggesting improvements.
- Contributes to defining the audit scope.
- Compiles detailed final audit documents reviewed by key program stakeholders.
- Designs auditing policies for medical records ensuring compliance with documentation guidelines.
- Verify that services are documented and billed in compliance with regulations.
- Facilitated program development and presentation to staff for achieving educational goals in the Compliance Program.
- Collaborates in charge master evaluations and coordinates subsequent actions.
- Facilitates data retrieval supporting department heads in achieving compliance objectives.
- Worked closely with independent contractors for auditing purposes, ensuring completion of final reports.
- Monitored regulatory compliance impacting operations.
- Created extensive library of reference materials supporting federal coding and documentation compliance.
- Attends industry professional groups to remain informed about the latest developments and best practices in healthcare compliance.
- Collaborated with Internal Audit, Finance, and other departments to plan annual work schedules.
- Conducted tasks with professionalism, using independent judgment and maintaining ethical standards.
- Communicates effectively with employees of all ranks, maintaining impartiality.
Medical Coding – Medical Billing and Coding Instructor, Part-time Adjunct Instructor (Contractual)
Housatonic and Norwalk Community Colleges
Bridgeport, CT
10.2015 - 01.2022
- Developed curriculum for CPC certification preparatory program.
- Facilitated understanding of essential concepts in Medical Billing and Coding.
- Delivered comprehensive guidance on ICD-9-CM, ICD-10-CM, HCPCS codes and surgical CPT coding.
- Explained disease classifications, origins of conditions, regions impacted in the body, and level of severity.
- Delivered education on anatomy, physiology, and medical terminology.
- Reviewed process to accurately interpret physician's progress notes and operative notes for correct application of ICD-10-CM, HCPCS, CPT codes and Modifiers.
- Developed a state-of-the-art course framework for both campus-based and online students.
- Directed creation and deployment of curriculums for adult billing and coding education.
- Attended necessary meetings and educational sessions as required.
Interim Billing and Coding Manager (Contractual)
HumanEdge
New Haven, CT
06.2018 - 08.2020
- Oversaw hiring, training programs and performance assessments for the billing and coding team.
- Aligned Coding team productivity with the department's operational goals.
- Played a key role in the annual budget development process.
- Implemented targeted methods for boosting the consistency of documentation and efficiency in financial outcomes.
- Spearheaded and implemented coding process enhancement initiatives across departments and institution.
- Maintained efficient appeal processes supported by robust clinical documentation.
- Partnered closely with healthcare team members to deliver data and develop solutions.
- Informed and educated coding staff on regulatory changes to ensure compliance.
- Ensured compliance with regulatory standards based on various reports and audits.
- Facilitated sessions to examine possible breaches of work regulations.
- Guided Coding team on necessary steps to achieve performance standards.
- Coordinate and supply essential knowledge-based resources for the Coding team to achieve quality and productivity benchmarks.
Senior Charge Capture Analyst/Coder
Yale New Haven Health System
Bridgeport, CT
05.2012 - 05.2018
- Focus on CPT extraction, charge entry, charge capture, reconciliation of charge entry processes
- Monitors work queues and ensure the completeness and timeliness of the charge entry and charge capture functions for Northeast Medical Group (NEMG)
- Find trends in charge-review and claim errors
- Work with NEMG Operations to reduce errors and denials to enhance revenue collections
- A resource for physicians and office coordinators to obtain information and clarification on correct and ethical billing standards, guidelines, and regulatory requirements
- Support NEMG Management in the preparation and coordination of the documents for the NEMG internal and external audits
- Facilitate the orientation and training of new staff
- Participate in seminars and in-services and maintain knowledge of medical billing, operations, and finance
- Assess workflows and make recommendations to improve processes
- MHS Project management
- Set-up and training of hospital physicians to use the electronic billing interface system (EPIC)
- Prepares, indexes and records charge ticket batches, and enters patient charges into billing system
- Ensures all patients’ demographic and financial information is correctly entered into the claims reporting system
- Process denied claims reports and provided necessary information or written appeals to ensure positive claim resolution
- Reviews physician documentation to accurately code and key inpatient and outpatient Primary Care, Pediatrics, Wound Care, Neurology, Podiatry, ENT, OB/GYN, Burn Care, Critical Care, and Surgical/Trauma
- Reviews physician assistants’ documentation to accurately code and key inpatient and outpatient Cardiology, Vascular, Thoracic, Orthopedic, Breast, Urology, and General Surgery
- Investigates and resolves claim billing issues with all insurance carriers to reconcile and close patient’s accounts as per requests from the Yale Central Billing Office
- Creation and management of databases to track patient revenue and provider credentialing
- Review of auditing requests to compile proper information requested for Auditing review
- Coordinates and assists various Central Billing Office staff in charge-entry review and modifications and/or corrections as needed
Application Specialist I, Scheduling & Bed Management
Yale New Haven Health System
Stratford, CT
12.2011 - 05.2012
- Coordinates system builds for physician schedules at hospital inpatient and outpatient visits.
- Oversees system construction to improve scheduling efficiency in private practices.
- Oversees the construction and organization of Televox patient call systems.
- Leads the integration of physical systems to facilitate hospital-private practice interaction.
- Directed the physical mapping of network printers across multiple medical facilities.
