Melissa Armistead Cerci
Jacksonville,,FL
Summary
Diligent, compassionate and detail-oriented Health Care Professional with proven history of effective intervention to increase patient, team and business satisfaction. Passionate about improving health outcomes for vulnerable populations by improving access to resources, education and outreach. Streamline patient needs, reduce waste, compile research, recognize trends, assist care teams with closing Quality Gaps. Ability to handle multiple projects simultaneously with a high degree of accuracy. Organized and dependable, self motivated, successful at managing multiple priorities with a positive attitude. Flexibility from Independent to Collaborative work style to meet team goals.
Overview
12
12
years of professional experience
Work History
Population Health Coordinator - Remote
Ascension Medical Group
Jacksonville, FL
03.2022 - Current
- Entered data, generated reports, and produced tracking documents.
- Research projects requiring special attention to High Utilization Patients, submit findings, advise on course of action
- Reduced traditional Medicare patients' re-hospitalization rates by 23%.
- Aid in implementation of strategies, improving/updating existing protocols
- Utilize active listening, interpersonal, and telephone etiquette skills
- Attended continuing education classes to maintain current knowledge.
- Participated in continuing education and professional development activities.
- Drive processes, efficiency and quality improvements, resulting in improved Start Ratings
- Adhere strictly to federal, state and guidelines
- Demonstrate self-reliance by meeting and exceeding workflow needs.
- Conducted research and outreach and resolve discrepancies.
- Attended continuing education workshops, maintain professional standards and up-to-date with new developments.
- Led trainings with Interns and support staff
- Compiling research, recognizing trends, assist in closing gaps, focusing on Quality Management
- Obtain and analyze quality program metrics, reports for care opportunities via payor portals
- Address trends in Coding and Billing to maximized revenue and reduce waste
- Participated in workshops and in-service meetings to enhance personal growth and professional development.
- Evaluated operational practices and identified improvement opportunities to develop revisions for systems and procedures.
Medical Coder
Jacksonville Orthopaedic Institute
Jacksonville, FL
06.2016 - 11.2019
- Protected patient data in alignment with HIPAA privacy protocols.
- Utilized active listening, interpersonal, and telephone etiquette skills when communicating with others.
- Reviewed patient charts to better understand health histories, diagnoses, and treatments.
- Resourcefully used various coding books, procedure manuals, and on-line encoders.
- Verified signatures and checked medical charts for accuracy and completion.
- Interacted with physicians and other healthcare staff to ask questions regarding patient services.
- Correctly coded and billed medical claims for Office Visits, Surgeries and ED Rounds.
- Applied official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services to assign diagnostic codes.
- Monitored changes in coding regulations to provide recommendations for compliance.
- Trained and mentored junior coders to support growth and development and apply high-quality coding practices.
- Followed up with medical staff regarding missing information in patient records.
- Translated procedural information to facilitate understanding between doctors and patients.
- Streamlined patient and provider interaction by providing channel of effective communication.
- Followed ethical codes to protect confidentiality of patient medical information.
- Translated documents about treatment directions and helped non-English speaking patients fill out medical forms.
- Served as medical interpreter for patients and staff clinical encounters by delivering accurate, skilled interpretations to facilitate effective communications.
- Verified understood medical information for patients by simplifying any jargon.
Medical Coder / ED Coding Specialist
McKesson
Jacksonville, FL
11.2015 - 07.2016
- Correctly coded and billed medical claims for various hospital and nursing facilities.
- Applied official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services to assign diagnostic codes.
- Verified signatures and checked medical charts for accuracy and completion.
- Reviewed, analyzed, and managed coding of diagnostic and treatment procedures in medical records.
- Resourcefully used various coding books, procedure manuals, and on-line encoders.
- Monitored changes in coding regulations to provide recommendations for compliance.
- Utilized electronic medical record systems to store, retrieve and process patient data.
- Examine and apply diagnosis/es for accuracy, completeness, specificity and appropriateness according to services rendered.
- Used classification manuals to gain additional knowledge of disease and diagnoses processes.
