Tiffany Baker BSHIM, RHIT
Avon,Indiana
Summary
Dedicated Health Information Management (HIM) professional committed to delivering medical record auditing, provider education, and quality improvement recommendations in various areas of the medical field. Hardworking professional applies official coding conventions and rules established by American Medical Association and Centers for Medicare and Medicaid Services. Confident Medical Coder adheres to data confidentiality and privacy rules in all workflows and promotes dynamic interpersonal skills.
Overview
17
17
years of professional experience
1
1
Certification
Work History
Coding Analyst
Bill Dunbar and Associates, LLC
01.2022 - Current
- Review medical records for appropriate provider documentation to support CPT, ICD-10CM, and HCPCS coding guidelines
- Report educational findings to Regional Director for provider education
- Compile reports for provider review
- Perform additional audits/projects as needed.
- Improved coding accuracy by conducting thorough research and staying up-to-date with industry standards.
Clinical Data Reviewer
Ascension St. Vincent Hospital
07.2021 - 01.2022
- Compile and abstract clinical data into the American College of Surgeons National Surgical Quality Improvement (ACS NSQIP) data registry platform
- Review data on postoperative outcomes and identify opportunities for process improvement and clinical review
- Participate in Quality Improvement meetings as needed
- Meet with the hospital (NSQIP) surgeon champion as needed for procedure and documentation clarifications
- Review and add CPT and ICD-10-CM codes into the data registry
- Utilize 3M Coding and Reimbursement software for CPT and ICD-10-CM codes as needed.
Clinical Prepayment Specialist, Team Lead
IBM Watson Health (BcForward Contractor)
03.2018 - 06.2021
- Adjudicate claims by reviewing medical record documentation for overutilization of services or other billing practices that directly or indirectly result in unnecessary cost to Indiana Medicaid
- Educate providers on appropriate billing and CPT coding practices
- Update OMPP Program Integrity on provider claims, documentation findings, education letters, and compliance review summary data
- Coordinate and schedule meetings with the team and/or providers to resolve questions or concerns
- Complete MFCU (Medicaid Fraud Control Unit) referrals if needed
- Respond to provider inquiries regarding the status of prepayment review
- Complete monthly and productivity reports
- Complete team lead tasks as directed
- Review and create reports on provider claims data in J-SURS (Java Surveillance Utilization Review System).
Manager, Health Information Department
OrthoIndy Hospital
03.2016 - 03.2018
- Supervise and direct HIM staff by organizing work to ensure accurate and timely processing of work
- Complete weekly physician notifications for incomplete documentation
- Audit medical records for accuracy and completeness within HFAP standards and ISDH regulations
- Perform random audits on HIM Analyst staff
- Compile monthly security report and quarterly QA reports
- Complete 1-1 meetings as well as monthly staff meetings reporting updates and/or changes
- Monitor staff productivity stats
- Assist in professional development activities
- Approve staff schedule changes and payroll
- Interview, hire, and assist with training and orientation of new employees
- Ensure the quality, timeliness, availability, and preservation of patient medical records
- Identify and communicate operational issues to Director of HIM
- Assist facility with documentation compliance for proper reimbursements, such as in Medicare and Medicaid programs.
Medical Records Coordinator
Northwest Healthcare Center
08.2007 - 03.2016
- Audit medical records for accuracy and completeness
- Release of Information
- Monitor documentation trends within the facility
- Ensure privacy and confidentiality of the medical record
- Completed facility transition from ICD-9 to ICD-10 to ensure facility compliance with CMS
- Prepared and submitted Medicare ADRs
- ICD-10-CM coding of medical records for rehabilitation services and long-term care
- Ensure ICD-10-CM codes are accurately listed on UB-04 claims
- Assist facility with documentation compliance for proper reimbursements, such as in Medicare and Medicaid programs
- Assisting in EHR (Electronic Health Record) implementation
- Provide education/in-service on EHR to new employees
- Assist in triple check process for proper billing for reimbursement
- Administer daily medications, provide treatments, and document medication administration in the patient’s medical record.
Education
Bachelor of Science - Health Information Management
Western Governors University
Associate of Science - Health Information Technology
Ivy Tech Community College
Registered Health Information Technician (RHIT) -
Skills
- Inpatient records coding
- Records Management
- Medical Billing
- Regulatory guidelines
- Clinical Documentation
- Medical Terminology
- Medical claims coding
- HIPAA Compliance
- Time Management
- Records Review
- Professionalism
- Registered Health Information Technician
- Inpatient Coding
Certification
- RHIT - Registered Health Information Technician
Timeline
Coding Analyst
Bill Dunbar and Associates, LLC
01.2022 - Current
Clinical Data Reviewer
Ascension St. Vincent Hospital
07.2021 - 01.2022
Clinical Prepayment Specialist, Team Lead
IBM Watson Health (BcForward Contractor)
03.2018 - 06.2021
Manager, Health Information Department
OrthoIndy Hospital
03.2016 - 03.2018
Medical Records Coordinator
Northwest Healthcare Center
08.2007 - 03.2016
Bachelor of Science - Health Information Management
Western Governors University
Associate of Science - Health Information Technology
Ivy Tech Community College
Registered Health Information Technician (RHIT) -
- RHIT - Registered Health Information Technician
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