Heather Villalpando
Spokane,WA
Summary
Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.
Overview
13
13
years of professional experience
Work History
BILLING COMPLIANCE SPECIALIST
Community Health Association of Spokane
05.2024 - Current
- Provides Compliance department with analytical support as part of compliance and monitoring activities, including drafting reports and presentations
- Supports Billing Compliance department with auditing and monitoring tasks related to Billing program compliance
- Assists with documentation collection, review, and quality assurance for department as needed
- Facilitates Corrective Action Plan process
- Monitors department help ticket system and completes tasks as assigned
- Managed staff work assignment
- Received and tracked all Adverse Safety Event claims and reconsiderations from providers
- Research coding concepts with vendors to create system flags for accurate coding
- Utilized electronic medical record systems for claims processing
- Implemented innovative coding strategies to enhance efficiency and accuracy in claims submissions, leading to reduced processing times and increased revenue.
CERTIFIED CODING SPECIALIST
Kaiser Permanente of WA
01.2012 - 05.2024
- Managed staff work assignments
- Received and tracked all Adverse Safety Event claims and reconsiderations from providers.
- Research coding concepts with vendors to create system flags for accurate coding.
- Utilized electronic medical record systems for claims processing.
- Implemented innovative coding strategies to enhance efficiency and accuracy in claims submissions, leading to reduced processing times and increased revenue.
- Conducted regular audits of coded records, identifying areas for improvement and providing constructive feedback to staff.
- Increased overall productivity by working closely with colleagues when faced with complex cases requiring input from multiple specialists within the organization.
- Reduced claim denials by maintaining up-to-date knowledge of insurance guidelines and coding regulations.
- Maintained strict adherence to HIPAA regulations while handling sensitive patient information during the coding process.
- Enhanced collaboration between departments by establishing clear communication channels for addressing coding discrepancies.
- Supported the implementation of new coding software by providing input on user experience and participating in testing phases to identify areas for improvement.
- Optimized workflow efficiency through cross-training in multiple specialties, enabling flexibility in task assignments according to team needs.
- Increased department efficiency through streamlining coding processes and providing regular feedback to team members.
- Resourcefully used various coding books, procedure manuals, and on-line encoders.
- Processed and tracked requests for medical records from external organizations.
Education
Associate of Applied Science - Medical Secretary
Spokane Community College
Spokane, WA01.2003
Skills
- Coding Strategies Development
- Claims Reports and Documentation
- Healthcare Compliance
- Claims Handling and Investigation/Analysis
- Critical Thinking
- Outlook
- Microsoft Teams
- EPIC
- CPC certification AAPC #01375723
- Internal Auditing
- Investigation techniques
- Operations Support
Timeline
BILLING COMPLIANCE SPECIALIST
Community Health Association of Spokane
05.2024 - Current
CERTIFIED CODING SPECIALIST
Kaiser Permanente of WA
01.2012 - 05.2024
Associate of Applied Science - Medical Secretary
Spokane Community College
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