Mitzi Ambrose
Liberty Hill,TX
Summary
Dedicated and Motivational Leader with 12 years managerial experience and 25 years' experience in medical coding, billing, and collections. Adept in all aspects of the Revenue Cycle including reconciliation of accounts and implementation of standardized workflows for operational efficiency.
Overview
13
13
years of professional experience
1
1
Certification
Work History
HCA Healthcare
Certified Coding Specialist
04.2021 - Current
- Correctly code and bill medical claims for physician services provided in a hospital setting, including inpatient and outpatient surgical procedures
- Stay up-to-date on industry trends and changes in coding standards and proactively align processes to meet Medicare guidelines
- Ensure supporting documentation is available within the patient record and identify areas for improvement and implement steps as needed
- Followed up with medical staff regarding missing information in patient records
- Communicated with insurance companies to research and resolved coding discrepancies
- Verified signatures and checked medical charts for accuracy and completion
HCA Healthcare
Revenue Cycle Coordinator
08.2019 - 03.2021
- Oversaw charge, denial and adjustments for 70+ Practices
- Collaborate with Senior Leadership, 35+ Market and Practice Managers to reduce initial and final denials
- Create, implement and provide training for Epic billing workflows
- Transition Coding from practice to Central Coding Unit for multiple practices to ensure smooth transition.
- Coordinated cross-departmental efforts for timely resolution of account discrepancies, improving cash flow management.
- Improved overall patient satisfaction with billing and insurance procedures for a more positive experience.
- Conducted regular audits of billing records to ensure compliance with industry regulations, minimizing potential risk exposure.
- Developed customized reports that provided actionable insights into key financial metrics, guiding strategic decision-making processes.
- Worked closely with EMR Analysts to implement system enhancements that improved billing efficiency and accurate automated payment and adjustment posting.
HCA Healthcare
Cardiology Coding Manager
01.2019 - 08.2019
- Supervise 25+ coding staff members
- Create, document and provide workflows and training
- Approve and schedule time off requests
- Ensure adherence to company policies and procedures
- Manage 30+ Cardiology Practices specializing in General Cardiology, Electrophysiology, Interventional Cardiology and Cardiothoracic Surgery
- Reconciled accounts to determine root cause and updated workflows accordingly
- Provide instruction and written workflow to Physician, practice manager and staff
- Complete annual evaluation, performance feedback and improvement plan as needed
- Monitor Production and Quality to ensure standards are met by utilizing reports and conducting quality analysis
- Identify, utilize and develop the skill set of each team member
- Develop and implement processes and workflows for maximum efficiency and production
- Collaborate with Epic analysts to create rules and edits for clean claim submission for timely maximum reimbursement.
HCA Healthcare
Coding Manager I
02.2014 - 12.2018
- Supervise 25+ coding staff members
- Create, document and provide workflows and training
- Approve and schedule time off requests
- Ensure adherence to company policies and procedures
- Manage 30+ Cardiology Practices specializing in General Cardiology, Electrophysiology, Interventional Cardiology and Cardiothoracic Surgery
- Reconciled accounts to determine root cause and updated workflows accordingly
- Provide instruction and written workflow to Physician, practice manager and staff
- Complete annual evaluation, performance feedback and improvement plan as needed
- Monitor Production and Quality to ensure standards are met by utilizing reports and conducting quality analysis
- Identify, utilize and develop the skill set of each team member
- Develop and implement processes and workflows for maximum efficiency and production
- Collaborate with Epic analysts to create rules and edits for clean claim submission for timely maximum reimbursement.
HCA Healthcare
Certified Hospital Coder
05.2011 - 02.2014
- Abstracted CPT and ICD-9/10 billing after provider documentation review
- Coded and billed for up to 11 Cardiologists
- Queried physicians for clarification or required documentation for any charge discrepancies
- Reviewed and coded complex operative reports
- Educated providers on coding and documentation guidelines
- Reconciled multiple surgical schedules to ensure complete charge capture
- Directed multiple practice managers and staff in surgical documentation, billing and coding
- Maintained current knowledge of coding guidelines through the use of current CPT, HCPCS, and ICD-9/ICD10 materials
- Resolved claim denials with Appeals or provider education to reduce negative AR impact.
Education
Health And Biology
University of Texas
Austin, TXSkills
- Epic Build - Rule and Edits for Charge and Payment Automation
- Operational Reporting
- Payment Reconciliation
- Process Improvement
- Insurance Claim Analysis
- Data Trending
- Team Collaboration
- Problem Solving
- Strategy Development
- Medical Billing Expertise
Accomplishments
- Best in Class Billing Leadership
- Awarded “Outstanding Performance in Project Management” CWTX Division 2016
Hca Professional Highlights
- Develop and Implement Telehealth billing process in Epic in response to Pandemic
- Coding Unification Project - Revenue Cycle restructure for over 800 practices - 300+Coders throughout the U.S. transitioned to Work From Home
- Led oversight of successful Revenue Cycle transition of large Multi-Specialty Market, comprised of 26 COIDs and 130 Physicians
- Facilitated triumphant transition of 20-member team to Epic EMR by developing and implementing standardized workflows
- Led oversight of 3 large paper-based Cardiology practices through the Revenue Cycle transition associated with Epic Go Live
- Spearheaded the Business Process Outsourcing Project – Worked in collaboration to provide charge posting and payment reconciliation instruction and training
Certification
- CPC - Certified Professional Coder
Since 2012
Timeline
HCA Healthcare
Certified Coding Specialist
04.2021 - Current
HCA Healthcare
Revenue Cycle Coordinator
08.2019 - 03.2021
HCA Healthcare
Cardiology Coding Manager
01.2019 - 08.2019
HCA Healthcare
Coding Manager I
02.2014 - 12.2018
HCA Healthcare
Certified Hospital Coder
05.2011 - 02.2014
Health And Biology
University of Texas
- CPC - Certified Professional Coder
Since 2012
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