Jacquelin Cissel
Frederick,MD
Summary
Hardworking professional applies official coding conventions and rules established by American Medical Association and Centers for Medicare and Medicaid Services. Confident Medical Coder adheres to data confidentiality and privacy rules in all workflows and promotes dynamic interpersonal skills.
Overview
26
26
years of professional experience
1
1
Certification
Work History
Senior Facility Edits Coder
Medovent Solutions
03.2023 - Current
- Assigned to queues that have claims with MUE, LCD or NCCI edits that did not pass through the billing system/scrubber. Medicare and Medicaid procedures and guidelines must be followed.
- Compare documentation to the coding and correct the error that was preventing the chart from being billed, utilizing the documentation, CPT, ICD10, CPT ASSIST, and several other coding resources.
- Systems Utilized: Epic, 3M, Codify
Emergency Department Pro Fee and Facility Coder
Providence Health System/R1 RCM
09.2023 - 03.2025
- Providences Hospitals in Alaska and Washington State
- Code Emergency Room Pro Fee and Facility (E&M, infusions, injections, CPT and HCPCS procedures, ICD10 etc.)
- Audit average is 98%. The last audit was at 100%.
- Meets or exceeds production goals.
- Versatile in moving between the different hospitals.
Emergency Department Pro Fee and Facility Coder
United Audit Systems
01.2023 - 01.2024
- Northern INYO Hospital, California
- E&M leveling for Emergency Department, both pro fee and facility, infusions, injections, procedures, etc.
- 50% of my work queue is auditing/verifying. Documentation from provider must support what is coded and if adjustment is needed, that is documented as to why and from what source.
- Multispecialty Clinic office visits (including E&M leveling, procedures, immunizations, etc.)
- Code all Ancillary procedures.
Senior Outpatient Edits Coding Consultant, Remote
Medovent Solutions
01.2021 - 12.2022
- Marshfield Clinic Health System, Wisconsin
- Assigned to numerous work queues that have claims with MUE, LCD or NCCI edits that did not passed through the billing system/scrubber.
- I compare the documentation to the coding and correct the error that has been stopping the billing process, utilizing the documentation and CPT, ICD10 and correct coding.
- Systems Utilized: Cerner Millennium, Power chart, Sorian Financials, and AAPC’s Codify.
Multispecialty Coder, Remote
MediRevv
02.2020 - 12.2021
- Katherine Shaw Bethea Hospital, Dixon, IL
- Responsible for the review and coding of Evaluation and Management (E&M) and Surgical Procedures for all Specialty doctors and Hospitalists.
- 50% - 75% is auditing/verifying. What is coded has to be supported by the documentation. (E&M level, procedures, ICD-10, etc.) When I must make changes, it has to be documented why and from what source.
- Utilizes OP Coding guidelines to identify appropriate ICD-10, CPT, HCPCS, and related modifiers to meet Medicare and correct coding requirements.
- Systems Utilized: Epic and 3M.
Multispecialty Coding Consultant, Remote
Oxford HIM
08.2018 - 01.2020
- Maniilaq Health Clinics – Kotzebue, AK
- Responsible for the review and coding of Evaluation and Management (E&M) levels, CPT procedures, ICD10.
- 75% of my work queue is auditing/verifying. What is coded has to be supported by the documentation. (E&M level, procedures, ICD-10, etc.) When I must make changes, it has to be documented why and from what source.
- Take the documentation and see if it holds up as to what is coded (E&M level, procedures, ICD-10, etc.) When I have to make changes, it has to be documented why and from what source.
- 97.5% accuracy rating for daily production.
Emergency Room Coding Consultant, Remote
Harmony Healthcare
02.2017 - 08.2018
- South Georgia Medical Center (460 Bed Level I Trauma)
- Abstracted and coded all documentation from Providers for both Facility and Pro fee.
- 98% accuracy rating for daily coding.
- Exceeded coding production expectations.
Multispecialty Coding Auditer, Remote – PRN
HRS Coding Elevated
01.2017 - 02.2017
- Provide auditing services on HRS audit project.
- Provide physicians with audit results and coding recommendations, including back up from various coding resources.
Emergency Department Coder Profee and Facility, Remote
Gebbs Healthcare Solutions
01.2016 - 12.2016
- Beaumont Troy Hospital (Trauma I, 1070 beds), Beaumont Royal Oak Hospital (Trauma II, 520 beds), Beaumont Gross Point Hospital (Trauma III, 250 beds).
- Conduct coding, billing, and documentation compliance audits within established timeframe and in accordance with the organization standards.
- Abstracted and coded all documentation from the emergency physicians and nurses for correct E&M leveling, procedures and ICD-10 diagnosis for both the physician side and facility side in addition to injections and infusions.
- 98% accuracy rating for daily coding.
- Met or exceeded coding production expectations.
Emergency Department Profee and Facility/Multispecialty Pro Fee Coder, Remote
Navigant/Cymetrix
03.2014 - 01.2016
- Wake Forest Baptist Medical Center (Trauma I, 1004 beds) And St. Luke’s Medical Center
- Emergency Department pro fee and facility coding with infusions and injections for a trauma facility.
