Frank Spencer, MHA, BA, CPC, CCS-P8 Leonov, Lane, Richmond, ME 04357Tel: (H) (207) 656-3211 (C) (207) 737-9940

Profile Dedicated and skilled healthcare professional with strong organizational skills Excellent ability to work under pressure Seasoned background in the medical coding profession Exceptional ability to multitask many projects with exceptional results.

EducationKaplan University School of Health Sciences – Master of Healthcare Administration – January 2013 – January 2015

Kaplan UniversitySchool of Health Sciences – Bachelor of Science in Public Health – April 2010 – January 2013

New Hampshire CollegeSchool of Business Administration – June 1991 – January 1995

Field Medical Services SchoolUS Naval School of Health Sciences – February 1988 – April 1988

Hospital Corpsman A SchoolUS Naval School of Health Sciences – October 1987 – February 1988

Richmond High SchoolSeptember 1984 – June 1987

Certifications

Certified Coding Specialist – Provider American Health Information Management Association – February 2013

Certificate Program in Case Management University of Southern Maine Continuing Education – April 2008 – June 2008

Certified Professional CoderAmerican Academy of Professional Coders – June 2004

Professional Experience

Health Information Services, Charge Posting / Coding Specialists, January 2017 - PresentMaineGeneral Medical Center, Waterville, ME

Provides coding support for a variety of physician practices, including but not limited to Family Practice, Pediatrics, Pulmonology, Nephrology, Dialysis, Surgery, Orthopedics, Express Care, Allergy Immunology, Diabetes and Nutrition, Anticoagulation, Pediatric Behavioral Health, Physiatry, Neurology, Rheumatology

Reviews and confirms that all of the required information has been captured on the encounter form. Responsible for the coding accuracy of all encounter (including ICD-10, CPT and HCPCS codes). This also

includes accurate use of coding modifiers. Captures all hospital (inpatient, outpatient and ambulatory services) and assures that these charges are coded and

posted in a timely manner. Assures that all encounter charges are accounted for by completing charge reconciliation daily. Reviews denial and lag time reports monthly and discusses the findings with the Practice

Administrator/Coordinator to assure appropriate procedure changes and ongoing education Has knowledge in the use of the EMR, 3M/HDM Encoding system, Soarian Financials and other computer

programs used for the various physician practices. Checks regulatory documents to ensure ICD-9, CPT and HCPCHS codes are correct

Revenue Cycle Compliance Specialist, October 2016 – January 2017MaineGeneral Health, Augusta, ME

Monitors, reviews and tracks on-going communications from Medicare/CMS including monitoring and tracking of Medi-messages.

Communicates timely with areas impacted by regulatory changes and assists depts. in developing self-monitoring protocols and processes.Performs random self-monitoring/reviews of high-risk areas or recently implemented changes in CDMs, billing and other regulatory requirements to ensure accurate and complete reporting on third party payer bill forms including CMS 1500 and UB92. Collaborates with Revenue Cycle Leaders to ensure self-monitoring of process changes are completed and documented.

Assists with self-monitoring of significant or high-risk changes within the revenue cycle. Collaborates with Ethics and Compliance and Health Information Services departments to provide resource for ancillary departments on revenue cycle regulatory questions for medical center regarding CMS and or other regulatory rules and changes.

Serves as the primary contact for revenue cycle core departments – PFS, Pt Registration and Revenue Management for questions regarding revenue cycle compliance. Screens and refers questions for legal guidance as appropriate.Leads the development of on-going education and training plans related to annual APC/CMS changes. Collaborates with members of the PARC Support team, Revenue Management charge master team, Ethics and Compliance and HIS to ensure timely training and education on regulatory changes is provided to ancillary areas impacted by change. Assists Patient Registration and Patient Financial Services and their respective Training Coordinators in developing education and training on regulatory changes to ensure staff education and training is completed timely and effectively.Works with PARC Support team and ancillary department representatives to analyze and implement quarterly Outpatient Prospective Payment System (OPPS), Inpatient Prospective Payment System (IPPS) and Ambulatory Payment Classification (APC) changes.

Serves on various ad-hoc or established workgroup to assist in revenue cycle implementation/changes in processes. Other duties and tasks assigned by the Director that support the on-going education, training and accurate implementation of revenue cycle regulatory changes.

Trainer Physician Practice Coding Educator, November 2010 – October 2016MaineGeneral Medical Center, Waterville, ME

Provides ongoing training to physician practice coding staff related to claims review findings, regulatory updates and established coding practices.

