Marjorie Blanche Plandes
Summary
Managed inpatient and outpatient coding staff, overseeing daily operations and ensuring timely, accurate clinical data for billing and patient information systems.
Directed end-to-end process activities, including interactions with healthcare providers, medical record reviews, document processing, and data verifications.
Implemented coding productivity and quality guidelines, assisted in the review process, and generated necessary reports to ensure accuracy of final bills.
Managed coding reconciliation processes, reported DRG/coding changes.
Responsible for the education of new coders, defining training requirements, and ensuring team members were well-prepared to meet performance goals.
Promoted high levels of employee engagement and development through ongoing feedback and coaching.
Overview
17
17
years of professional experience
Work History
Certified Clinical Coder III
Hamad Medical Corporation
12.2023 - Current
- Performed root cause analyses on denied claims and implemented corrective actions to prevent future occurrences; this led to a reduction in overall denial rates over time.
- Assisted with the development of internal coding guidelines and procedures, ensuring consistency and accuracy across the organization.
- Provided ongoing education and training sessions for fellow coders, promoting professional development and skill enhancement.
- Optimized revenue cycle management through timely and accurate code assignment for billing purposes.
- Maintained up-to-date knowledge of industry best practices, contributing to a consistently high-performing coding team.
- Collaborated with clinical documentation improvement specialists to enhance the quality of patient records, leading to more accurate reimbursement levels.
- Facilitated cross-functional collaboration with medical staff to address complex coding scenarios, resulting in improved patient care.
- Supported organizational compliance efforts by adhering to all relevant policies, regulations, and guidelines regarding clinical coding practices.
- Resourcefully used various coding books, procedure manuals, and on-line encoders.
- Reviewed patient charts to better understand health histories, diagnoses, and treatments.
- Maintained accuracy, completeness, and security for medical records and health information.
- Utilized electronic medical record systems to store, retrieve and process patient data.
- Verified accuracy of patient information in medical records.
- Reviewed medical records for completeness and filed records in alphabetic and numeric order.
Clinical Coding Manager/Auditor
Al Khor Hospital, Hamad Medical Corporation
03.2013 - 12.2023
- Achieves the corporation’s targets for standards of accuracy, completeness, and timeliness of clinically coded data
- Demonstrates the continued achievement of high standards of clinical coding in order to ensure that both clinicians and managers maintain a high level of confidence in the quality of the data
- Develops clinical coding training program for staff and physician
- Keeps abreast of clinical coding standards, reporting, and information policies
- Assists in the development of a Clinical Coding Audit program involving clinician and clinical coders
- Checks, analyzes, and audits medical records for accuracy, adequacy, and consistency of documentation
- Assigns appropriate codes for each diagnosis, operation and procedure based on the International Classification of Diseases and Procedures
- Data gathering for research, studies, and statistics
- Accounts for daily discharges and performs audit as necessary
- Manages and supervises the clinical coding section
- Assisted with the implementation of Cerner Millennium suites – Electronic Medical Records and Qatar’s National Health Insurance for Al Khor Hospital
- Member of various committees such as the AKH Patient Quality and Safety committee and AKH Business planning committee
- Data Custodian for Al Khor Hospital and a core member of the Business Intelligence committee for HMC
- Ensured compliance with relevant regulations by staying current on updates related to ICD-10-AM/ACS/ACHI guidelines.
- Performed coding quality reviews and tracked, trended and managed coding quality performance.
- Conducted thorough audits of coding practices, identifying opportunities for optimization and streamlining processes.
- Boosted team morale and fostered a positive work environment by organizing team-building activities and recognizing individual achievements regularly.
- Attended facility meetings and reported on performance.
- Participated in hiring and training coding team.
- Mentored junior coders, enhancing their skills and knowledge through targeted coaching and guidance.
- Facilitated communication between coders, clinicians, and administrative staff for seamless information exchange across departments.
- Collaborated with cross-functional teams to optimize the coding process, resulting in improved accuracy and quality.
- Evaluated team and updated training curriculum based on feedback.
- Implemented ongoing training initiatives to keep staff up-to-date on industry trends and best practices in Clinical coding coding.
- Established clear performance metrics to monitor progress and drive continuous improvement within the department.
- Led regular code review sessions to maintain high-quality output and identify areas for further development.