- Provided multispecialty evaluation and management, procedures and ICD-10 coding for a university hospital to ensure increased accuracy and reduce coding errors.
Multispecialty & Ancillary Services Coding Consultant, Remote
Signature Performance
07.2013 - 03.2014
- Kern Medical Center (Trauma II, 222 beds)
- Ohio State University Medical Center (Trauma I, 937 beds)
- Abstracted and coded hospital ancillary services; in addition to, multi-specialty physician services (E&M, procedures, and ICD10).
Emergency Department Coder, Remote
Atlantic Billing/Chesapeake Physicians
01.2011 - 07.2013
- Chesapeake Regional Medical Center (Trauma I, 309 Beds)
- Coded emergency department records for both the facility and the physicians.
- Captured all IV, infusions, injections, procedure, diagnoses and leveling for the facility.
- Captured all procedures, diagnoses and E&M leveling for the physician.
- Exceeded production and quality goals.
Multispecialty Medical Records, Auditor, Onsite
Doma Technologies
04.2008 - 12.2010
- Bethesda Naval Medical Center which is now Walter Reed National Military Medical Center
- Multispecialty coding auditor (E&M, CPT procedures, and diagnosis coding).
- Audit Emergency Department pro fee, internal medicine, orthopedics, family practice, endocrinology, urology and gynecology.
Multispecialty Auditor, Remote
MedPartners HIM
03.2007 - 04.2008
- Kaiser Colorado
- Auditor of Physician documentation for Family Practice, Internal Medicine and Pediatrics.
- Provide feedback for the Physicians and coding staff.
Emergency Department and Pediatric Coder/Auditor, Remote and Onsite
Emergency Medicine Associates
09.2001 - 03.2007
- Washington Adventist Hospital (Acute Care, 252 beds) Suburban Hospital (Trauma II, 222 beds), Montgomery General Hospital (Acute Care, 149 beds)
- Audit and train new coders teaching them E&M coding guidelines.
- Participate in peer review audits monthly to maintain accuracy and consistency with the coding department as part of the Compliance Program.
- Code inpatient Pediatrics.
Coding Research and Appeals
Inter-Med Multi-Specialty Group
11.1999 - 09.2001
- Conducted chart audits as part of the compliance program and provided feedback for physicians regarding their coding and documentation decreasing errors.
- Processed denials from insurance carriers, determining grounds for appeal, researching documentation from physician’s notes, providing backup from AMA, Federal Register, and other coding resources to resolve denied claims.
- Developed effective working relationships with insurance provider representatives with productive resolution of systematic denials.
- Integrated coding, billing, and site staff by utilizing our new managed care module and maximizing the capabilities of the billing system, which increased effective communication and reduced claim denials.
- Improved training of site staff, providing direct training on coding issues.
Education
High School Diploma -
Thomas S. Wootton
Rockville, MDNo Degree -
Palomar College
San Marcos, CASkills
- Medical terminology
- Insurance coding (ICD-10 and CPT)
- Insurance claims analysis
- Claims processing
- Anatomy and Physiology
- Proficiency in EPIC, 3M, Ahlta, Codify
- Training and mentoring
- Clinical documentation
- Medical billing
- Records management
- Revenue cycle management
- Medical claims coding
- Coding error resolution
Certification
- 2015 ICD-10-CM Code Set Training
- 2014 Complete Anatomy and Pathophysiology Training
- 2002 American Academy of Professional Coders – Certified Professional Coder CPC
Timeline
Emergency Department Pro Fee and Facility Coder
Providence Health System/R1 RCM
09.2023 - 03.2025
Senior Facility Edits Coder
Medovent Solutions
03.2023 - Current
Emergency Department Pro Fee and Facility Coder
United Audit Systems
01.2023 - 01.2024
Senior Outpatient Edits Coding Consultant, Remote
Medovent Solutions
01.2021 - 12.2022
Multispecialty Coder, Remote
MediRevv
02.2020 - 12.2021
Multispecialty Coding Consultant, Remote
Oxford HIM
08.2018 - 01.2020
Emergency Room Coding Consultant, Remote
Harmony Healthcare
02.2017 - 08.2018
Multispecialty Coding Auditer, Remote – PRN
HRS Coding Elevated
01.2017 - 02.2017
Emergency Department Coder Profee and Facility, Remote
Gebbs Healthcare Solutions
01.2016 - 12.2016
Emergency Department Profee and Facility/Multispecialty Pro Fee Coder, Remote
Navigant/Cymetrix
03.2014 - 01.2016
Multispecialty & Ancillary Services Coding Consultant, Remote
Signature Performance
07.2013 - 03.2014
Emergency Department Coder, Remote
Atlantic Billing/Chesapeake Physicians
01.2011 - 07.2013
Multispecialty Medical Records, Auditor, Onsite
Doma Technologies
04.2008 - 12.2010
Multispecialty Auditor, Remote
MedPartners HIM
03.2007 - 04.2008
Emergency Department and Pediatric Coder/Auditor, Remote and Onsite
Emergency Medicine Associates
09.2001 - 03.2007
Coding Research and Appeals
Inter-Med Multi-Specialty Group
11.1999 - 09.2001
High School Diploma -
Thomas S. Wootton
No Degree -
Palomar College
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