Summary
Overview
Work History
Education
Skills
Timeline
Generic

KISHA CARTER

Stone Mountain,GA

Summary

Coder with experience entering data by reviewing accounts and applying appropriate codes. Expert at organizing information, correctly applying codes and running reports. Top-ranked in team of 150 staff for coding accuracy rates.

Overview

16
16
years of professional experience

Work History

Coder

COMFORCE(contrator)
11.2023 - Current
  • Apply ICD-10-CM diagnosis codes to the highest level of specificity available
  • Accurately apply diagnosis and procedure codes utilizing ICD-10-CM, ICD-10-PCS, CPT, and HCPCS
  • Claim edit resolution
  • Align conduct with AHIMA's Standards of Ethical Coding and the Company’s Code of Ethics and Business
  • Multi-Specialty SDS, Ortho, Gastro, E/M, ENT, OB-GYN, Gen Surg, Ophthalmology, Urology, pain management, Diagnostic imaging Ultrasounds MRI, CT, pediatrics, podiatry, Male reproduction, Cosmetic Surgery (Crescent medical

Medical Coder

CORROHEALTH (Contract)
06.2023 - 11.2023
  • Codes surgical procedures typical of an ER and Trauma Level 1 setting
  • Apply ICD-10-CM diagnosis codes to the highest level of specificity available
  • Accurately apply diagnosis and procedure codes utilizing ICD-10-CM, ICD-10-PCS, CPT, and HCPCS
  • Charge entry, claim edit resolution
  • Interpret coding guidelines for accurate code assignment
  • Identify the importance of documentation on code assignment and the subsequent reimbursement impact
  • Align conduct with AHIMA's Standards of Ethical Coding and the Company’s Code of Ethics and Business
  • Multi-Specialty SDS, Ortho, Gastro, ENT, OB-GYN, Gastro, Gen Surg, E/M levels, Ophthalmology, Urology, pain management, Diagnostic imaging, Ultrasounds, pediatrics, podiatry, Male reproduction, Cosmetic Surgery

Analyzes, investigates, and resolves coding edits for services

KIWI-TEK
01.2021 - 03.2023
  • Multi-Specialty SDS, ED, E/M leveling, OBS and Facility claims

Lead Coder

ADDISON GROUP
01.2014 - 03.2023
  • Edited, Ancillary, OBS, SDS, Ttrauma, Burn, Ortho, Mom & baby, OB-GYN, Urology, Radiology, Pro-fee, OP Clinic
  • Abstracted medical record data for accurate coding of medical diagnosis and procedures
  • Claim edit correction
  • Utilized Epic and 3M Encoder, Meditech, Cerner, HPF software
  • Developed and implemented coding standards, guidelines and best practices.

Auditor/Coder/Edits

LEXICODE
01.2021 - 05.2022
  • Codes charts including Emergency Room, Ancillary, SDS, Observations, and Clinics
  • Resolves related coding issues in all phases: production, coding scrub, and coding denial resolution, NCCI, OCE, Medical Necessity LDC/NCD and diagnosis code rejections
  • Selects and assigns the appropriate ICD-10 CPT codes, based on chart review documentation of Pro-fee/facility encounters occurring in the ED, Observation, Clinic, , MRI, CT, Xrays, Coding of same day surgery claims
  • Claim edits and denial resolution
  • Efficient in systems including 3M360, Cerner, and Powerchart

Coding Auditor/Coder

MANAGED RESOURCES
11.2019 - 05.2020
  • Facility charts including Emergency Room and Same Day Surgeries, Ancillary services
  • Provided review and/or coding/auditing of any professional services including but not limited to surgeries, encounters, and diagnostic services for appropriate use of CPT, ICD-10, HCPCS, and Modifier usage/linkage as well as provide ICD-10 coding where needed for handwritten/missing diagnoses
  • Provided same for areas where work files are used
  • In areas where paper is used, reconcile daily charges against log (if available/applicable) to ensure daily capture of coding charges expected
  • Productivity and accuracy for work file and non-work file standards must be met according to guidelines set by manager
  • Reviewed and assisted in updates of coding dictionaries/encounter forms/charge slips as needed for accuracy of CPT, HCPCS and ICD-10 Coding
  • Efficient in systems including EPIC and 3M

Senior Surgical, ED, Ancillary, Multi- Specialty Auditor/Coder

PEAK HEALTHCARE
07.2014 - 10.2019
  • Code Outpatient and profee charts including SDS, Emergency Room, Ancillaries, OB-GYN, OBS, Multi-specialty, Acute care, Oncology, Ortho, Pathology, Plastics, Gastro, Urology, IVR, ETC, Diagnostic Ultrasounds, Critical Care, E&M Level, and Acute Care
  • Reviews medical records to determine if facility coding is accurate
  • Charge capture
  • Educated staff with professional guidance via resources of Official Coding guidelines, ICD-10 Coding Handbook, Coding Clinic and/or other recognized sources
  • Served as mentor for other coders
  • Recommends root cause solutioning for additional audit opportunities
  • Abstracted medical record data for accurate coding of medical diagnosis and procedures
  • Utilized 3M 360 Encoder, Cerner, HPF software
  • Claim Edits NCI/LCD
  • Banner healthcare, Grady healthcare, Alabama Uni
  • Hosp.