Billing/Charge Entry Analyst
Yale New Haven Health System
Bridgeport, CT
08.2009 - 12.2011
- Oversaw planning and execution of on- or off-site meetings between Physicians, Department, and Pharmacy vendors.
- Scheduled and organized patient appointments for inpatient, outpatient, and office procedures.
- Compiled necessary paperwork for both medical and pharmacy insurance pre-authorizations.
- Indexed and prepared charge ticket batches for recordkeeping.
- Ensured accurate input of all patient details into the claims management system.
- Reviewed and addressed denied claims by delivering requisite documentation for effective appeal outcomes.
- Evaluated and distributed all received correspondence to appropriate destinations.
- Developed a comprehensive training manual for Allscripts.
- Trained and coached personnel at Bridgeport Hospital and Northeast Medical Group on the new Allscripts billing system.
- Conducted training sessions for hospital physicians on the new electronic billing interface.
- Managed payment postings, reconciliations of adjustments, and refund processing.
- Evaluates and resolves disputes to reconcile patient accounts.
- Develop and maintain spreadsheets tracking patient revenue.
- Coordinates departmental activities for operational efficiency.
Pharmacy/Member CAG - Inquiry Resolution Unit Representative
United Healthcare, NE Division
Trumbull, CT
03.2005 - 03.2010
- Ensured Pharmacy Resolution Unit team met and exceeded established service standards.
- Analyzed issues, appeals, and ensured adjustment and processing of medical claims.
- Acted as liaison to address and resolve escalated member issues within the mandated DOI and UHC timeframes.
- Produced and refreshed significant online documents to aid Claims Processing.
Supervisor, Prospect Pro Tele-Marking Division, Administrative Assistant to Regional and Operations Manager
Omega Financial Group LLC
Orange, CT
03.2001 - 03.2005
- Managed routine employee supervision along with office functions.
- Maintained office facilities and records to meet HIPPA and SEC standards.
- Ensured proper use of and bi-weekly restocking for office supplies.
- Coordinated scheduling efforts to ensure adequate coverage.
- Oversaw employee records for annual evaluations.
- Ensured precise tracking of insurance applications, providing frequent updates.
- Ensured compliance with liability coverage for both in-state and out-of-state entities.
- Ensured seamless communication for coordination among clients, insurance brokers, and various insurer representatives.
Education
Bachelor’s Degree - Healthcare Administration
University of New Haven
05.2026
Bachelor’s Degree - History, Psychology
Southern Connecticut State University
12.2021
Associate degree - General Studies
Housatonic Community College
01.2018
Associate degree - Behavioral and Social Science: History Concentration
Housatonic Community College
01.2018
Skills
- Effective Team Management
- Leadership Skill Enhancement
- Excellent communication
- Engaged Listening Skills
- Data Analysis
- Collaborative Team Development
- Effective Time Management
- Customer Engagement
- Positive Interpersonal Skills
- Quality Assurance
- Informed Decision-Making
- Strong Multitasking Skills
- Effective Task Prioritization
- Operational Planning
- Skilled in Microsoft Office Applications
- Reliable Team Member
- Constructive Conflict Management
References
Will be provided upon request.
Certification
- Certified Professional Coder, American Academy of Professional Coders (AAPC)
- Certified Professional Compliance Officer, American Academy of Professional Coders (AAPC)
- Certified Professional Medical Auditor, American Academy of Professional Coders (AAPC)
- Certified in ICD-10 –CM, American Academy of Professional Coders (AAPC)
- Certified Medical Reimbursement Specialist, American Medical Billing Association (AMBA)
- Certified Medical Coding Specialist, American Medical Billing Association (AMBA)
- Notary Public, State of Connecticut, Office of Secretary of State, 07/01/12 - Present
- Insurance Producer, Life, Heath, Accident, and Annuities, State of Connecticut, Department of Insurance, 01/01/02 - 01/31/06
Publications
- Leukemia & Lymphoma Awareness, S. Tahir, AAPC Healthcare Business Monthly, 09/01/23
- Multiple Sclerosis Awareness, S. Tahir, AAPC Healthcare Business Monthly, 03/01/24
Timeline
Professional Revenue Auditor/Educator
Yale New Haven Health System
10.2021 - Current
Interim Billing and Coding Manager (Contractual)
HumanEdge
06.2018 - 08.2020
Medical Coding – Medical Billing and Coding Instructor, Part-time Adjunct Instructor (Contractual)
Housatonic and Norwalk Community Colleges
10.2015 - 01.2022
Senior Charge Capture Analyst/Coder
Yale New Haven Health System
05.2012 - 05.2018
Application Specialist I, Scheduling & Bed Management
Yale New Haven Health System
12.2011 - 05.2012
Billing/Charge Entry Analyst
Yale New Haven Health System
08.2009 - 12.2011
Pharmacy/Member CAG - Inquiry Resolution Unit Representative
United Healthcare, NE Division
03.2005 - 03.2010
Supervisor, Prospect Pro Tele-Marking Division, Administrative Assistant to Regional and Operations Manager
Omega Financial Group LLC
03.2001 - 03.2005
Bachelor’s Degree - Healthcare Administration
University of New Haven
Bachelor’s Degree - History, Psychology
Southern Connecticut State University
Associate degree - General Studies
Housatonic Community College
Associate degree - Behavioral and Social Science: History Concentration
Housatonic Community College
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