Melissa Abell
Summary
An innovative leader with reputable experience in revenue cycle operations, claims, medical coding, and project management. Demonstrates high level of initiative to achieve operational excellence through precise communication and process improvement. An outstanding problem-solver that uses policies, procedures, and action plans to formulate strategies and coordinate operations to implement effective changes to drive company success and achieve results.
Overview
11
11
years of professional experience
1
1
Certification
Work History
Manager II, Medical Coding
Wal-Mart Health
12.2022 - Current
- Implementation of daily operations and supervision of internal and vendor coders using coding quality standards, and define process workflows to increase efficiency in coding, charge capture, billing, and claims management.
- Ensures accurate medical billing and coding by improving system development and training
- Successfully led cross-functional teams in the implementation of Epic EHR Systems and records management of legacy systems
- Utilized continuous process development methodologies such as creation of SOPs to develop and improve overall operations processes, drive profitability, efficiency, and execute deliverables
- Served as subject matter expert of coding, charge capture, and charge review and applied knowledge of coding documentation and billing regulations related to government and commercial insurance to enhance training guidance for the providers, team, and field operations
- Created, analyzed, and distributed monthly data reports on operational performance metrics including clinic financial performance, coding activity, and coding accuracy rate
- Leveraged analytical thinking skills to identify trends and take necessary measures in resolving issues impacting charges and revenue
- Establish and perform quality assurance measures such as SOX control and KPIs to align with compliance standards
- Enhanced vendor relationship management through the review and update of SLA and SOW work agreements
- Recognized for collaborating business needs with revenue projections to streamline improvement processes and achieve operational financial goals and objectives
- Successfully engaged with a diverse range of stakeholders, including business partners and employees, by utilizing strong communication and negotiation abilities
- Collaboration with Legal and Compliance partners to provide support and resolution to complex attorney client privilege cases
- Demonstrated strong ability in conducting analysis and identifying key areas for business plan development.
- Strategically maximized overall productivity by defining project prioritizations, reducing risk, and providing appropriate status tracking updates
Certified Procedural Coder
Wal-Mart Health
05.2016 - 12.2022
- Offered strategic support to improve revenue cycle operations at both Walmart Care Clinic and Walmart Health.
- Provided subject matter expertise in coding, data entry, records management and monthly oversight organization.
- Conducts claim correction projects from analyzing revenue cycle data and trends and communicating results and corrective action with training, operations, and vendors
- Coding quality review of internal & vendor coding teams
- Drove efficiency by collecting, analyzing, and sharing data reports on coding accuracy rate. Provided metrics summarizing general trends impacting revenue cycle
- Focused on enhancing coding performance through defining coding requirements, creating trainin materials, and implementing process improvement initiatives.
- Executed risk management, project analysis, operational planning and effective communication.
- Maximized overall productivity by mitigating risks, reducing roadblocks & providing appropriate resources
Medical Administrative Officer
U.S. Secret Service
11.2013 - 02.2016
- Contractor with Public Trust Security Clearance, Administrative Officer to U.S Secret Service Safety, Health & Environmental Programs Division
- Provided comprehensive administrative and program support to the entire division staff including records managements, scheduling, generating reports for distribution
- Greeted visitors in a professional manner, responding to inquiries and directing them to appropriate personnel.
- Organized and maintained filing systems for physical documents, ensuring accuracy and confidentiality of records.
- Composed letters, memos, reports, emails, presentations and other written correspondence as required by management staff.
- Coordinated mailings including sorting mail, preparing packages for shipping via courier service
- Facilitated communication between different departments within the organization.
- Handled confidential documents in an organized fashion according to established protocol.
- Streamlined supply procurement requests, executed efficient supply procurement strategies, and ensured timely completion of maintenance activities.
- Effectively communicates with management officials using written or oral briefings, reports, and presentations
- Responded promptly to customer inquiries and records requests in a polite manner.
- Managed incoming calls while providing information or transferring callers to appropriate personnel, resulting in effective business correspondence
Education
Certificate of Medical Coding -
College of Southern Maryland
Skills
- Revenue Cycle Operations
- Billing/Claims Management, Reimbursement from commercial insurance, Medicaid, Medicare
- Process Improvement
- Policy Implementation
- Workflow and Standard Operating Procedure Documentation
- Account Receivable/ Accounts Payable
- Medical Coding, Urgent Care, Primary Care E/M Coding
- Data analysis and reporting for monthly and quarterly financial activity
- Data & Record Entry
- Confidential and HIPAA record privacy
- Strategic Planning
- Project Management and Implementation
Certification
- American Association of Professional Coders; CPC Certification, 01290978
- CPT/ICD-10 Certification
- Notary Public of Maryland
- Certified Epic User
Timeline
Manager II, Medical Coding
Wal-Mart Health
12.2022 - Current
Certified Procedural Coder
Wal-Mart Health
05.2016 - 12.2022
Medical Administrative Officer
U.S. Secret Service
11.2013 - 02.2016
Certificate of Medical Coding -
College of Southern Maryland
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