Remote Coder VA/ HCC

HCRS
08.2017 - 10.2018
  • Department for Veteran Affairs
  • Valid Security Clearance
  • Adhered to current VHA coding guidelines
  • Applied E/M level based on 95 & 97 Guidelines
  • E/R, Observations, Clinic, SDS, Ancillary, Multi-Specialty
  • Assigned codes to document patient care encounter, /sequencing of principal and secondary diagnosis
  • Correction of claim edits NCI/LCD
  • Identified the principal diagnosis and principal procedure for every encounter
  • Identified significant complications and/or co-morbidities treated or impacting treatment
  • Abstracted designated statistical data from patient record and enters the information into the abstract database
  • Knowledge of Federal and Private Sector coding and billing requirements

Remote Coder, Level 1 Trauma

GRADY MEMORIAL HOSPITAL
08.2016 - 06.2018
  • Performed daily coding of encounters performed in assigned locations to ensure that charges were entered into the EPIC
  • Reviewed clinical documentation as appropriate to extract data and assign appropriate ICD10, CPT, and HCPCS codes, verify charges
  • Performed CCI edit corrects, Resolves TES edits, Denials CDI review clinical documentation reflects the level of service rendered to patients
  • Emergency dept., Observations, SDS, Radiology, Imaging Xrays, CT, MRI, US, Ortho, Pathology, ophthalmology, Ancillary, facility, Clinic, Multispecialty, Pro-fee

Remote Outpatient Coder

CSI COMPANY
07.2014 - 05.2017
  • Multi-specialty coding, Ancillary, SDS, OBS, ER, IVR, Ortho, Opthal, Burns, Pathology, I&I, charging, Pro-fee, Facility
  • Charge capture
  • HCC Risk adjustment
  • Epic, 3M, Meditech

Remote HCC Coder

WAVE GLOBAL
01.2014 - 11.2016
  • MRA/HCC /HEDIS medical coding/Risk adjustment coding
  • Reviewed submitted medical records to identify diagnoses/procedures that were provided by an acceptable risk adjustment provider type and physician specialty
  • Selected the correct ICD-9-CM / ICD-10 coding of chronic conditions which map to HCC
  • Coded all diagnoses and services accurately and completely, from the medical record in accordance with the ICD-9-CM, CPT and HCPCS coding classification systems

Remote Outpatient Coder

HIMAGINE SOLUTIONS
08.2013 - 10.2016
  • Case Mix: Emergency Room, Observations, Multi-Specialty SDS and Ancillaries
  • Claim edit correction
  • Utilized Epic and 3M Encoder, Meditech, Cerner, HPF software

Remote Outpatient Coder

EXCITE HEALTH PARTNERS
08.2013 - 10.2016
  • Case Mix: Emergency Room, Ortho, Pathology, Radiology, Critical Care, Observations, Rehab and Ancillaries, SDS(multi-specialty)
  • Systems: Epic, 3M 360, CAC

On-site Lead Coder (St. Croix Virgin island)

GOV. JUAN F. LUIS HOSPITAL
06.2015 - 12.2015
  • Case Mix: Emergency Room, Trauma, Observations, Otho, IVR, SDS(multi-specialty)
  • Revenue Cycle, claim submittal and claim correction
  • System: Meditech, 3M

Remote Outpatient Coder (454 beds)

MAXIM-REGIONS HEALTHCARE
10.2014 - 02.2015
  • SDS, Observation Coder for multi-specialty hospital corporation
  • Case Mix: Emergency, Observation, Multi-specialty, SDS, IVR, Trauma, Burn, ENT, Ortho, Neuro Mom & baby, OB, Injections & Infusions, Radiology invasive outpatient procedures
  • Charts Per Hour: ED 10-15, OBS 3-5, SDS 4-6 Accuracy 97%
  • EMR System: Epic, Cerner Encoder: 3M

