Lisa R.

Experience

• 

  Cigna Healthcare

  Jan 1994 - Jan 2002

  Quality Care Liasion

  Credentialing of dental providers, case management.

• 

  Baylor Scott & White Health

  Jan 2002 - now

  °Perform routine coding quality reviews on all coders and/or auditors including third party suppliers asappropriate.°Perform coding quality reviews in collaboration with or for internal customers of the organization.°Provide feedback and education as appropriate depending on findings.°Abstracts and validates required data elements into the coding and abstracting system.°Evaluation and Management auditing°Experience in multi-specialties°Experience in Pro-Fee, Hospital, Emergency Department, General Surgery, Pediatrics, Ob/Gyn, Podiatry, Wound°Review, research, and process billing edits working collaboratively with revenue cycle departments toensure coding and edits are processed timely and accurately.°Work collaboratively with other departments to communicate opportunities for accurate, completeand compliant documentation.°Complete production coding when needed and assigned by one over.°Research and update coding hot tips as needed.°Create articles for coding newsletter.°Research and create educational presentations.°Tasked with training new coding auditors to team. Show less • Utilized keen knowledge in CPT and ICD-10 coding. • Analyzed and interpreted medical records to ascertain complete and accurate information for coding.• Investigated and resolved denied claims for payment processing.• Coded and entered diagnostic and procedure codes into billing system on service accounts as appropriate.• Led follow-up with provider on any unclear and/or insufficient documentation.• Ensured codes proved accurate and sequenced correctly in accordance with government and insurance regulations.• Maintained continuing education requirements by attending education workshops. Show less • Welcomed patients and visitors in a friendly manner. • Answered and directed phone calls in a polite and confidential way.• Greeted and registered patients in a professional manner.• Collected and verified required patient demographic and financial data elements, including determining a patient’s financial responsibility. Accepted insurance payments for physician/clinic services.• Managed check-in and check-out process efficiently. Prepared necessary correspondence for patients.• Created a positive patient experience by accurately and efficiently handing the day-to-day operations related to verification of eligibility/benefits, as well as scheduling, confirming, and verifying patient appointments.• Oversaw charge entry and performed daily chart review.• Facilitated ICD-9 and CPT coding. Scanned medical records. Show less

  • Coding Auditor

    Jul 2021 - now

  • Medical Records Coder I/II

    Jan 2015 - Jul 2021

  • Physician Office Representative

    Jan 2002 - Jan 2015