Summary
Overview
Work History
Education
Skills
Certification
Professionalorganizations
Softwaresystemsexperience
Timeline
Generic

Kelli Rain

Allen,TX

Summary

Experienced medical coder and auditor with a 20-year track record. Seeking part-time remote position in physician's office, hospital, or clinic. Extensive knowledge in Medical Coding, Auditing, Ethics and Confidentiality, Medical Terminology, Reimbursement, Coding Regulations, and Medicare Regulations. Committed to accurate and compliant coding practices and maintaining high standards of patient care.

Overview

25
25
years of professional experience
1
1
Certification

Work History

Coding Analyst, Sr

Texas Oncology
06.2018 - Current
  • Ensured charges complied with Medicare Research billing guidelines
  • Compared research charges with corresponding Research Billing Guides, Medicare Coverage Analysis, and protocol guidelines
  • Entered all research charges, including standard of care and non-standard of care
  • Coordination with multiple clinic sites to ensure research billing compliance
  • Tracked variances by clinic site, nurse, lab, radiation, and imaging.
  • Utilized active listening, interpersonal, and telephone etiquette skills when communicating with others.
  • Performed on-site coding audits to determine accuracy and compliance with coding guidelines.

Coding Auditor

HealthCare Express
06.2023 - 10.2024
  • Identified control gaps in processes, procedures and systems through in-depth research and assessment and suggested methods for improvement.
  • Interpreted state and federal laws, accepted auditing principles and procedures and program standards to audited materials and data to detect non-compliance and facilitate recommendations.
  • Followed established auditing processes to meet internal and regulatory requirements.
  • Analyzed data and findings to prepare reports detailing financial information.
  • Planned and executed follow-up audits at appropriate intervals.
  • Prepared working papers, reports and supporting documentation for audit findings.

Medical coder/auditor

Medical Practice Success/HealthCare Express
06.2010 - 06.2018
  • Audited physician documentation
  • Audited in-house and remote coders for accuracy
  • Provided feedback to both physicians and coders through reports and in-person meetings
  • Monitored E/M utilization monthly and provided feedback to Medical Director and Billing Supervisor
  • Supervised in-house and remote coders
  • Trained physicians in improving documentation
  • Attended conferences, webinars, and researched trends and updates in coding for revenue optimization and compliance with national regulatory guidelines
  • Coded multi-specialty charts, including evaluation and management codes
  • Utilized NCCI and MUE edits
  • Tracked physician queries and incomplete charts to ensure timely filing deadlines.

Billing Analyst

Wadley Regional Medical Center
06.2006 - 06.2010
  • Coded Emergency Department facility charges
  • Captured supply charges for Emergency Department
  • Coded IV infusion charges for observation patients.

Medical coder

E-Med Billing Solutions
09.1999 - 06.2006
  • Coded Emergency Physician charts for reimbursement
  • Tracked incomplete charts to ensure proper billing
  • Charged professional and facility charges for Emergency Department.

Education

Medical Terminology Certificate -

Texarkana College

General Studies - undefined

Texarkana College
05.2002

Skills

  • Critical thinking abilities
  • HIPAA Compliance
  • Verbal Communication
  • Regulatory guidelines
  • Knowledgeable in Athena IDX, eCW, GE Centricity
  • Workflow Management
  • E/M coding
  • Oncology coding
  • Office procedure coding

Certification

  • Certified Professional Coder (CPC), 08/01/11
  • Certified Professional Medical Auditor (CPMA), 09/01/15

Professionalorganizations

AAPC, 07/01/11, Present

Softwaresystemsexperience

  • GE Centricity
  • Athena IDX
  • Aria
  • EClinical Works
  • Practice Velocity
  • Docutap
  • WebPT


Timeline

Coding Auditor

HealthCare Express
06.2023 - 10.2024

Coding Analyst, Sr

Texas Oncology
06.2018 - Current

Medical coder/auditor

Medical Practice Success/HealthCare Express
06.2010 - 06.2018

Billing Analyst

Wadley Regional Medical Center
06.2006 - 06.2010

Medical coder

E-Med Billing Solutions
09.1999 - 06.2006

Medical Terminology Certificate -

Texarkana College

General Studies - undefined

Texarkana College
Kelli Rain