Medical Coder / Prior Authorization Specialist
Anthony Wolfe, MD
Miami, FL
06.2015 - 11.2015
- Learned and adapted quickly to new technology and software applications.
- Maintained 100% Authorization approvals
- Identified issues, analyzed information and provided solutions to problems.
- Applied effective time management techniques to meet tight deadlines.
- Used strong analytical and problem-solving skills to develop effective solutions for challenging situations.
- Proven ability to learn quickly and adapt to new situations.
- Self-motivated, with strong sense of personal responsibility.
- Proven ability to develop and implement creative solutions to complex problems.
- Reached out to insurance carriers to obtain prior authorization for testing and procedures.
- Verified eligibility and compliance with authorization requirements for service providers.
- Reviewed appeals for prior authorization requests and communicated with payers to resolve issues.
- Analyzed medical records and other documents to determine approval of requests for authorization.
- Verified signatures and checked medical charts for accuracy and completion.
- Reviewed patient charts to better understand health histories, diagnoses, and treatments.
- Applied official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services to assign diagnostic codes.
- Resourcefully used various coding books, procedure manuals, and on-line encoders.
- Reviewed, analyzed, and managed coding of diagnostic and treatment procedures contained in outpatient medical records.
- Created and maintained up-to-date patient medical records to enable tracking history and preserve consistent information.
Medical Coder / HIM Technician
High Point Treatment Center
Cooper City, FL
06.2012 - 06.2015
- Applied official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services to assign diagnostic codes.
- Interacted with physicians and other healthcare staff to ask questions regarding patient services.
- Reviewed patient charts to better understand health histories, diagnoses, and treatments.
- Resourcefully used various coding books, procedure manuals, and on-line encoders.
- Verified signatures and checked medical charts for accuracy and completion.
- Reviewed, analyzed, and managed coding of diagnostic and treatment procedures contained in outpatient medical records.
- Correctly coded and billed medical claims for various hospital and nursing facilities.
- Performed on-site coding audits to determine accuracy and compliance with coding guidelines.
- Processed and tracked requests for medical records from external organizations.
- Upheld HIPAA regulations and standards for protecting patient information.
- Studied and researched various medical terms as well as software and coding systems.
- Coded and abstracted medical records according to ICD-10-CM and CPT coding guidelines.
- Secured confidential patient information from unauthorized access.
- Retrieved medical data for physicians and patients.
- Performed regular quality and validation assessments on patient data to verify accuracy.
- Exercised leadership capabilities by successfully motivating and inspiring others.
- Adaptable and proficient in learning new concepts quickly and efficiently.
- Demonstrated strong organizational and time management skills while managing multiple projects and site visits
Education
CPMA - Certified Professional Medical Auditor
AAPC
FL 10.2023 - Current
Certified MACRA / MIPS Proficient
4 Med Pro Plus
FL12.2023
Lean Six Sigma Yellow Belt & Organizational Goals
Ascension
06.2023
Medical Coder -
Sheridan Technical College
Hollywood, FL2012
Skills
- Complex Problem-Solving
- Operational / Process Improvement
- MS Office / Google Workspace / Excel
- Auditing / Quality Data Analysis / Attestation
- EMR /Documentation
- Additional Languages spoken: Spanish
- Value-Based Care Programs
- Team Building / Collaboration
- HIPAA Compliance
- Chart review
Timeline
CPMA - Certified Professional Medical Auditor
AAPC
10.2023 - Current
Population Health Coordinator - Remote
Ascension Medical Group
03.2022 - Current
Medical Coder
Jacksonville Orthopaedic Institute
06.2016 - 11.2019
Medical Coder / ED Coding Specialist
McKesson
11.2015 - 07.2016
Medical Coder / Prior Authorization Specialist
Anthony Wolfe, MD
06.2015 - 11.2015
Medical Coder / HIM Technician
High Point Treatment Center
06.2012 - 06.2015
Certified MACRA / MIPS Proficient
4 Med Pro Plus
Lean Six Sigma Yellow Belt & Organizational Goals
Ascension
Medical Coder -
Sheridan Technical College
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