Marie Mundt

(2025 – Current)

Focused on Risk audits. Determine Providers risk, based on last 3 years' billing.

Reviewing 25 cases per provider, per code showing possible risk.

CPT Codes include – E/M, procedures, and modifiers

Provider finding results to management.

2023 – 2024

Full audit reviews to include all facets of coding and billing: CPT codes. HCPCS codes, ICD-10, and Modifiers. Audits were conducted by specialty. 10 cases reviewed for each provider in specific specialty.

Findings to be presented to management with detailed reports. Also shared with the Provider Education department for recommended education.

Educate providers in coding and government guidelines.

Review audits for education opportunities.

New provider orientation.

Instructor for Coding 101 offered to all CHOA employees.

Special projects as needed.

Work denials and look for trends.

Specialties include; Nephrology, General Surgery, Infectious Disease, Anesthesia, Sedation, CT Surgery, and Sibley Cardiology

Provide coding and compliance education to physicians, clinical personnel and billing in all specialties.

Mentor new employees joining the team.

Audit medical records for accuracy & compliance relating to documentation, coding, charging and billing practices.

Work closely with billing to educate providers on billing denials.

Develop written policies promoting compliance and helping to prevent fraud and abuse.
Provide new provider orientation.

Complete pre-acquisition audit of practice.

Monitor the coding help line.

Participate in monthly team roundtables.

12-30 students each semester

Office procedures in a medical environment.

Basic anatomy, tutorials on medical billing codes, diagnosis coding.

Setting appointments.

Standard privacy policies

(This class is a prerequisite to Billing and Coding.)

Audited medical records of newly acquired practices for appropriate and accurate documentation, coding and billing.

Reviewed office procedures to eliminate coding and billing errors.

Provided physician education on documentation and government guidelines.

Served as backup coder for critical care, pulmonary, cardiology procedures, gynecology and oncology.

Coded for 9 Family Practice providers. Focused on evaluation/management and in office procedures.

Performed annual review/audit of physicians and physician assistants.

Provided ongoing provider education.

Provided monthly orientation and education to all new providers.

Audited all new providers for documentation, medical record practices, and billing.

Reviewed all providers annually to ensure compliance with government guidelines.
Provided ongoing provider education.

Worked Medicare denials.