Tracy Graham

• Promoted to supervisor of professional coding and A/R billing with a team of 22 staff members.
• Under the general direction of the manager of patient financial services, I was responsible for coordination, monitoring and supervision of physician charging, coding and collections
• This includes coding, billing and collections of all hospital based physician and mid-level services in the outpatient clinics emergency room, outpatient surgery, and in the inpatient setting
• Insuring that services are fully and accurately captured, coded and in compliance with payer guidelines and regulations
• Provides encoding education with staff and outside coding vendors
• Meet with project managers every two weeks for two outside coding vendors
• Supervises the charging capture process, and ensuring that all services are billed in a timely manner
• Continually evaluates billing and follow up functions and the delivery of service; maintains knowledge base necessary to provide training and direction to staff
• Provide staff with modifier education; oversees charging to ensure modifiers are used correctly
• Oversee physician coding for all specialties
• Conduct audits as needed and provide feedback to the providers
• Understand payer guidelines related to coding and modifiers
• Identifies, tracks, and communicates payer issues and denials to manager
• Ensures that under payments are identified and appealed, monitoring credit balances, as well as making sure credits are worked at least twice monthly
• Participates in the interview and hiring process of new employees
• Consistently completes new hire process and coordinates orientation, scheduling training, and probationary evaluations according to the established policies and procedures
• Responsible for staff call ins and all time card functions
• Attends appropriate meetings with leaders in the organization
• Responsible for all staff yearly performance evaluations
• Works collaboratively with Provider Support team to help educate providers
• Performed unit meetings once a month
• I assisted in the opening of Enloe Primary Care clinic, helping providers with their documentation as well as coding,and what is needed to bill for Medicare Annual Wellness visits.
• Monitored employee productivity to provide constructive feedback and coaching.

• Certified coder in a Level II trauma hospital, coding for physician services
• Skill in OB/GYN, Women's Services, Prompt Care Services, Wound, Trauma, Radiology, Pathology, ENT, Urology, Wound, Gastroenterology, Behavioral Health, Primary Care (E&M's, office procedures, POCT), Pediatrics, Critical Care.
• Review clinical documentation for coding accuracy assigned by providers
• Assign procedure and diagnosis codes to claims based on provider documentation
• Skill in OB/GYN, Women's Services, Prompt Care Services, Wound, Trauma, Radiology, Pathology, ENT, Urology, Wound, Gastroenterology, Behavioral Health, Primary Care (E&M's, office procedures, POCT), Pediatrics, Critical Care
• Informed supervisor of any coding and documentation trends
• Corrected diagnosis codes on clinical charges
• Corrected denied medical necessity claims and MUE
• Worked denied claims from commercial insurances, Medi-care, Medi-cal, and Medi-cal Managed Care insurances
• Worked closely with billing team in order to help figure out denials
• Familiar in working with Epic EHR, FinThrive coding assistant, Optum CAC, Medicare website and Preventive Services, Optum Enterprise for coding validation.

• As a supervisor of a multi specialty RHC, I performed the work listed below, in the certified coder description, as well as supervisory duties
• Supervisor of 20+staff consisting of certified coders, billers, work comp specialist, credentialing team, and front business office team for patients with disputes or needing to pay their bills
• All staff reported to me and I handled all call ins; was responsible for payroll corrections and approval
• I was responsible for running month end reports and balancing, assisting the team with coding and billing issues
• Conducted staff annual evaluations, reviewed productivity, assisted in providing providers with coding updates and education
• Approved patient and insurance refunds
• Auditing of all new providers and quarterly audits for established providers
• Assisted in the merger of Lassen Medical Clinic with Dignity Health.

• Coding of Family Practice Services, Dermatology, Pediatrics, Internal Medicine, Urgent Care, Radiology, Pathology, and hospital provider services.
• Review clinical documentation for coding accuracy assigned by providers
• Assign procedure and diagnosis codes to claims based on provider documentation
• Auditing of coding performed by new and established providers
• Meeting with new providers to instruct them on proper documentation and coding as well as reviewing with them, the findings of my audit results
• Assisted in the transition of EHR, from eCW to Athena
• Assisting in training of new providers in their coding role in the facility and the use of the Athena EHR
• Participated in Compliance Committee
• Assisted in the conversion from E Clinical Works to Athena Health in June 2015 by updating the fee schedule and adding procedure codes via template mapping
• Reviewed audit results from outside coding agency, Avia Coders, for our internal coders.
• Corrected denied medical necessity claims and MUE denials
• Assigning correct diagnosis codes for laboratory claims based on encounter diagnosis and LCD's and NCDs
• Training of new Patient Services Representatives on the billing cycle in the business officer department

Assisted Pharmacists with the daily operations of the pharmacy. I worked here for 25 years and can provide more of my duties, if necessary