Paula208
Guest
PAULA ABBRUZZESE CCS, CPC, & PCS
215-888-7889 PaulaAbbruzzese@gmail.com
HEALTH CARE MANAGEMENT/ADMINISTRATION
Principled, high level of integrity, dedicated, loyal, dependable, hard-working, strong work ethic
Hands-on, motivated, high-energy, technically proficient, confident, multi-talented team player
Personable, outgoing, great people skills, highly effective communicator and relationships builder
Creative, thinks on demand, easily takes control, strong crisis resolution and problem solving expertise
Organized, focused, detail-oriented, thorough, efficient, works well in a fast-paced environment
Enthusiastic, quick learning, multi-tasking challenge-seeker, goes the extra mile to get the job done
AREAS OF EXPERTISE
MS Office Proficient Management Quality and Assurance Injection/Infusion coding Guidelines
Quadramed/Quantim 3M Administration Hospital Practices / Policies
Compliance CPT-4 Codes Auditing ICD-9 Diagnoses/Procedures
EDUCATION
Mid-way through a Counseling Psychology Master's Degree
Bachelor of Science Degree in Healthcare Administration Management 2006
Thomas Jefferson University – Philadelphia, PA (GPA: 3.54 – Cum Laude, Dean's List for 4 years consecutively)
Member: Alpha Sigma Lambda Honors Society
SYNOPSIS OF EMPLOYMENT CHALLENGES
Initially worked as an Inpatient coder at Thomas Jefferson University Hospital. Maintaining productivity and accuracy for three years and assuring that there was proper assignment of the correct DRG. After the IP charts I went to the CPT world working with Outpatient. Since then I have accomplished working Anesthesia, Emergency Room- Physician and Facility, Surgery, Pediatrics and working with CMS for an audit on documenting the HCC's in the patient's chart over a three year span.
Latest proficiencies are working for the past two years on The Three Day Window as a Compliance Manager training coders how to extract correct charges for the ED visit from the Inpatient Stay without it effecting the already billed and paid DRG. Also during that time have assisted in the product development for a MS-DRG project including physician education on documentation and the code assignment to help generate increase in revenue.
CAREER HISTORY
Have worked multiple facilities as a consultant and have taken the opportunity to supply just a few of them to explain the various job duties that I have perfected.
IMA-Consulting, Chadds Ford, PA 2009-
Permanent Full-Time
Quality Assurance, Coding and Compliance Manager
Working with Coding and Compliance the Emergency Departments that fall under the Three-Day Window Rule. Specializing in Injection and Infusion Hierarchy. Train staff to follow Federal coding guidelines according to CMS. Provide service to the HIM departments in the multiple facilities that utilize our products. Work with the charge extraction process to create patient accounts that had previously been bundled into an Inpatient visit and prepare them correctly to be accurately billed as a new encounter for Medicare.
McBee Associates, Wayne Pennsylvania 2008- 2009
Permanent Full-Time Coder and Auditor
Code for multiple facilities located nationwide. Utilize the Three day payment window, 72 hour Rule from Medicare. Participate in the development of new products inside the healthcare market that would increase reimbursement for our clients.
Children's Hospital of Philadelphia, Philadelphia Pennsylvania 2007-2008
Permanent Full-time Abstractionist/Certified Coder
Abstracting, Coding and Entering ICD-9 and CPT-4 codes. Assigning E/M levels for ER encounters
Utilizing appropriate ICD-9, CPT-4 coding with all necessary Modifiers. Feedback forms to physicians and tracking the system to make sure that the patients that we are responsible for are documented correctly.
St. Christopher's Pediatric Associates, Philadelphia Pennsylvania 2007
Certified Procedural Coder
Emergency Department coding- Physician end, Radiology- Physician end and Pathology coding.
ICD-9, CPT-4 coding with all Modifiers needing to be properly applied.
Diskriter Pennsylvania 2007
Consultant
Consultant- Have been working on projects at Crozier Hospital – at Taylor division doing ED coding- Hospital end.
Coding and charge entry for all patients, applying ICD-9, ICD-9 CM, CPT-4 and Medicare Modifiers.
Evolution Staffing- MERCK Philadelphia
Consultant/Auditor 2007
Prepare and perform Medical Coding of CRF data (e.g. adverse events, medication, medical history, surgical history) according to commercial and/or study specific dictionaries. Assign codes to items requiring coding.
Associate Data Management Specialist, US DMC and Consolidated Manual Encoding/ Vocabulary Standards Data Operations Integration, WCDMO
KForce, Tampa, FL 2005
Professional Consultant /Auditor
Multiple consultant jobs; working onsite and remote.
Outpatient, Emergency Room, Radiology, Pain Management as well as conducting audits to ensure correct coding and compliance.
Currently working a remote project for Kaiser Permanente
CMS – Leprechaun
Professional Consultant /Auditor 2006
Conduct on-site chart reviews of patient records in physician offices as an auditor to improve the accuracy of these records for enhanced quality of care and more accurate payment to insurers.
Interacts frequently with physicians, nurses and office staff, while maintaining a thorough knowledge of patient records organization and provider office operations.
