Kaylisse Ruiz
Westfield,MA
Summary
Pursuing full-time role that presents professional challenges and leverages interpersonal skills, effective time management, and problem-solving expertise in the Business Intelligence healthcare field. Dedicated and detail-oriented Coding Analyst with a robust background in medical coding, billing, and data oversight. Proficient in ICD-10-CM, CPT coding, and various software applications such as Expanse, Meditech, RCx and Intergy. Skilled in conducting code analyses, resolving errors, and ensuring compliance with stringent regulations. Adapt easily with collaborating across departments, fostering seamless operations, and providing excellent skills to be a part of a successful healthcare organization. Willingness to learn and demonstrates a proven track record in developing tailored solutions and meticulous documentation. Organized and dependable candidate successful at managing multiple priorities with a positive attitude.
Overview
4
4
years of professional experience
1
1
Certification
Work History
Coding Analyst
Holyoke Medical Center/Holyoke Medical Group/Practice
05.2023 - Current
- Played an integral role in achieving a positive financial impact for the organization by identifying opportunities for revenue enhancement through strategic coding initiatives.
- Analyzes and resolves complex coding/patient issues and work towards implementing solutions accordingly.
- Collaborates with colleagues/higher management to ensure accuracy of software development efforts.
- Enhance overall efficiency through continuous process reevaluation, identifying areas of potential improvement within current systems.
- Conducted regular audits of medical records to identify areas for improvement within the organization''s coding practices.
- Creates detailed documentation for existing and new coding projects.
- Supported departmental goals by consistently meeting or exceeding performance metrics related to accuracy, productivity, and timeliness of completed work assignments.
- Participated in collaborative initiatives aimed at reducing claim denials due to improper coding practices or insufficient documentation.
Medical Coder Specialist
New England Orthopedic Surgeons
04.2022 - 05.2023
- Ran reports of different insurances to show A/R for each insurance
- Coded diagnoses and procedures from patient medical records using ICD-10-CM and CPT codes.
- Reviewed patient medical records for accuracy, completeness and compliance with coding regulations.
- Verified accuracy of procedure codes to ensure proper reimbursement levels.
- Researched discrepancies between documentation and billing information in order to resolve any issues prior to submission.
- Collaborates effectively with other departments while demonstrating comprehensive understanding of third-party knowledge and insurance company operational protocols to assess impact.
- Increased coding accuracy by diligently reviewing medical documentation and applying appropriate codes.
Patient Billing Specialist
New England Orthopedic Surgeons
11.2020 - 04.2022
- Supported revenue growth by accurately coding medical procedures for optimal reimbursement from insurance companies.
- Improved cash flow management with consistent follow-up on overdue invoices and establishing clear lines of communication with patients regarding their financial responsibilities.
- Maintained accurate records of all financial transactions related to patient billing. Investigated customer accounts and resolved discrepancies in billing information.
- Generated invoices, credit memos, and other documents required for patient billing.
- Provided supervision, mentorship, and training to employees and interns.
Education
Medical Coding & Billing Associate Degree - Medical Coding & Billing
Springfield Technical Community College
Springfield, MA09-2020
STCC Internship Program -
NEOS Worker’s Compensation
Springfield, MA11-2020
Skills
- Meditech/ Expanse software
- RCx software
- Revenue Cycle Management
- Data Entry
- Statistical modeling/ Run data reports
- HIPAA Compliance
- Workflow Management
- Knowledge CPT, ICD-10-CM
- Bill entry/ Payment Posting
- EHR/EMR Microsoft Office
- Appeals,Denials
- Intergy Software
- EMR/ EHR
- Microsoft Office
- Inpatient coding
- Documentation Oversight
- Data Security Procedures
- Coding Error Resolution
Certification
- CCA Certified- AHIMA
Timeline
Coding Analyst
Holyoke Medical Center/Holyoke Medical Group/Practice
05.2023 - Current
Medical Coder Specialist
New England Orthopedic Surgeons
04.2022 - 05.2023
Patient Billing Specialist
New England Orthopedic Surgeons
11.2020 - 04.2022
Medical Coding & Billing Associate Degree - Medical Coding & Billing
Springfield Technical Community College
STCC Internship Program -
NEOS Worker’s Compensation
- CCA Certified- AHIMA
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