OP Surgical Coder

EMORY/ GRADY MEMORIAL HOSPITAL
12.2007 - 05.2013
  • Emergency room, outpatient physician & facility via operative reports by abstracting information using appropriate diagnosis ICD-9-CM, ICD-10-CM and CPT-4, HCPCS, Resolves TES edits
  • Reviewed medical record documentation to identify all services provided by physicians
  • Gathered required medical record documentation in response to payer audits and requests
  • Provided provider credentialing and staff education on proper documentation and coding
  • Case Mix: Multi-specialty, SDS, OBS, ED, E&M, OB-GYN, Trauma, IVR, Burn, ENT, Podiatry, Pathology, Plastics, Neuro, Ortho, Radiology, Diagnostic Imaging, Pathology, Opthal, OP Visits (clinic and hospital)
  • Charts Per Hour: SDS: 4-6, OBS: 6-7, Labs and OP Clinic: 20, IP: 2-3 Accuracy: 98%
  • EMR System: Epic, Cerner Encoder: 3M
  • Optum/Encoder Pro

Senior Coder

NORWOOD (Contract)
11.2021
  • Coding of SDS, Observations, Emergency Department, Coding Edits/Denials, charge entry
  • Ortho, Gastro, ENT, OB-GYN, Gen Surg Ophthalmology, Urology, pain mgmt., pediatrics, podiatry, otolaryn, etc
  • Resolves related coding issues in all phases: production, coding scrub, and coding denial resolution, Verifying accuracy of assigned CPT codes for complex and/or error prone procedures
  • Verifying the diagnosis coding accuracy for complex and/or error prone encounters
  • Validating discharge dispositions
  • Reviewing charge and procedure mismatches
  • Reviewing codes with revenue integrity for NCD/LCD coverage, diagnosis code rejections
  • Reviewing invalid codes, code conflicts, and missing modifiers
  • Selects and assigns the appropriate ICD-10 CPT codes, based on chart review documentation of Pro-fee/facility encounters occurring in the ED, Observation, Clinic, and inpatient claims
  • Coding of same day surgery (MULTI-SPECIALTY) claims

Education

Professional Studies in Business & Human Service -

AUDREY COHEN COLLEGE FOR HUMAN SERVICE & BUSINESS

Medical Coding & Billing Certification -

NATIONAL HEALTH ASSOCIATION/AMA

Oasis-C Hospice/Home Care Coding -

RELIAS ACADEMY

ICD-10 Certificate -

LIBMAN EDUCATION0

CPC- 10/2005 -

AAPC

Skills

  • Epic
  • Cerner
  • Citrix
  • Medical Manager
  • Dalcon
  • Medisoft
  • Meditech
  • IDX
  • Athena
  • Centricity
  • Misys Tiger
  • Actus
  • Next Gen
  • 3M 360
  • CAC
  • CPT
  • ICD-9
  • ICD-10
  • DRG
  • HCPCS
  • HCFA-1500 & UB-92
  • CCI edits

Timeline

Coder

COMFORCE(contrator)
11.2023 - Current

Medical Coder

CORROHEALTH (Contract)
06.2023 - 11.2023

Senior Coder

NORWOOD (Contract)
11.2021

Analyzes, investigates, and resolves coding edits for services

KIWI-TEK
01.2021 - 03.2023

Auditor/Coder/Edits

LEXICODE
01.2021 - 05.2022

Coding Auditor/Coder

MANAGED RESOURCES
11.2019 - 05.2020

Remote Coder VA/ HCC

HCRS
08.2017 - 10.2018

Remote Coder, Level 1 Trauma

GRADY MEMORIAL HOSPITAL
08.2016 - 06.2018

On-site Lead Coder (St. Croix Virgin island)

GOV. JUAN F. LUIS HOSPITAL
06.2015 - 12.2015

Remote Outpatient Coder (454 beds)

MAXIM-REGIONS HEALTHCARE
10.2014 - 02.2015

Senior Surgical, ED, Ancillary, Multi- Specialty Auditor/Coder

PEAK HEALTHCARE
07.2014 - 10.2019

Remote Outpatient Coder

CSI COMPANY
07.2014 - 05.2017

Lead Coder

ADDISON GROUP
01.2014 - 03.2023

Remote HCC Coder

WAVE GLOBAL
01.2014 - 11.2016

Remote Outpatient Coder

HIMAGINE SOLUTIONS
08.2013 - 10.2016

Remote Outpatient Coder

EXCITE HEALTH PARTNERS
08.2013 - 10.2016

OP Surgical Coder

EMORY/ GRADY MEMORIAL HOSPITAL
12.2007 - 05.2013

Professional Studies in Business & Human Service -

AUDREY COHEN COLLEGE FOR HUMAN SERVICE & BUSINESS

Medical Coding & Billing Certification -

NATIONAL HEALTH ASSOCIATION/AMA

Oasis-C Hospice/Home Care Coding -

RELIAS ACADEMY

ICD-10 Certificate -

LIBMAN EDUCATION0

CPC- 10/2005 -

AAPC

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KISHA CARTER