LORI ARCHAMBAULT
Sidney,NY
Summary
Medical Coding Manager with proven leadership and efficiency seeking a Senior Medical Coding Manager position. Focused on improving business compliance, workflow and processes through detailed audits and optimization recommendations. Successful track record of fully evaluating information, procedures, and initiating corrective actions while effectively leading team members.
Overview
17
17
years of professional experience
1
1
Certification
Work History
Medical Coding Auditor
United Health Services
03.2022 - Current
- Identifies coding documentation trends as well as coding compliance issues through medical record review; educate providers and coders on how to improve their documentation and coding skills in order to maintain 95% accuracy rate
- Conducts meetings with individual coders to review and educate on findings/errors in detail from their audit to improve future effectiveness
- Meets quarterly deadlines, effectively prioritizes tasks, and manages workload to meet deadline completion
- Follows established auditing processes to meet internal and regulatory requirements
- Performs observations and evaluated supporting documents to supplement audit findings
Medical Coding Manager
SohoMD
07.2020 - 10.2023
- Responsible for daily operations of the medical coding department including monitoring quality and quantity of workflows to ensure completion of work assignments
- Designed and successfully implemented workflow processes/policy & procedures for the coding department; to support continuous improvement within the department and organization
- Conducted internal audits on provider’s documentation to ensure proper compliance and provided education when necessary
- Consistently performed coding quality reviews, provided feedback, and educated coders
- Successfully managed and led staff while attending to multiple projects/tasks
- Responsible for researching potential billable CPT codes for different services to maximize reimbursement while maintaining compliance standards
- Maintained thriving relationships among all staff members for effective communication
- Frequently reported to CEO/Founder and Operations Director on department success and quality improvement opportunities
- Analyzed areas in coding department that needed improvement; restructured positions that would improve overall revenue and efficiency of department and organization
- Built successful relationships with commercial insurance representatives; conducted meetings to resolve claim issues resulting in less money owed to insurance companies based on coding guideline standards
- Managed and motivated employees to be productive and engaged in work.
- Accomplished multiple tasks within established timeframes.
Coding Compliance Educator
United Health Services
01.2018 - 11.2020
- Focused on potential documentation improvement opportunities, provided feedback, and presented solutions to Director of coding, coding team members, providers, and site supervisors at outpatient/inpatient clinics
- Developed strong knowledge of multiple EMR systems and other technical programs to ensure proper coding/documentation guidelines
- Supervised and monitored coding workflows as well as coding errors to help facilitate a successful department and eliminate future errors
- Developed policy and procedures for coding department to improve workflow processes
- Communicated directly with providers to provide feedback and education to improve standards and efficiency
Coding Specialist
United Health Services
11.2014 - 01.2018
- Assigned appropriate CPT codes and ICD-10 codes: ability to code ninety to one hundred charts daily while maintaining ninety five percent accuracy rate
- Educated and interacted with providers and other medical health professionals regarding billing and documentation policies, procedures, and regulations
- Maintained knowledge of coding requirements through continuing education and certified renewal
- Maintained and complied with HIPAA regulations due to responsibility of handling patient confidentiality and sensitive information
- Reviewed outpatient records and interpreted documentation to identify diagnoses and procedures
Access Care Representative
United Health Services
08.2008 - 11.2014
- Maintained patient records by updating account information while maintaining HIPAA standards
- Served patients by providing service information and resolving service problems
- Collected and posted co-payments and explained patient financial responsibility to patients and family
- Provided outstanding and professional customer service to promote positive patient experience
Supervisor
Morrison Healthcare
08.2006 - 08.2008
- Successfully supervised fifteen to twenty staff members daily for the Food & Nutrition Department
- Consistently communicated with senior staff members on current issues and provided suggestions for quality improvement
- Handled patient complaints one-on-one and educated staff members for future growth
- Applied strong leadership talents and problem-solving skills to maintain team efficiency and organize workflows
- Handled customer complaints, resolved issues, and adjusted policies to meet changing needs
Education
Bachelor of Science - Business
Excelsior College
Albany, NY.2018
Associates - Liberal Arts
Suny Broome
Binghamton, NY.2016
Skills
- Internal Controls
- Root Cause Analysis
- Report Writing
- Staff Development
- Business Administration
- Performance Management
- Strategic Planning
- Operations Management
- Team Leadership
- Policy Implementation
- Verbal and Written Communication
- Organizational Skills
- Time Management
Accomplishments
- Leadership: Successfully manages and supervises day-to-day operations of the medical coding department including coordination, prioritization, personnel supervision, and issues resolution of coding
- Organizational: Prioritizes deadlines and workloads daily for timely filing and revenue cycle purposes. Ability to multi-task while achieving organizational skills by self-management
- Efficiency: Ensures quality data while optimizing reimbursement, compliantly
- Self-management: Maintains updated knowledge on coding requirements through continuing education and certification renewal
- Detail Orientation: Focuses on potential documentation improvement opportunities, provides feedback, and presents sufficient solutions to administration, team members, and providers
- Analytical: Identifies coding documentation trends as well as coding compliance issues through medical record review to develop a plan; educate providers and coders on how to improve their documentation and coding skills while demonstrating excellent interpersonal communication.
Certification
Certified Professional Coder (CPC)
Certified Professional Medical Auditor (CPMA)
Certified Risk Adjustment Coder (CRC)
Certified Professional Practice Manager (CPPM)- In progress
Timeline
Medical Coding Auditor
United Health Services
03.2022 - Current
Medical Coding Manager
SohoMD
07.2020 - 10.2023
Coding Compliance Educator
United Health Services
01.2018 - 11.2020
Coding Specialist
United Health Services
11.2014 - 01.2018
Access Care Representative
United Health Services
08.2008 - 11.2014
Supervisor
Morrison Healthcare
08.2006 - 08.2008
Bachelor of Science - Business
Excelsior College
Associates - Liberal Arts
Suny Broome
Certified Professional Coder (CPC)
Certified Professional Medical Auditor (CPMA)
Certified Risk Adjustment Coder (CRC)
Certified Professional Practice Manager (CPPM)- In progress
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