HEIDI KLEIMAN
Charlotte,NC
Summary
Seasoned Coding & Compliance Manager with 20 years of experience working collaboratively with top leaders and staff to optimize adherence to coding policies, procedures, standards and regulations. Well-versed in coding and billing operations, process improvements, with recommendations towards best practices. Certified Professional Coder (CPC) and Ambulatory Surgery Center Coder (CASCC).
Overview
13
13
years of professional experience
Work History
Manager Coding/ Sr. Compliance Analyst
WestMed Practice Partners/ Optum
05.2013 - Current
- Lead quality reporting and analysis based on continuous monitoring of denials and coding error trends for CPT, ICD-10 and modifiers, worked by the coding team
- Identify day-to-day operational priorities and work flow issues; to ensure that all goals and team metrics are met
- Conduct regular provider audits of CPT, ICD-10, and provide ongoing monitoring of documentation and coding
- Identified potential areas of compliance vulnerability and risk to develop and implement corrective action plans.
- Create focused educational programs on the results of the audits to providers and staff
- Review escalated claim denials and rejections pertaining to coding and medical necessity issues, and recommend corrective measures
- Coordinate with client's internal training department to create and present coding related training sessions when needed in the form of webinars, zoom meetings, and one-on-ones or job aids for providers, clinical staff and any ancillary staff
- Oversee team of coders focused on HCC chart review for the United Health Care MCAIP program, and have achieved the superior bonus rate for the client every year.
Practice Manager/ Infusion Coordinator
Joint & Muscle Medical Care and Research Institute / Ballantyne Rheumatology
09.2011 - 04.2013
- I was manager of a private Rheumatology practice with two locations. The practice had two physicians, a physical therapist, as well as a Research Institute
- I Recruited, hired and trained all staff, providing direct supervision, ongoing staff development and continuing education to employees. I was also responsible for the billing of insurance claims, collections and denials, and working A/R.
- My duties also included coordination of the infusion suites in regards to verifying patient's benefits for infusion drugs, obtaining prior authorizations, determining drug dosages, locating co-pay assistance for patients, determining where to obtain medication, and coordinating their deliveries.
- I had successfully implemented new collection polices which resulted in profit growth for the company, strategized marketing plans, and updated software and IT programs
- On the research side of the Company I was responsible for reviewing contracts and budgets, determining projected patient recruitment numbers and strategies thru our own database
- I have GCP training, and am familiar with reviewing study protocols, informed consent, and communicating with sponsors and IRBs.
Certified Coder/Billing Specialist
Presbyterian Physicians Group/ Mid Carolina Cardiology
07.2009 - 09.2011
- This position required coding of cardiology services, to include interventional procedures, diagnostic testing, electrophysiology, and peripheral vascular studies
- I had a case load of 20 physicians, which I managed all aspects of their billing and documentation
- Duties also included daily auditing and data entry of charges, obtaining and entering demographic information, correcting of claims, physician education, and assisting other departments in appealing claims denials and follow up.
- Consulted with physicians on documentation that was incomplete, inaccurate or required further diagnosis specification.
- Reviewed records and coding batches for accurate reporting and adherence to standards.
Education
Completed Course For Certified Medical Biller (CMB) -
AAPC
2021
Certified ICD-10 Instructor -
AAPC
2014
Certified ASC Coder (CASCC) -
AAPC
2014
Associates in Allied Health - Health Information Technology
Rasmussen College
Lake Elmo, MN2010
Certified Professional Coder (CPC) -
American Academy of Professional Coders
2000
Associate of Applied Arts - Communications
Bay De Noc Community College
Escanaba, MI1995
Diploma -
North Central Area Junior/Senior High School
Powers, MI1993
Skills
- Problem Resolution
- Risk Identification
- Proficient in CPT, ICD-10, HCPCS
- Attention to detail
- Employee Coaching and Motivation
- Managing Employee Relations
- Managing Multiple Tasks
- Technical Presentations
TECHNICAL SKILLS
- Mediformatics/ECIS
- Centricity Business/ GE
- Epic
- Athena
- Misys/ Tigyr
- Review Mate
- Soapware
- Intelicode
- Encoder Pro
Timeline
Manager Coding/ Sr. Compliance Analyst
WestMed Practice Partners/ Optum
05.2013 - Current
Practice Manager/ Infusion Coordinator
Joint & Muscle Medical Care and Research Institute / Ballantyne Rheumatology
09.2011 - 04.2013
Certified Coder/Billing Specialist
Presbyterian Physicians Group/ Mid Carolina Cardiology
07.2009 - 09.2011
Completed Course For Certified Medical Biller (CMB) -
AAPC
Certified ICD-10 Instructor -
AAPC
Certified ASC Coder (CASCC) -
AAPC
Associates in Allied Health - Health Information Technology
Rasmussen College
Certified Professional Coder (CPC) -
American Academy of Professional Coders
Associate of Applied Arts - Communications
Bay De Noc Community College
Diploma -
North Central Area Junior/Senior High School
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