Summary
Overview
Work History
Education
Skills
Websites
Certification
Languages
Knowledgeskillsabilities
Timeline
Generic

Victoria Newland

Lafayette,LA

Summary

Seasoned Physician Auditor with a robust background at i3 ACS Medical Business Solutions, showcasing expertise in coding and billing integrity, compliance, and physician education. Leveraged analytical skills and in-depth knowledge of EMR systems and ICD-10-CM guidelines to enhance documentation quality and operational efficiency. Renowned for exceptional communication and a proven track record in implementing creative solutions to complex problems. Highly-motivated employee with desire to take on new challenges. Strong work ethic, adaptability, and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills. Experienced and dependable general worker with a proven track record of efficiently completing tasks in various settings. Skilled in manual labor, equipment operation, and maintaining a clean and organized workspace. Safety-conscious with a strong work ethic and the ability to adapt to different environments. Ready to contribute to a dynamic team and make a positive impact. Proactive and versatile professional with a dedication to quickly adapting to new challenges. Strong problem-solving abilities and a proven track record of fostering strong relationships with clients and team members. Focused on supporting team success and achieving positive results. Adaptable professional with a quick-learning ability and a talent for adjusting to new environments. Skilled in rapidly acquiring new knowledge and applying it effectively. Driven by a passion for continuous learning and successfully navigating change. Results-oriented individual with a passion for continuous learning and innovation. Known for leveraging analytical thinking and creativity to solve problems and deliver high-impact solutions in fast-paced environments. Dedicated and adaptable professional with a proactive attitude and the ability to learn quickly. Strong work ethic and effective communication skills. Eager to contribute to a dynamic team and support organizational goals. Detail-oriented Internal Auditor with well-established knowledge of control process validation. Trained in audits and known for great attention to detail, exemplary auditing skills, and commitment to excellence. Seasoned Auditor with comprehensive understanding of financial regulations and compliance laws. Skilled in assessing and improving internal controls for companies of various sizes, resulting in improved financial integrity and streamlined operations. Strengths include strong analytical skills, problem-solving ability, thoroughness, and commitment to the highest level of professional standards. Notable impact includes identification of significant operational inefficiencies and implementation of effective corrective measures. Analytical Auditor known for productivity and efficient task completion. Specialize in financial compliance, risk assessment, and regulatory knowledge. Excel in critical thinking, problem-solving, and communication to navigate complex auditing environments effectively. Committed to integrity and transparency in all audit processes. Proven expertise in conducting in-depth audits and devising successful improvement strategies. Methodically evaluated documents and systems and initiated corrections in compliance with established standards. Superb analytical and communications skills enabled optimum results.

Overview

12
12
years of professional experience
1
1
Certification

Work History

Physician Auditor

i3 ACS Medical Business Solutions
06.2015 - Current
  • Performs comprehensive audits to determine integrity of coding/billing for physician & clinical fees, detection/correction of documentation, coding/billing errors and/or medical necessity of services billed
  • Audits consist of evaluation of the accuracy of documentation, including E/M and other payer codes, medical necessity, reimbursement overpayments and underpayments, and compliance with other documentation standards
  • Conduct internal audits of medical documentation supporting claims billed to third parties to ensure billing is done in accordance with the appropriate third-party regulations and/or standards
  • Using CPT and ICD-10, HCPCS II, provider documentation and other approved resources, evaluate the proper assignment of procedure, modifier and diagnosis codes to professional services in order to validate accuracy and compliance
  • Develops and executes provider comprehensive educational opportunities/ curriculums (coding resources, materials, tools, webinars, etc.) based on audit results, noted trends & changes within coding compliance and regulatory guidelines
  • Identifies inaccurate coding practices; prepares reports of findings and meets with providers and medical office staff in-person to provide education and training on accurate coding practices, compliance risks, and revenue cycle efficiencies
  • Provide physician feedback, initial and ongoing education and training, and technical support in regards to proper clinical documentation guidelines, service selection, charge capture and timely submission, healthcare data accuracy and coding principles
  • Maintains updated knowledge of coding requirements, through continuing education and certification renewal; Stay current with all coding changes and updates through regular research and verification
  • Provides professional services and support in a dynamic work environment
  • Learns and adapts quickly to new technology and software applications

Director of Health Information

Community Specialty Hospital
Lafayette, USA
06.2013 - 06.2015
  • Collaborated closely with physicians and nursing staff to improve quality of patient records documentation
  • Maintained accuracy, completeness, and security for medical records and health information
  • Processed and tracked requests for medical records from external organizations
  • Transcribed and entered patient medical information into medical records systems
  • Sorted, scanned and indexed documents, developed workflows and processed workflow reports to keep clinical records maintained in accordance with guidelines
  • Proven ability to develop and implement creative solutions to complex problems

Education

Bachelor of Science - Health Information Management, Business

UNIVERSITY OF LOUISIANA AT LAFAYETTE

Skills

  • EMR Systems: Epic
  • Cerner PowerChart
  • EClinicalWorks
  • Allscripts
  • Aetnahealth
  • Facility Access Platforms: Citrix
  • VMWare
  • GlobalProtect
  • 3M
  • Optum EncoderPRO
  • Adobe Acrobat Expertise
  • Microsoft Office: Word
  • Excel
  • PowerPoint
  • Outlook
  • ICD-10-CM Official Guidelines for Coding and Reporting
  • Coding Clinics
  • Clinical Validation
  • CPT
  • HCPCS coding guidelines
  • E/M regulations
  • CMS Documentation Guidelines
  • Web Graphics
  • HIPAA Compliance and Regulations
  • Report Preparation and Analysis
  • Effective and Professional Communication
  • Medical terminology
  • Anatomy and physiology
  • Coding quality issues
  • Trends and data analysis
  • Statistical reporting
  • Analytical skills
  • Attention to detail
  • Organization skills
  • Communication skills
  • Independent judgment
  • Decision making

Certification

  • RHIA, Registered Health Information Administrator
  • CEMC, Certified Evaluation & Management Coder

Languages

Vietnamese

Knowledgeskillsabilities

  • EMR Systems: Epic, Cerner PowerChart, eClinicalWorks, Allscripts, & aetnahealth
  • Facility Access Platforms: Citrix, VMWare, & GlobalProtect
  • 3M & Optum EncoderPRO
  • Adobe Acrobat Expertise
  • Microsoft Office: Word, Excel, PowerPoint, & Outlook
  • Comprehensive knowledge of ICD-10-CM Official Guidelines for Coding and Reporting, Coding Clinics, Clinical Validation
  • Advanced knowledge of CPT, HCPCS coding guidelines especially E/M regulations and CMS Documentation Guidelines
  • Web Graphics
  • HIPAA Compliance and Regulations
  • Report Preparation and Analysis
  • Effective and Professional Communication
  • Advanced knowledge of medical terminology, anatomy and physiology
  • Advanced ability to identify coding quality issues/concerns and provide recommendations for improvement
  • Advanced ability to analyze trends and data and display in a statistical reporting format
  • Advanced analytical skills, with a high attention to detail
  • Advanced organization and communication (verbal and written) skills
  • Ability to work independently and exercise independent judgment and decision making

Timeline

Physician Auditor

i3 ACS Medical Business Solutions
06.2015 - Current

Director of Health Information

Community Specialty Hospital
06.2013 - 06.2015
  • RHIA, Registered Health Information Administrator
  • CEMC, Certified Evaluation & Management Coder

Bachelor of Science - Health Information Management, Business

UNIVERSITY OF LOUISIANA AT LAFAYETTE
Victoria Newland