1435 N.W. 22nd Ave, Delray Beach, Florida 33445, E-Mail: [email protected] Phone: (561) 843-8978
CAREER SUMMARY
MRA Dept. team leader
Train billers/coders, general staff, and PCPs for documentation, E&M, MRA, HEDIS, & PQRS (for original Medicare) guidelines
Continue EHR experience: Practice Fusion, MD 2000, Soap Notes, E-clinical works, Kareo, Medisoft, GPRO, & Athena
Possess the combination of years of organizational and administrative skills coupled with expertise in medical coding and instructing physicians and their staffs in compliance.
Earned various certifications including in A+, CPC, and ICD-10 Proficiency certifications (currently pursuing CPMA) which make for a valuable asset to every team.
Contribute to the workplace major strengths: critical thinking skills, problem solving, maintaining target goals and completing projects while accommodating path adjustments, a determined thirst for knowledge, excellent interpersonal skills and customer service.
Master essential communication and technical areas while possessing and an eye for detail.
Embrace the challenge of data integrity through planning, maintenance, and employee training, which is (Humana) and has been relevant throughout my professional career.
Perform secretarial duties along with mentoring new members as the Secretary of AAPC Palm Beach Chapter
Work History
Medical Specialists of the Palm Beaches, Inc.
HCC CODER/Auditor/Educator
January 9th Current
Reviewed medical records and practice management code data to determine if the medical record is complete, accurate, and in support of individual patient risk adjustment score accuracy.
Sequenced and assigning codes from ICD-10 methodology based on the code which most accurately describes each documented diagnoses.
Educated providers and their practice staff in Medicare coding guidelines, focusing on revenue enhancement opportunities.
Collaborated with other departments to develop plans and materials that support education and system changes to meet practice and revenue goals.
Humana
MRA Coder/Auditor
March 15 December 21st 2016
Reviewed medical record information to identify all appropriate coding based on CMS HCC categories.
Complete appropriate paperwork/documentation/system entry regarding claim/encounter information.
Provided support, education, and training related to the quality of documentation, level of service, and diagnostic coding consistent with established coding guidelines and standards.
Extended real time support and coordination with Primary Care Providers and Care Coordinators for MRA coding, HEDIS, and STARS.
Coordinated with clinical leadership in the development of provider training plans and for active support in the training process.
Organized and schedule periodic training as indicated from chart review results, and/or as requested by medical leadership or CBO management.
Monitored coding modifications to ensure that the most current information is available.
Facilitated coding support to CBO as requested.
Outcomes Health Information Solutions
December 14- May 15: Remote HCC Coder/Auditor
Auditing/Coding charts for Compliance/MRA
TSI Billing & Coding of USA
February 12- /current: Medical Billing / Internal Auditing services
Medical Billing and Auditing records for local Physicians
Primus Health Network Inc., LLC
September 12- November 14: Coding Specialist/Auditor
Audited charts for MRA, HEDIS, & PQRS for G-PRO
Trained physicians & staff in documentation compliance
Assisted physician & staff capturing HEDIS measures
Supervised billing staff with the coding process
American Academy of Professional Coders (AAPC)
January 17 – Current: Secretary of Palm Beach Chapter
Perform secretarial duties along with mentoring new members
March 12- January 13: New Member Development Officer of Palm Beach Chapter
Performed duties as a mentor
Dr. Saleem A. Haq, M.D
November 98 April 12: Office Manager/ Medical Biller & Coder
Managed all office matters
Medical billing and coding for all types of payers
Referral Coordinator
MD credentialing
Assisted in hiring process
Maintained all office computer systems
, maintenance, and employee training, which is (Humana) and has been relevant throughout my professional career.
PROFESSIONAL SKILLS/ PREVIOUS JOB RESPONSIBILITIES
Knowledge of Share point and clouds
Auditing Humana, BCBS, United HealthCare, and Medicare, among other major insurance companies
Earned certification from FHIMA for inpatient coding (Advanced ICD-10- CM & ICD-10 PCS)
In depth knowledge of coding guidelines (ICD-9-CM, ICD-10-CM & PCS, CPT, and HCPCS), CMS regulations, state provider licensure and certification requirements, commercial insurance clinical and reimbursement policies, and audit and appeal techniques
Flexible, detail-oriented ability to be a positive influence on others, skilled at working independently, willingness to take ownership of responsibilities, quality conscious, dependable, and ability to adapt well to change
Proficiency with Microsoft Office Suite, including Word/Power Point/Excel
Strong interpersonal and presentation skills
Proficient in written and oral communication skills at all corporate levels
Multilingual: English, Hindi, and Urdu
18+ years of billing and coding experience in outpatient settings
Member of American Health Information Management Association (AHIMA) & American Academy of Professional Coders (AAPC)
EDUCATION/TRAINING
CPMA (in progress)
ICD-10 Proficiency Certification
CPC
18+ years of coding and auditing experience in HCC & HEDIS and outpatient office setting
BA in general studies
CONTINUING EDUCATION
MRA education & Training Disease Specific
2017 CPT updates
2017 Professional Development for Officers
Humana-based courses/certifications (a variety of skills)
Clinical Documentation Improvement
Experienced in coding/auditing E & M, HEDIS, MRA
Data Breach Compliance and Response: Preparing for the First 24 Hours of a Data Breach and Beyond
How To Find Coding Info You Didn’t Know You Needed To Know
Pay for Performance: Putting the Pieces Together
CDI, Coding and Your Physician Relationship
Be the Pack Leader
ICD-10 The Good The Bad & The Ugly
E & M: Navigating the Real World Record
References: Upon Request