Jill Keeler
Bartlesville,Ok
Summary
Detail-oriented Coding Compliance Supervisor with 25 years of experience managing teams and enhancing operational functions within the healthcare and insurance sectors. Recognized for exemplary relationship-building skills, fostering collaboration at all employment levels, and ensuring compliance with reimbursement policies. Proven track record in strategic planning and process management, significantly improving company revenue. Committed to maintaining integrity in all projects while delivering superior results.
Overview
27
27
years of professional experience
1
1
Certification
Work History
Coding Compliance Supervisor
Community Care
01.2022 - Current
- Serve as a clinical coding resource across the Community Care Health Network Division to support ongoing and future coding-related initiatives
- Adhere to all official coding rules and CMS guidelines for risk adjustment programs
- Ensure accuracy, completeness, specificity, and appropriateness of diagnosis information
- Monitoring of CPT, CMS, and other regulations and their impact on coding and other business functions
- For Risk Adjustment Validation Audits (RADV), conduct chart review of inpatient and outpatient medical records for Hierarchal Condition Category (HCC) coding
- Summarizes audit findings and recommendations for coding and/or documentation improvement
- Evaluate Medicare Wellness Visit documentation for accuracy and completeness in addressing gaps in care and expiring HCCs
- Present findings to providers on a regularly scheduled basis
- Evaluate/prioritize the results of new Medicare Advantage and Marketplace member self-reported health risk assessments for risk adjustment conditions that should be addressed
- Create analyses and summary reporting and coordinate with providers
- Engage with other Health Network Division Department leaders for opportunities to optimize clinical documentation at the point of care delivery
- Provide measurable, actionable solutions for best practices to improve documentation and coding accuracy
- Develop a feedback loop for provider queries and education
- This will involve collaborative work with owner and non-owner providers
- Analyze the in-home assessment program for opportunities to follow up on members who decline the assessment or do not schedule care
- Support work/data from the Benefits Interpretation Committee (BIC) and the quarterly coding review workgroup
- Support clinical coding needs of ASO (self-insured employers) marketing, claims and configuration departments, and preventative services list maintenance
- Work in collaboration with company fraud, waste, and abuse program on issues with specific providers or
Coding and Documentation Specialist
St. John Clinic
01.2017 - 01.2022
- Helped develop internal audit processes and education to help physicians achieve and maintain 80% accuracy in compliance and documentation
- Conduct and develop all staff and physician education
- Educate and develop education for the Complex Coding Staff
- Establish and maintain good working relationships with corporate compliance entities, such as Medicare, Community Care, Aetna, and multiple other insurance companies
- Maintain and stay educated on new and upcoming changes and rules to stay ahead of the curve
Night Instructor
Tri-County Tech
Bartlesville, USA
01.2001 - 01.2021
- Instructor for medical office coding, including CPT, ICD-9, and HCPCS coding
- Instructor for medical terminology
- Developed and grew the program from a 5-week course to a nine-month course with National Certification Testing
Staff Supervisor
St. John Clinic
01.2014 - 01.2017
- 3+ years of experience with SAP- PRA Ownership Module or other land system software
- 3+ years of experience with Business Objects or other Data Query and Reporting software
- Manage and oversee all work queues to ensure they are handled promptly
- Establish and make sure to maintain working relationships with Vendors and other work groups that we service
- Participated in serving on the team for an internal training program for finance associates
- Served as supervisor representative for the internal safety group
- Maintained and monitored Metrics on all my direct reports
Coding and Compliance Manager
Ceres Medical Practice Management/St. Johns Clinic
01.2004 - 01.2014
- Handle all the compliance for over providers in multi-specialty group practice
- Manage the coding department and oversee all inpatient and outpatient coding
- Conduct and develop all staff and physician education
- Responsible for all internal and external audits
- Establish and maintain good working relationships with corporate compliance entities, including Medicare, Community Care, Aetna, and multiple other insurance companies
- Played a key role in rolling out ICD-10 implementation
- Developed internal audit process and education to help physicians achieve and maintain 80% accuracy or above in compliance and documentation
Medical Assistant/Coder
Blue Stem Medical Clinic
Bartlesville, USA
01.1998 - 01.2002
- Handled all patient nursing issues
- Assisted Physician with procedures
- Handled all inpatient and Outpatient procedures, scheduling and billing
Education
Bachelor’s Degree - Business Administration, Emphasis in Healthcare Administration
Oklahoma Wesleyan University
Skills
- Training Facilitation
- Talent Acquisition
- Leadership Skills Development
- Professional Guidance Support
- Change Implementation
- Instructional Training Facilitation
- Workplace Relationship Management
- Organizational Growth Strategy
- Audits management
- Data evaluation
- Risk assessments
- Compliance initiatives
- Reimbursement strategies
- Denial resolution
- Insurance verification
- Revenue cycle management
- Claims management
- Billing and collections procedures
- Medical billing
- Medicare
- HIPAA compliance
- Provider relations
- HCPCS coding
- Documentation
Certification
- American Association of Medical Personnel (RMA), 1998
- American Academy of Professional Coders (CPC), 2000
- AAPC Instructor (CPC-I), 2010
- AAPC ICD-10 Certified Train the Trainer, 2013
- Alpha Sigma Lambda, 2012
- Medical Assistant/Phlebotomist, 12215
Timeline
Coding Compliance Supervisor
Community Care
01.2022 - Current
Coding and Documentation Specialist
St. John Clinic
01.2017 - 01.2022
Staff Supervisor
St. John Clinic
01.2014 - 01.2017
Coding and Compliance Manager
Ceres Medical Practice Management/St. Johns Clinic
01.2004 - 01.2014
Night Instructor
Tri-County Tech
01.2001 - 01.2021
Medical Assistant/Coder
Blue Stem Medical Clinic
01.1998 - 01.2002
- American Association of Medical Personnel (RMA), 1998
- American Academy of Professional Coders (CPC), 2000
- AAPC Instructor (CPC-I), 2010
- AAPC ICD-10 Certified Train the Trainer, 2013
- Alpha Sigma Lambda, 2012
- Medical Assistant/Phlebotomist, 12215
Bachelor’s Degree - Business Administration, Emphasis in Healthcare Administration
Oklahoma Wesleyan University
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