Ruby Magee
Osyka,MS
Overview
14
14
years of professional experience
Work History
SENIOR NICU CODER
University of Kentucky HealthCare
Lexington, KY
08.2021 - Current
- Assigns diagnosis codes and procedure codes utilizing the current version of ICD 10 diagnosis and procedure codes and CPT-4 coding classification systems in compliance with hospital guidelines, ICD-10-CM Official Guidelines for Coding and Reporting, and UPHOLDS definitions.
- Meets the established productivity standards for each visit type coded.
- Abstracts clinical and requested data from the health record and enters HRM with abstraction accuracy rate.
- Communicates via Coding Queries with medical staff when appropriate to facilitate the assignment of proper diagnosis and procedure codes.
- Demonstrates competencies with all software and hospital systems utilized, including EPIC, 3M Encoder, and AMPFM.
- Monitors daily the Fatal Edit report to ensure all assigned records are coded on a timely basis within the four-day bill hold time frame.
- Acts as a resource to hospital staff for all coding related questions. Responds in a timely manner to e-mails, bill edits, or other requests.
- Maintains professional certification and technical competency by attending education and training activities sponsored through the hospital, professional associations, and through independent study.
- Keeps apprised of current trends, developments and awareness of coding changes.
- Performs miscellaneous job-related duties as requested
Facility Edit/PB Coder
Southwest Mississippi Regional Medical Center
McComb, MS
07.2021 - Current
- Performs data quality reviews on outpatient encounters to validate the ICD-10-CM, CPT, and HCPCS Level II code and modifier assignments, APC group appropriateness, missed secondary diagnoses and/or procedures, and ensure compliance with all APC mandates and outpatient reporting requirements.
- Monitors medical visit code selection by departments against facility specific criteria for appropriateness. Assists in the development of such criteria as needed.
- Monitors facility CRC reports for prebill edits related to APC. Addresses CCI and LCD edits within the various billing scrubbers while abiding by the Standards of Ethical Coding as set forth by the American Health Information Management Association.
- Meets and/or exceeds Conifer’s APC specialist productivity standards.
- Reviews claim denials in comparison with medical records for the determination of accurate assignment of all documented diagnoses and procedures adhering to the standards of ethical coding.
- Professional Development: Stays current with AHA Official Coding and Reporting Guidelines, CMS and other agency directives for ICD-10-CM/PCS, ICD-10 initiatives, and CPT/HCPCS coding.
- Stays current with CMS annually updated National Correct Coding Initiative Coding Policy Manual, CMS coding and billing regulations, MUE and OCE.
- Monitors inpatient and outpatient unbilled accounts report for outstanding and/or uncoded outpatient encounters to reduce accounts receivable days for outpatients. Brings identified issues to department managers for resolution.
Outpatient Coder
KDMC Medical Clinic, LLC
Brookhaven, MS
04.2017 - 07.2021
- Assign codes for diagnoses, treatments and procedures according to the ICD-10-CM and CPT Official Guidelines for Coding and Reporting through review of coding critical documentation.
- Extracts and abstracts required information from source documentation, to be entered into the appropriate electronic medical record system.
- Works from assigned coding queue, completing and re-assigning accounts correctly.
- Manages accounts on scrub or edit Hold, finalizing accounts when corrections have been made, in a timely manner.
- Meets or exceeds the designated productivity standard per chart type.
- Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA).
- Assists in implementing solutions to reduce backend-errors.
- Expertly queries providers for missing or unclear documentation, by working with the HIM department and Clinical Documentation Improvement Specialists.
- Participates in both internal and external audit discussions.
- Reviews medical records to identify pertinent diagnoses and procedures relative to the patient's health care encounter.
- Selects the principal diagnosis and principal procedure, along with other diagnoses and procedures using UHDDS definition.
- Ensures appropriate DRG assignment.
- Abstracts appropriate information from the medical record based on the guidelines provided by the client and after a thorough review of the medical record.
- Solicits clarification from the physician regarding ambiguous or conflicting documentation in the medical record using guidelines provided by the client.
PATIENT ACCOUNTS REPRESENTATIVE
THE SPECIALTY CLINIC
Brookhaven, MS
01.2012 - 01.2017
- Perform patient billing and reporting activities in a timely fashion.
- Review patient accounts to identify delinquent and due accounts.
- Follow collection procedures to receive the payments.
- Utilize computer software to process, print and e-mail patient medical bills.
- Maintain a database of client accounts and billing information.
- Contact insurance companies for claim processing and reimbursements.
- Address billing issues and inquiries from patients.
- Arrange payment schedules, generate billing entries, print or e-mail bills, and create reports.
- Perform front-desk duties and administrative work when needed.
- Coordinate with insurance companies to resolve payment problems and reimbursement issues.
- Experienced in Medicare, Medicaid, Advantage plans and all commercial insurance appeals, reconsiderations, corrections and denials.
Timeline
SENIOR NICU CODER
University of Kentucky HealthCare
08.2021 - Current
Facility Edit/PB Coder
Southwest Mississippi Regional Medical Center
07.2021 - Current
Outpatient Coder
KDMC Medical Clinic, LLC
04.2017 - 07.2021
PATIENT ACCOUNTS REPRESENTATIVE
THE SPECIALTY CLINIC
01.2012 - 01.2017