Kayla Price
Falling Waters
Summary
Experienced professional in ICD-10 coding and medical documentation review. Proven ability to enhance workflow efficiency and ensure HIPAA compliance through meticulous attention to detail.
Overview
18
18
years of professional experience
1
1
Certification
Work History
Medical Documentation Reviewer
WellSky
03.2023 - 10.2025
- Reviewed and verified accuracy of medical documentation for compliance with regulatory standards.
- Collaborated with healthcare professionals to ensure clarity and completeness of patient records.
- Supported clinical decision-making by ensuring the availability of accurate and up-to-date patient information.
- Enhanced workflow efficiency through thorough analysis of medical records and identification of discrepancies.
- Strengthened interdepartmental communication through effective collaboration with physicians, nurses, and other healthcare professionals regarding patient record updates.
- Demonstrated exceptional attention to detail in the identification and correction of errors within patient records, ultimately contributing to improved care outcomes.
- Enhanced the accuracy of diagnostic coding by thoroughly reviewing physician notes and applying appropriate ICD-10 codes as needed.
- Facilitated timely insurance claims processing through diligent examination and validation of medical documents.
- Improved patient record accuracy by meticulously reviewing and updating medical documentation.
- Kept abreast of industry developments and regulatory requirements, applying this knowledge to ensure the highest standards of medical documentation review were upheld.
- Maintained confidentiality of all medical records and sensitive information to comply with HIPAA regulations.
- Reviewed charts and flagged incomplete or inaccurate information.
- Followed up with medical staff regarding missing information in patient records.
- Communicated effectively with staff, patients, and insurance companies by email and telephone.
- Researched and resolved medical record discrepancies.
- Reviewed OASIS assessments and recommended corrections to maintain greater than 95% accuracy.
- Led weekend team operations to resolve documentation backlogs and improve review turnaround time.
- Utilized multiple EMR systems and OASIS scrubbers to identify and correct documentation discrepancies.
Home Health Coder
Aviacode/Gebbs
10.2020 - 01.2023
- Analyzed medical records for coding accuracy and compliance with industry standards.
- Collaborated with healthcare professionals to resolve discrepancies in patient documentation.
- Utilized ICD-10 coding systems to ensure precise billing processes.
- Maintained high coding standards by adhering to industry best practices and staying current with emerging technologies.
- Resourcefully used various coding books, procedure manuals, and on-line encoders.
- Applied official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services to assign diagnostic codes.
- Reviewed patient charts to better understand health histories, diagnoses, and treatments.
- Delivered consistent results under pressure by prioritizing tasks effectively during periods of high workload or tight deadlines.
- Expedited project completion timelines with strong time management skills and adherence to deadlines.
- Interacted with physicians and other healthcare staff to ask questions regarding patient services.
- Verified signatures and checked medical charts for accuracy and completion.
- Monitored changes in coding regulations to provide recommendations for compliance.
- Reviewed outpatient records and interpreted documentation to identify diagnoses.
- Utilized active listening, interpersonal, and telephone etiquette skills when communicating with others.
- Used classification manuals to gain additional knowledge of disease and diagnoses processes.
- Utilized electronic medical record systems to store, retrieve and process patient data.
- Researched and resolved medical record discrepancies.
- Reviewed physician records and OASIS to ensure documentation met homebound criteria with 95%+ coding accuracy.
- Ran SHP OASIS Scrubber and resolved discrepancies to reduce documentation errors and claim denials.
- Coordinated with clinicians to clarify orders and updated 485/POC to improve care plan accuracy.
Homecare Coding Specialist
Home Health Solutions Group
03.2018 - 08.2018
- Reviewed medical records for accuracy, ensuring adherence to insurance guidelines and coding protocols.
- Managed high volumes of medical records efficiently while maintaining strict attention to detail during the coding process.
- Ensured accuracy in coding through regular audits, identifying discrepancies and areas for improvement.
- Reviewed outpatient records and interpreted documentation to identify diagnoses.
- Maintained strict confidentiality in accordance with HIPAA regulations, ensuring secure storage and handling of sensitive patient information.
- Optimized revenue cycle management by accurately assigning codes for diagnoses and procedures according to established guidelines.
- Maintained up-to-date knowledge on industry changes, attending training sessions and workshops regularly.
Remote Home Health Coding Specialist
Select Data
11.2014 - 03.2018
- Analyzed coding data to ensure compliance with healthcare regulations and standards.
- Reviewed patient records for completeness, ensuring proper codes were assigned for billing accuracy.
- Reviewed outpatient records and interpreted documentation to identify diagnoses and procedures.
- Validated OASIS and POC documentation to secure accurate billing for at least 22 assessment data elements per case.
- Ensured medical necessity and homebound criteria were met before coding to reduce claim denials and payment delays.
- Identified clinical documentation gaps and recommended targeted OASIS corrections.
- Fostered collaboration with clinical teams to gather comprehensive patient information, enhancing the accuracy of coding and improving patient care documentation.
Home Health Coding Specialist
Lutheran Home Care and Hospice
04.2008 - 09.2013
- Streamlined medical record review processes to improve coding accuracy and reduce claim denials by measurable results.
- Trained new staff on documentation and code selection, increasing coding consistency across the team.
- Maintained up-to-date OASIS knowledge and applied quarterly changes to ensure regulatory compliance.
- Coordinated plan of care and OASIS completion with clinical staff to ensure accurate physician-ready documentation before submission.
- Evaluated medical records to ensure coding accuracy, resulting in improved compliance and reduced claim denials.
- Streamlined training processes for new staff on coding guidelines, enhancing team efficiency and reducing onboarding time.
- Coordinated with clinical staff to finalize care plans and OASIS documentation, ensuring timely physician approvals and quality outcomes.
- Executed thorough chart audits, identifying discrepancies that led to marked improvements in documentation standards.
- Fostered a culture of continuous learning by sharing updates on OASIS changes, contributing to team adaptability and knowledge retention.
- Partnered with clinical teams to refine care plans, ensuring timely documentation that elevated overall patient care quality.
Education
Associate of Science - Medical Billing And Coding
Kaplan University
Hagerstown, MD07-2004
Skills
- HIPAA compliance
- ICD-10 coding
- Continuous learning attitude
- Medical terminology expertise
- Ethical conduct awareness
- Medical record auditing
- Healthcare regulatory compliance
- Clinical documentation proficiency
- Decision-making capacity
- Electronic health records management
- Quality assurance monitoring
- HIPAA regulations
- Written and verbal communication
- Patient confidentiality
- Staff education and training
- Meeting coordination
- ICD-9 coding experience
- Work well independently
- Time management
- Attention to detail
- Problem-solving abilities
- Multitasking Abilities
- Reliability
- Critical thinking
- Organizational skills
- Team collaboration
- Active listening
- Adaptability and flexibility
- Detail-oriented
- Troubleshooting abilities
- Microsoft Excel
- Computer proficiency
Accomplishments
Received recognition from Director that my coding was resulting in better reimbursement rates from Medicare and decreased denials which helped to have the resources available to fulfill their mission of caring for people.
Certification
HCS-D-Certified Home Care Coding Specialist-Diagnosis
Timeline
Medical Documentation Reviewer
WellSky
03.2023 - 10.2025
Home Health Coder
Aviacode/Gebbs
10.2020 - 01.2023
Homecare Coding Specialist
Home Health Solutions Group
03.2018 - 08.2018
Remote Home Health Coding Specialist
Select Data
11.2014 - 03.2018
Home Health Coding Specialist
Lutheran Home Care and Hospice
04.2008 - 09.2013
Associate of Science - Medical Billing And Coding
Kaplan University