Rachel Macek
Boyd,Texas
Summary
Dynamic individual with hands-on experience in Medical Coding/Auditing/Clinical Documentation Improvement and known for navigating challenges. Brings strong problem-solving skills and proactive approach to new tasks. Known for adaptability, creativity, and results-oriented mindset. Committed to making meaningful contributions and advancing organizational goals.
Overview
23
23
years of professional experience
Work History
CDIP/CODER/AUDITOR
CENTRACARE
02.2016 - Current
- Managed IP education developing educational power points, webinars and training materials presenting to coders, CDI, and Physicians to help facilitate and ongoing learning process
- Managed Clinical Documentation with DRG variance program, reviewing accounts with variance between coding and clinical documentation nurses (CDN) providing feedback and education to coding and CDN.
- Built Cardiothoracic/IVR/peripheral vascular surgical templates, with a team of surgeons and CDI, for surgeons to use for procedures note templates in Epic: arterial embolization (various devices), aneurysm repairs (endovascular/open), angioplasty (stent/non-stent), angiography (coronary/peripheral), bypass procedures, ablation/cryoplasty procedures, thrombectomy/thrombolysis, endarterectomy, TAVR, pacemaker/CDRT
- Performed Coder Audits for Inpatient/OP services across several specialties answering coder/CDN questions, providing feedback utilizing Coding Guidelines, Coding Clinics, and ACDIS.
- Pre-bill review and conducted education on new technology and procedures in cardiothoracic and vascular procedures.
- Developed Job Aides, Coding prompters, and FCI’s effectively communicating with Physician education and Coder leads ensuring proper workflow and information is similar between coders, CDI, and physicians.
- Coordinated with cross-functional teams to align coding projects with organizational goals and strategies.
- Developed Coder/CDI centralized information and resource location.
- Delivered consistent results under pressure by prioritizing tasks effectively during periods of high workload or tight deadlines.
MEDICAL AUDITOR/LEAD/CODER
AMN/PEAK HEALTH SOLUTIONS
04.2011 - 04.2017
- Reviewed and analyzed medical records for accurate coding and compliance with regulations, maintaining 96-99% accuracy and achieving productivity goals
- Conducted comprehensive audits of medical records to ensure compliance with regulatory standards and validate coding accuracy, ensuring proper reimbursement for services rendered.
- Trained and mentored junior auditors on best practices in medical auditing and compliance protocols.
- Developed and implemented audit methodologies to streamline review processes and improve efficiency.
- Maintained an up-to-date understanding of evolving healthcare regulations by engaging in continuous professional development opportunities.
- Prepared detailed reports outlining audit findings; communicated results to stakeholders promptly for prompt resolution of issues identified during audits.
MEDICAL CODER
HEARTLAND REGIONAL MEDICAL CENTER, MARION IL
08.2007 - 04.2011
- Utilized coding software to assign appropriate ICD-10 and CPT codes for various diagnoses and procedures.
- Reviewed and analyzed medical records for accurate coding and compliance with regulations, maintaining 96-99% accuracy and achieving productivity goals
CIVILIAN
VETERANS AFFAIRS TRANSITION PROGRAM
02.2006 - 01.2007
COMBAT MEDIC 91W SKILL LEVEL 2.0
U.S. ARMY
03.2003 - 01.2006
Education
CDIP -
AHIMA Certified Clinical Documentation Course
01.2024
Bachelor of Science - Biological Sciences
Southern Illinois University
01.2010
CCS - undefined
AHIMA Certified Coding Course
01.2010
Skills
- Audit planning/reporting
- External/Internal auditing
- Epic / Solventum 3M 360/R2
- Experienced with Microsoft Excel, Visio, PowerPoint, and Teams
- Cerner, Meditech, Iodine
- Engaging online presentations
CODING SPECIALTY EXPERIENCE
- Acute Trauma (Levels 1-5 and CAH)
- Newborn/Neonatal/NICU
- Pediatrics
- Pro-Fee / SDS / Inpatient / OBS
- Hematology and Oncology (Chemotherapy/Radiation)
- Cardiology
- Cardiovascular and Thoracic Surgery
- Gastroenterology
- OB-GYN
- Neuroprogressive/Spinals
- Orthopedic Surgery
- Plastic Surgery
- General Surgery
- Psychiatric
- Long Stay (IP, Mental Health)
- Hospice, Alternative Care
- Radiology
- Emergency
- Interventional Radiology
- Ambulatory Surgery
Timeline
CDIP/CODER/AUDITOR
CENTRACARE
02.2016 - Current
MEDICAL AUDITOR/LEAD/CODER
AMN/PEAK HEALTH SOLUTIONS
04.2011 - 04.2017
MEDICAL CODER
HEARTLAND REGIONAL MEDICAL CENTER, MARION IL
08.2007 - 04.2011
CIVILIAN
VETERANS AFFAIRS TRANSITION PROGRAM
02.2006 - 01.2007
COMBAT MEDIC 91W SKILL LEVEL 2.0
U.S. ARMY
03.2003 - 01.2006
Bachelor of Science - Biological Sciences
Southern Illinois University
CCS - undefined
AHIMA Certified Coding Course
CDIP -
AHIMA Certified Clinical Documentation Course