- Coordinated, managed and implemented auditing projects and prepared for evaluation.
Accredited Clinical Coder
Royal Victoria Infirmary, National Health Service Foundation Trust
03.2008 - 02.2013
- Highly Skilled in coding Paediatric Cases (Medicine, Trauma and Orthopaedics, Plastic Surgery, General Surgery, and Oncology), Adult General medicine, Plastic Surgery, General Surgery, Oncology etc
- Code approximately 90-100 cases per day depending on the complexity of the cases in the patient’s case notes
- Mentoring Trainee and Junior Clinical Coders
- Ensure that complex clinical data regarding diagnoses and surgical procedures of patient episodes, both inpatients and outpatients, are coded using national (ICD-10 WHO) and national (OPCS-4.0)
- Visit hospital wards and other departments as necessary view source documents (case notes) required to complete coding; to collect source document sheets (e.g discharge summaries); to take reasonable steps to chase up outstanding source data
- Source documents will include electronic records
- Enter Clinical coded data unto the hospital electronic record system ensuring accuracy, completeness, and timeliness at all times
- Plan and prioritize own workload to meet departmental targets and to advise the manager of any hindrance to the achievement of these targets
- Carry out specific duties including checking histopathology, microbiology and blood test reports to achieve high standards of quality and completeness of clinical coded data
- To consult coroners to clarify causes of death
- Develop and maintain good links with clinical staff to improve and ensure good quality and depth of clinical coded data, amending clinical coding where necessary
- Liaise and attend meeting with clinicians
- Maintain the strictest confidentiality
- Undertake any other duties relevant to clinical coding as maybe required from time to time as necessary
Education
Bachelor of Science - Nursing
Adventist University of The Philippines
Philippines03.1998
Certificate of Internal Clinical Coding Audit -
La Trobe University
Australia10.2014
Clinical Coding Foundation course -
Sunderland University Hospital
Sunderland, United Kingdom03.2010
Accredited Clinical Coder -
The National Clinical Coding Qualification
United Kingdom09.2011
Advanced ICD 10-AM/ACS/ACHI Clinicla Coding - Advanced Certified Clinical Coder, Australia
HIMAA
Australia04.2021
Skills
- Results-oriented
- Organized
- Attention to details
- Operability
- Continuous learning mindset
- Commitment
- Ability to motivate staff
- Maintain good relations
- Resistance to stress
- Fast learner
- Keen observer
- ICD-10/ICD-10-AM/ ICD-10-CM Proficiency
- ACHI/CPT Proficiency
- Clinical Documentation Review
- Clinical Coding Expertise
- Auditing and Quality Assurance
- Electronic Health Records Management
- Training and mentoring
- Medical Terminology
- Critical thinking abilities
Certified Clinical Coder/Manager/auditor
Experienced and detail-oriented Coding manager with over 10 years of expertise in managing clinical coding systems, Adept with handling complex coding issues, and maintaining relationships with various departments such as finance and accounting, Quality and Patient Safety and Clinical Documentation.Demonstrated ability to lead coding teams, ensure data accuracy, and uphold high standards of Quality and Compliance. Proven tract record of resolving problems, managing complaints, and training staff to achieve operational excellence.
Computerprograms
- Cerner Millennium suite
- 3M encoder
- PAS
- MS Excel
- MS Word
Inhousetrainingcourses
- ICDL applied skills in cyber security, 10/01/19
- Resource allocation and cost-effective analysis, 04/01/14
References
All references and supporting documents available on request
Timeline
Certified Clinical Coder III
Hamad Medical Corporation
12.2023 - Current
Clinical Coding Manager/Auditor
Al Khor Hospital, Hamad Medical Corporation
03.2013 - 12.2023
Accredited Clinical Coder
Royal Victoria Infirmary, National Health Service Foundation Trust
03.2008 - 02.2013
Bachelor of Science - Nursing
Adventist University of The Philippines
Certificate of Internal Clinical Coding Audit -
La Trobe University
Clinical Coding Foundation course -
Sunderland University Hospital
Accredited Clinical Coder -
The National Clinical Coding Qualification
Advanced ICD 10-AM/ACS/ACHI Clinicla Coding - Advanced Certified Clinical Coder, Australia
HIMAA
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