Iterm Njuguna
Plymouth,MN
Summary
Health Information Management professional with over 6 years of expertise in outpatient coding, revenue cycle, and population health.
Adept at reviewing medical records to ensure compliance with federal regulations and guidelines. Knowledgeable administrative professional with expertise in medical records management, coding and data entry. Proven ability to review and document clinical data, ensuring accuracy and compliance. Well-versed in ICD-10, CPT and HCPCS coding systems. Adept at collaborating with cross-functional teams to implement process improvements and optimize revenue cycle workflows. Skilled in identifying discrepancies and errors in medical records and resolving them. Proficient in analyzing and interpreting chargemaster data to identify trends and patterns and develop strategies to improve revenue cycle performance. Skilled in conducting audits and reviews of billing processes to ensure compliance with regulatory requirements. Possess excellent communication, analytical, and problem-solving skills: strong communication skills and ability to work collaboratively with physicians, nurses, and other healthcare professionals.
Overview
8
8
years of professional experience
1
1
Certification
Work History
Population Health Analyst
M Health Fairview
01.2023 - Current
- Develop dashboards and reports to track key performance indicators for population health initiatives.
- Analyze healthcare data to identify trends and patterns in patient outcomes.
- Collaborate with care teams and leadership to design analytic reports for quality reporting and population health outcomes using electronic medical record data, claims, and other data sources.
- Work with EPIC staff to find solution to EPIC application issues
- Research and reviews data for comparison, validation, and scope. Build EPIC radar dashboards for different departments.
- Performed regular quality and validation assessments on patient data to verify accuracy.
- Upheld HIPAA regulations and standards for protecting patient information.
- Skilled at working independently and collaboratively in a team environment.
Revenue Intergrity Analyst
Allina Health Services
01.2021 - 01.2023
- Contributed a detail-oriented approach when preparing special reports and accurately collecting and analyzing revenue and usage and charge capture trends as needed.
- Supported clinical areas and departments in charge capture and coding accuracy to ensure organization-wide uniformity of charges and coding for similar products and procedures.
- Worked with the coding department and clinical areas with year-end CPT updates from CMS by adding, deleting, and modifying charge codes to reduce denials from payors.
- Performed accurate data analysis with understanding of Revenue Cycle workflow, identified denials, researched trends and issues, and reported/ presented to the appropriate area to provide feedback and recommend solutions relating to coding, provider education, and payor resolution.
- Built a department dashboard to track SLA for department workqueue.
- Applying documentation guidelines, ICD-10-CM, CPT-4, and HCPCS classification systems and coding guidelines to analyze medical record documentation.
- Expert in reviewing assigned providers/specialty areas and preparing educational communication, supporting documentation, etc., for provider and other Team coding/billing inquiries.
- Responded to customer concerns and questions on daily basis.
Outpatient Coding Specialist
Allina Health Services
01.2016 - 12.2020
- Perform medical chart audits to ensure that codes assigned are appropriate and supported by documentation in the patient’s record with the appropriate CPT, HCPC, or ICD-10 code.
- Assign ICD-10-CM, CPT, and HCPCS codes to patient medical records in different outpatient specialties from observation, emergency room visits, labs, radiology, same-day surgeries, etc.
- Review patient charts and identify discrepancies in the medical documentation.
- Perform computer-assisted coding (CAC) using EHR systems.
- Ensures accurate record documentation to support correct code assignment, reimbursement, precise reporting of services rendered, and compliance with government regulations.
- Collects and abstracts data elements to identify and suggest areas of improvement in high compliance risk coding areas
- Maintains current coding guidelines and reimbursement reporting requirements as dictated by compliance and regulatory agencies.
- Maintained 97% accuracy when assigning ICD and CPT codes to patient records.
- Monitoring and working work queues/dashboards for assigned specialties, including coding, researching, correcting claims, and trending coding/billing behaviors.
Education
Master of Science - Health Information Management
The College of St. Scholastica
Duluth, MN04.2025
Bachelor of Science - Health Informatics And Information Management
The College of St. Scholastica
Duluth, MN10.2021
Associate of Applied Science - Health Information Technician
Rochester Community & Technical College
Rochester, MN12.2015
Skills
- Microsoft Office (Excel, Word, outlook, Teams and PowerPoint)
- Coding ICD-10- CM, HCPCS and CPT
- EPIC (electronic medical records), Computer Assisted Coding (CAC) and 3M software (HDM and Encoder)
- Ad-hoc reporting using BOE application
- Medical and anatomical Terminology
Data management
Detail-oriented
- Ability to work independently and collaboratively
- Decision making
- Problem solving
- SQL knowledge entry level
- Time management
Certification
Registered Health Information Technician (RHIT) 08/16/ 2016 - present
Timeline
Population Health Analyst
M Health Fairview
01.2023 - Current
Revenue Intergrity Analyst
Allina Health Services
01.2021 - 01.2023
Outpatient Coding Specialist
Allina Health Services
01.2016 - 12.2020
Master of Science - Health Information Management
The College of St. Scholastica
Bachelor of Science - Health Informatics And Information Management
The College of St. Scholastica
Associate of Applied Science - Health Information Technician
Rochester Community & Technical College