CERTIFICATIONS
Member of AAPC CPC Certified
Member of AHIMA CCS Certified
Member of ACMCS PCS Certified
Certificate Program for Medical Coding – Thomas Jefferson University
Pursuing a CPMA (Certified Professional Medical Auditor)
Pursuing a CEDC (Certified Emergency Department Coder)
215-888-7889 PaulaAbbruzzese@gmail.com
HEALTH CARE MANAGEMENT/ADMINISTRATION
Principled, high level of integrity, dedicated, loyal, dependable, hard-working, strong work ethic
Hands-on, motivated, high-energy, technically proficient, confident, multi-talented team player
Personable, outgoing, great people skills, highly effective communicator and relationships builder
Creative, thinks on demand, easily takes control, strong crisis resolution and problem solving expertise
Organized, focused, detail-oriented, thorough, efficient, works well in a fast-paced environment
Enthusiastic, quick learning, multi-tasking challenge-seeker, goes the extra mile to get the job done
AREAS OF EXPERTISE
MS Office Proficient Management Quality and Assurance Injection/Infusion coding Guidelines
Quadramed/Quantim 3M Administration Hospital Practices / Policies
Compliance CPT-4 Codes Auditing ICD-9 Diagnoses/Procedures
EDUCATION
Mid-way through a Counseling Psychology Master's Degree
Bachelor of Science Degree in Healthcare Administration Management 2006
Thomas Jefferson University – Philadelphia, PA (GPA: 3.54 – Cum Laude, Dean's List for 4 years consecutively)
Member: Alpha Sigma Lambda Honors Society
SYNOPSIS OF EMPLOYMENT CHALLENGES
Initially worked as an Inpatient coder at Thomas Jefferson University Hospital. Maintaining productivity and accuracy for three years and assuring that there was proper assignment of the correct DRG. After the IP charts I went to the CPT world working with Outpatient. Since then I have accomplished working Anesthesia, Emergency Room- Physician and Facility, Surgery, Pediatrics and working with CMS for an audit on documenting the HCC's in the patient's chart over a three year span.
Latest proficiencies are working for the past two years on The Three Day Window as a Compliance Manager training coders how to extract correct charges for the ED visit from the Inpatient Stay without it effecting the already billed and paid DRG. Also during that time have assisted in the product development for a MS-DRG project including physician education on documentation and the code assignment to help generate increase in revenue.
CAREER HISTORY
Have worked multiple facilities as a consultant and have taken the opportunity to supply just a few of them to explain the various job duties that I have perfected.
IMA-Consulting, Chadds Ford, PA 2009-
Permanent Full-Time
Quality Assurance, Coding and Compliance Manager
Working with Coding and Compliance the Emergency Departments that fall under the Three-Day Window Rule. Specializing in Injection and Infusion Hierarchy. Train staff to follow Federal coding guidelines according to CMS. Provide service to the HIM departments in the multiple facilities that utilize our products. Work with the charge extraction process to create patient accounts that had previously been bundled into an Inpatient visit and prepare them correctly to be accurately billed as a new encounter for Medicare.
McBee Associates, Wayne Pennsylvania 2008- 2009
Permanent Full-Time Coder and Auditor
Code for multiple facilities located nationwide. Utilize the Three day payment window, 72 hour Rule from Medicare. Participate in the development of new products inside the healthcare market that would increase reimbursement for our clients.
Children's Hospital of Philadelphia, Philadelphia Pennsylvania 2007-2008
Permanent Full-time Abstractionist/Certified Coder
Abstracting, Coding and Entering ICD-9 and CPT-4 codes. Assigning E/M levels for ER encounters
Utilizing appropriate ICD-9, CPT-4 coding with all necessary Modifiers. Feedback forms to physicians and tracking the system to make sure that the patients that we are responsible for are documented correctly.
St. Christopher's Pediatric Associates, Philadelphia Pennsylvania 2007
Certified Procedural Coder
Emergency Department coding- Physician end, Radiology- Physician end and Pathology coding.
ICD-9, CPT-4 coding with all Modifiers needing to be properly applied.
Diskriter Pennsylvania 2007
Consultant
Consultant- Have been working on projects at Crozier Hospital – at Taylor division doing ED coding- Hospital end.
Coding and charge entry for all patients, applying ICD-9, ICD-9 CM, CPT-4 and Medicare Modifiers.
Evolution Staffing- MERCK Philadelphia
Consultant/Auditor 2007
Prepare and perform Medical Coding of CRF data (e.g. adverse events, medication, medical history, surgical history) according to commercial and/or study specific dictionaries. Assign codes to items requiring coding.
Associate Data Management Specialist, US DMC and Consolidated Manual Encoding/ Vocabulary Standards Data Operations Integration, WCDMO
KForce, Tampa, FL 2005
Professional Consultant /Auditor
Multiple consultant jobs; working onsite and remote.
Outpatient, Emergency Room, Radiology, Pain Management as well as conducting audits to ensure correct coding and compliance.
Currently working a remote project for Kaiser Permanente
CMS – Leprechaun
Professional Consultant /Auditor 2006
Conduct on-site chart reviews of patient records in physician offices as an auditor to improve the accuracy of these records for enhanced quality of care and more accurate payment to insurers.
Interacts frequently with physicians, nurses and office staff, while maintaining a thorough knowledge of patient records organization and provider office operations.
CERTIFICATIONS
Member of AAPC CPC Certified
Member of AHIMA CCS Certified
Member of ACMCS PCS Certified
Certificate Program for Medical Coding – Thomas Jefferson University
Pursuing a CPMA (Certified Professional Medical Auditor)
Pursuing a CEDC (Certified Emergency Department Coder)