Mary Johnson
Piedmont,Oklahoma
Summary
Proven expertise in conducting in-depth audits and devising successful improvement strategies. Methodically evaluated documents and systems and initiated corrections in compliance with established standards. Superb analytical and communications skills enabled optimum results.
Overview
9
9
years of professional experience
1
1
Certification
Work History
Associate Investigator
Commonwealth Care Alliance
Boston, MA
04.2023 - 04.2024
- Triage and execute highly sensitive investigations into alleged violations of CCA's ethical standards, non-compliance with laws, regulations, and corporate policies.
- Successfully completed all scheduled audits according to the annual compliance work plan.
- Drove improvements while auditing Behavioral Health, Family Medicine, and Palliative Care specialties
CDI Specialist/Educator
Aledade
Bethesda, MD
06.2022 - 04.2023
- Conducted chart reviews to enhance accuracy in clinical documentation and coding
- Provided guidance to Aledade leaders on optimal clinical documentation and coding techniques
- Evaluated and optimized end-to-end practice clinical documentation and coding workflows
- Partnered with internal stakeholders to enhance reporting and analytics tools, driving advancements in clinical documentation accuracy and completeness.
Compliance Auditor
Unified Women's Healthcare
Boca Raton, FL
02.2022 - 06.2022
- Verified the integrity of clinical documentation through meticulous pre- and post-billing patient chart audits in accordance with coverage standards, Company policy,and regulatory obligations across multiple specialties like evaluation and management,surgery,radiology,pathology,and medicine.
- Conducts assigned comprehensive audits in a complete and timely manner
- Communicates reportable findings or identified matters to Compliance/Legal Department regarding audit risks
- Effectively communicates audit findings, corrective action, and performance improvement plans to care center locations and leadership.
Professional Coding Supervisor
SSM Health Care
Oklahoma City, OK
07.2021 - 02.2022
- Serves as subject-matter expert for evaluation, management, and procedural coding in assigned areas.
- Coded and audited specialties encompassed behavioral health, family medicine, dermatology, endocrinology, general surgery, gastroenterology, pediatrics, plastic surgery, infusions therapy and orthopedics.
- Facilitated regular communication and collaboration with coders, physicians, and health care practitioners to enhance understanding of coding and documentation guidelines/principles, as well as government and commercial payer rules.
- Collaborated with individual team members to optimize charge processing efficiency and accuracy
Responsibility Professional Analyst/Educator
SSM Health Care
Oklahoma City, OK
11.2016 - 07.2021
- Initiated development of compliance program with focus on education, implementation of policies and procedures, and monitoring policy adherence.
- Coded and audited specialties encompassed behavioral health, family medicine, dermatology, endocrinology, general surgery, gastroenterology, pediatrics, plastic surgery, infusions therapy and orthopedics.
- Documents and discusses detected deficiencies in billing and reimbursement with personnel of departments, and provides recommendations to prevent future deficiencies.
- Develops and maintains processes to monitor program effectiveness through audits, analysis of employee hot-line reports, post office box inquiries, and other feedback mechanisms.
Coding Specialist II
University of Oklahoma Health Science Center
, OK
11.2014 - 10.2016
- Abstracted and coded procedures from diverse medical records in various specialties including pediatrics, gastroenterology, general surgery, and plastic surgery.
- Aided pre-certification staff in acquiring accurate procedure codes.
Education
Bachelor of Science in Organizational Leadership -
Southern Nazarene University
Bethany, OK05.2004
Skills
- Medical Auditor
- Epic Electronic Health Record
- Medical terminology
- Proficient in MS Office
- 3M Encoder
- Super Coder
- Athena
- Excellent multi-tasker
- Outpatient Hospital Auditor
- Cerner Electronic Health Record
- AAPC Codify
- Staff development
- Dependable and reliable
- Strong communication skills
- Relationship and team building
- Time management
- Superior organizational skills
- Effective team player
- EClinicalWorks
- EMD EHR
Certification
- Certified Professional Medical Auditor (CPMA)
- Certified Coding Specialist (CCS)
- Certified Professional Coder (CPC)
- Certified Outpatient Coder (COC)
- Certified Risk Adjustment Coder (CRC)
- Certified Evaluation and Management Coder (CEMC)
- Certified Documentation Expert Outpatient (CDEO)
Timeline
Associate Investigator
Commonwealth Care Alliance
04.2023 - 04.2024
CDI Specialist/Educator
Aledade
06.2022 - 04.2023
Compliance Auditor
Unified Women's Healthcare
02.2022 - 06.2022
Professional Coding Supervisor
SSM Health Care
07.2021 - 02.2022
Responsibility Professional Analyst/Educator
SSM Health Care
11.2016 - 07.2021
Coding Specialist II
University of Oklahoma Health Science Center
11.2014 - 10.2016
Bachelor of Science in Organizational Leadership -
Southern Nazarene University