Monika Simko
Belleville,MI
Summary
Medical billing and coding professional with over 20 years of experience in various roles in the revenue cycle, including leadership. With a positive personality, I effectively communicate and collaborate with providers, peers, and other departments to ensure correct coding and resolve complex coding and billing issues.
Overview
23
23
years of professional experience
1
1
Certification
Work History
Certified Coding Supervisor II
Trinity Health - IHA Medical Group
Ann Arbor, MI
04.2024 - Current
- Promoted a positive work environment by addressing coder concerns promptly and effectively while fostering open lines of communication among team members.
- Managed a team of coders, providing guidance, support, and mentorship to enhance their professional growth and development.
- Monitored coder productivity to ensure timely completion of assignments while maintaining high-quality standards.
- Facilitated communication among coding staff through regular team meetings, fostering an environment of collaboration and knowledge sharing.
- Maintained up-to-date knowledge on ICD-10-CM/PCS codes as well as CPT-4 procedural codes through ongoing education efforts and certifications renewals when applicable.
- Assisted in recruitment efforts for new coding staff members, interviewing candidates and providing recommendations for hiring decisions.
- Served as a liaison between the coding department and other hospital departments, addressing any concerns or discrepancies related to medical coding or reimbursement matters.
- Reviewed outpatient records and interpreted documentation to identify diagnoses and procedures.
- Applied official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services to assign diagnostic codes.
- Generated reports to identify coding trends and discrepancies.
- Interacted with physicians and other healthcare staff to ask questions regarding patient services.
- Followed up with medical staff regarding missing information in patient records.
Certified Coding Specialist II
Trinity Health- IHA
03.2019 - 04.2024
- Increased overall productivity by working closely with colleagues when faced with complex cases requiring input from multiple specialists within the organization.
- Collaborated with physicians and clinical staff to ensure accurate documentation for proper billing and coding purposes.
- Provided valuable insights during team meetings with other coders, sharing best practices and discussing ways to improve individual and team performance.
- Optimized workflow efficiency through cross-training in multiple specialties, enabling flexibility in task assignments according to team needs.
- Achieved a high level of accuracy in code assignment, consistently meeting or exceeding departmental benchmarks for performance.
- Applied official coding conventions and rules from AMA, CMS, and insurance companies to assign CPT, HCPCS, and ICD-10 codes.
- Collaborated with other departments to address coding and billing issues.
Medical Coding and Billing Specialist
Oakland Physical Medicine
01.2018 - 03.2019
- Assisted in maintaining smooth office operations by managing essential administrative tasks such as recordkeeping and data entry.
- Achieved timely reimbursements from payers by submitting clean claims that adhere to payer-specific guidelines.
- Reduced errors in medical billings, effectively addressing discrepancies and rectifying issues promptly.
- Optimized revenue generation through diligent monitoring of denied claims, resubmitting corrected information when needed.
- Correctly coded and billed medical claims for various hospital and nursing facilities.
Medical Billing & Coding Specialist
IHA
04.2002 - 12.2017
- Optimized revenue cycle management by accurately assigning codes for diagnoses and procedures according to established guidelines.
- Maintained up-to-date knowledge on industry changes, attending training sessions and workshops regularly.
- Managed high volumes of medical records efficiently while maintaining strict attention to detail during the coding process.
- Reviewed inpatient and outpatient records and interpreted documentation to identify diagnoses and procedures.
- Interacted with physicians and other healthcare staff to ask questions regarding patient services.
- Resourcefully used various coding books, procedure manuals, and on-line encoders.
- Correctly coded and billed medical claims for various hospital and office locations.
- Communicated effectively with staff, patients, and insurance companies by email and telephone.
Business Services Supervisor- Pediatric A/R
IHA
02.2009 - 06.2010
- Improved efficiency in A/R process by streamlining workflows and implementing best practices.
- Successfully maintained a high level of team morale, fostering a positive work environment that encouraged collaboration and dedication to providing top-notch medical billing and A/R services.
- Organized regular team meetings to review performance metrics, discuss challenges, and share best practices for continuous improvement efforts.
- Increased revenue by identifying underpayments and errors, ensuring proper reimbursement from insurance companies.
- Maintained current accounts through aging reporting.
- Resolved complex billing issues.
- Communicated with insurance providers to resolve denied claims.
- Generated reports and analyzed trends to maximize reimbursement and reduce claim denials.
Education
Bachelor of Science - Healthcare Administration
Eastern Michigan University
Ypsilanti, MI12.2005
Skills
- Multi-specialty CPT, HCPCS, and ICD-10 coding
- Knowledgeable with AMA, CMS, and healthcare payer guidelines
- Strong understanding of the revenue cycle
- Coding and claim error resolution
- Teamwork and collaboration
- Attention to detail
- Problem-solving aptitude
- Analytical thinking
- Excellent written and verbal communication
- Team collaboration abilities
Certification
- CPC - Certified Professional Coder 2013
- CGSC- Certified General Surgery Coder 2020
Timeline
Certified Coding Supervisor II
Trinity Health - IHA Medical Group
04.2024 - Current
Certified Coding Specialist II
Trinity Health- IHA
03.2019 - 04.2024
Medical Coding and Billing Specialist
Oakland Physical Medicine
01.2018 - 03.2019
Business Services Supervisor- Pediatric A/R
IHA
02.2009 - 06.2010
Medical Billing & Coding Specialist
IHA
04.2002 - 12.2017
Bachelor of Science - Healthcare Administration
Eastern Michigan University
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