MzKeys
New
Kimberly D Keys CPC/ICD-10 Trainer
mzkimberly.keys@gmail.com
Objective:
Work Experience:
Ann & Robert H Lurie's Children's Hospital of Chicago (March 2011-Present)
Documentation Auditor for NICU/Peds, Infectious Disease, Allergy, Neurology
• Reviews and audits physicians' documentation in the medical record and the level of CPT code selection to verify accuracy through a concurrent coding program
• Determines visit, procedure and diagnosis code(s) based on documentation.
• Initiates corrections and resolves discrepancies
• Confers with the physicians to communicate and educate when deficiencies in documentation and code selection are identified
• Meets with Division Heads and Clinical Practice Directors or designees to present statistical data on audit findings, provides useful recommendations and documentation tools
• Keeps informed on coding and documentation guidelines.
• Performs monthly reconciliation between concurrent charges sent and entered
• Ensures that all concurrent charges and necessary information are submitted to the billing service in a timely manner
• Resolves all questions and problems with patients, third party payers, billing coordinators and coding and billing analysts and external billing services
Kelly Healthcare Resources (June 2010-March 2011)
Blue Cross Blue Shield ICD-9 to ICD-10 Analyst Consultant
• Developed the process and approach to use for conducting the mapping for the ICD-10 diagnosis and procedure codes
• Gathered business requirements through a variety of work sessions and interviews in order to facilitate and design workshops
• Provided leadership to departments regarding practices, tools and methods available to support the ICD-10 mapping efforts
• Reviewed the client's current ICD-9 claims experience and map them to the equivalent ICD-10 codes
• Facilitated cross-functional mapping sessions with the clients to review the complex mapping based on the client claims experience to determine consensus on the most appropriate map for the client
Straight Staffing (February 2010-June 2010)
Ingalls Memorial Hospital Outpatient Coder
WaterTower Surgicenter (January 2006-Decemeber 2009)
Lead Coding and Billing Specialist for General Surgery/Trainer
• Billed and coded for an ambulatory surgical center
• Verified that the physicians were using the appropriate level for their E/M services
• Ensured that the physicians were staying in compliance with dictating operative reports
• Educated physician on any changes pertaining to CPT and ICD9
• Audited other employee charts to be sure all codes meets medical necessity
• Trained new and existing employees on WTS protocol
Evaluation and Management Auditor for Inpatient and Outpatient
• Reviewed encounter forms and documentation to ensure physician services were coded according to coding guidelines from the AMA and CMS
• Reviewed medical records and abstracted pertinent information for proper assignment of E/M levels, ICD-9-CM diagnosis, HCPCS and modifiers according to coding guidelines
• Educated attending physicians, residents, and department/clinic staff to improve accuracy and completeness of documentation and coding
Chicago Heart & Vascular Consultants (February 2005-January 2006) Chicago, IL
Cardiovascular and Interventional Cardiology Coding Analyst
• Obtained appropriate reimbursement levels for professional services by reviewing and coding medical procedures, diagnoses and physician visits
• Analyzed denial and rejection reports and appeals whenever appropriate
• Provided information and direction to the physicians relevant to coding
• Submitted charges in a timely manner
Phoenix Physician Billing Service (April 2003-February 2005) Westchester, IL
Radiology and Interventional Radiology Coding Specialist
• Obtained appropriate reimbursement levels for professional services by reviewing and coding medical procedures, diagnoses and physician visits.
• Analyzed denial and rejection reports and appeals whenever appropriate.
• Provided information and direction to the physicians relevant to coding.
Education:
American Health Information Management Association Chicago, IL
Certified ICD-10-CM/PCS Trainer
August 2010
CPC Solutions PMCC Country Club Hills, IL
Certified Since 2003
Certified Professional Coder
Please email me with any career opportunities.
mzkimberly.keys@gmail.com
Objective:
Work Experience:
Ann & Robert H Lurie's Children's Hospital of Chicago (March 2011-Present)
Documentation Auditor for NICU/Peds, Infectious Disease, Allergy, Neurology
• Reviews and audits physicians' documentation in the medical record and the level of CPT code selection to verify accuracy through a concurrent coding program
• Determines visit, procedure and diagnosis code(s) based on documentation.
• Initiates corrections and resolves discrepancies
• Confers with the physicians to communicate and educate when deficiencies in documentation and code selection are identified
• Meets with Division Heads and Clinical Practice Directors or designees to present statistical data on audit findings, provides useful recommendations and documentation tools
• Keeps informed on coding and documentation guidelines.
• Performs monthly reconciliation between concurrent charges sent and entered
• Ensures that all concurrent charges and necessary information are submitted to the billing service in a timely manner
• Resolves all questions and problems with patients, third party payers, billing coordinators and coding and billing analysts and external billing services
Kelly Healthcare Resources (June 2010-March 2011)
Blue Cross Blue Shield ICD-9 to ICD-10 Analyst Consultant
• Developed the process and approach to use for conducting the mapping for the ICD-10 diagnosis and procedure codes
• Gathered business requirements through a variety of work sessions and interviews in order to facilitate and design workshops
• Provided leadership to departments regarding practices, tools and methods available to support the ICD-10 mapping efforts
• Reviewed the client's current ICD-9 claims experience and map them to the equivalent ICD-10 codes
• Facilitated cross-functional mapping sessions with the clients to review the complex mapping based on the client claims experience to determine consensus on the most appropriate map for the client
Straight Staffing (February 2010-June 2010)
Ingalls Memorial Hospital Outpatient Coder
WaterTower Surgicenter (January 2006-Decemeber 2009)
Lead Coding and Billing Specialist for General Surgery/Trainer
• Billed and coded for an ambulatory surgical center
• Verified that the physicians were using the appropriate level for their E/M services
• Ensured that the physicians were staying in compliance with dictating operative reports
• Educated physician on any changes pertaining to CPT and ICD9
• Audited other employee charts to be sure all codes meets medical necessity
• Trained new and existing employees on WTS protocol
Evaluation and Management Auditor for Inpatient and Outpatient
• Reviewed encounter forms and documentation to ensure physician services were coded according to coding guidelines from the AMA and CMS
• Reviewed medical records and abstracted pertinent information for proper assignment of E/M levels, ICD-9-CM diagnosis, HCPCS and modifiers according to coding guidelines
• Educated attending physicians, residents, and department/clinic staff to improve accuracy and completeness of documentation and coding
Chicago Heart & Vascular Consultants (February 2005-January 2006) Chicago, IL
Cardiovascular and Interventional Cardiology Coding Analyst
• Obtained appropriate reimbursement levels for professional services by reviewing and coding medical procedures, diagnoses and physician visits
• Analyzed denial and rejection reports and appeals whenever appropriate
• Provided information and direction to the physicians relevant to coding
• Submitted charges in a timely manner
Phoenix Physician Billing Service (April 2003-February 2005) Westchester, IL
Radiology and Interventional Radiology Coding Specialist
• Obtained appropriate reimbursement levels for professional services by reviewing and coding medical procedures, diagnoses and physician visits.
• Analyzed denial and rejection reports and appeals whenever appropriate.
• Provided information and direction to the physicians relevant to coding.
Education:
American Health Information Management Association Chicago, IL
Certified ICD-10-CM/PCS Trainer
August 2010
CPC Solutions PMCC Country Club Hills, IL
Certified Since 2003
Certified Professional Coder
Please email me with any career opportunities.