Conducts focused claim reviews to ensure coding and charging accuracy and compliance.Reviews late charge work list daily to ensure charges are accurately and efficiently resubmitted for corrected claims.Reviews the Enhanced Billing Error Work lists for NCCI, Diagnosis and modifier issues to ensure timely claims

submission.Reviews denials for accurate coding, modifier and diagnosis usage.Assists in secondary review of ePremis edits identified by claims editing staff.Monitors the accuracy of physician and facility claims for MGMC Physician Practices that have been or will be

submitted to third party payers.Provides ongoing coding and billing training to other patient care personnel involved in the claim development and

submission process to ensure material compliance with laws and regulations relating to the submission of claims.Facilitation of record compilation and reviews for Medicare ADR (Additional Documentation Requests, other

government payers and private payer requests.Complies with Corporate Compliance Policy as set out in the Standards of Ethical Conduct and Business Practices.Protected Health Information is kept confidential at all times.Enhances cooperation and communication between the physician offices, the MaineGeneral Health Information

Services Department, the Physician Liaison and the MaineGeneral Medical Center’s Registration and Patient Financial Services departments.

Maintains and fosters a positive working environment within the department by promoting ongoing communication and staff participation in active problem solving of practice issues.

Keeps Manager/Director informed of problems and issues. Seeks guidance in resolution of problems as needed.Assists the Health Information Services Coding Manager, Director of HIS and Practice Administration to ensure that

accepted auditing procedures are used to evaluate the accuracy of coding and documentation.

Assists the Health Information Services Coding Manager, Director of HIS and Practice Administration to ensure that provide ongoing education and training to ensure MaineGeneral policies and processes are in place.

Demonstrates performance, which is consistent with the organization mission, values, and quality improvement standards. Promotes a culture of customer service centered on care. Elements of performance will include teamwork, innovation, respect, corporation and honesty which create a positive image of leadership across the organization.

Participates in Health Information Services meetings, on-site and off-site coding training sessions and other activities as assigned by the HIS Coding Manager.

Accepts supervision and guidance and actively participates in efforts to improve quality of performance.Takes initiative for own professional growth and development by taking advantage of in-house educational offerings

and attending trainings as budget allows.

Charge Coding / Posting Representative II, June 2001 – November 2010MaineGeneral Medical Center, Winthrop, ME

Verifies that all demographic information is updated and accurate for each encounter. This includes securing accurate third party payer information.

Reviews and confirms that all of the required information has been captured on the encounter form. Responsible for the coding accuracy of all encounter (including ICD-9, CPT and HCPCS codes). This also

includes accurate use of coding modifiers. Captures all hospital and nursing home charges and assures that these charges are coded and posted in a timely

manner. Assures that all encounter forms are accounted for and completes the ticket reconciliation daily. Enters and

reconciles charges daily. Completes the hospital reconciliation report monthly and assures that all missing charges are captured and entered

in a timely manner. Assures that all medications and supplies are accurately priced and captured. Conducts or obtains an inventory of

supplies and medications comparing against existing charges in GPMS to assure that nothing new has been added to the inventory that is not being charged for and pursues appropriate action for anything identified that is not being charged for.

Reviews denial and lag time reports monthly and discusses the findings with the Practice Administrator/Coordinator to assure appropriate procedure changes and ongoing education

Has knowledge in the use of the EMR and other computer programs used in the practice. Is able to correctly keyboard pertinent information, as well as search for information in the appropriate areas of the EMR and other computer programs in the practice.

Checks regulatory documents to ensure ICD-9, CPT and HCPCHS codes are correct.

Patient Services Representative / Medical Assistant, April 2003 – November 2010Ryan White Part C Grantee – Horizon Clinic, MaineGeneral Medical Center Gardner, ME

Greets and registers patients in a prompt, courteous and helpful manner. Answers telephones, takes messages and provides non-medical information. Use EMR to provide information to patients and requests information from providers Schedules routine and acute appointments Verifies that all demographic information is updated and accurate for each encounter. This includes securing

accurate third party payer information. Discharges patients, schedule appropriate follow-up, diagnostic testing as needed. Facilitates a team approach to patient care; communicating effectively with patients, families and other members

of the HIV multidisciplinary team to provide appropriate level of care. Administers routine immunizations of HIV patients

Medical Service Representative, July 2000 – October 2000 Intelicare, Inc, Portland, ME

Answering multi-line telephone Patient Triage Printing, faxing and filing of medical triage reports

Data entry of patient information

Medical Administration ClerkJune 1997 – June 1998 Veterans Administration, Togus, ME

Answer multi-line telephone Patient check-in and check-out for multi-provider clinics Make routine, acute pre-operative, post-operative, ancillary service appointments Medical record upkeep

Navy Hospital Corpsmen / Emergency Medical TechnicianAugust 1987 – March 1995 United States Navy Various Locations,

Patient care in a clinic setting and emergency setting Emergency vehicle operator trainer – trained approximately 150 non-medical staff on operation of the base

ambulances Medical supply purchasing – responsible for an annual supply budget of $750,000 Supplemental healthcare agent – responsible for an annual supplemental healthcare budge of $250,000

Teaching

Adjunct Professor, January 2009 - PresentKaplan University, Lewiston, ME

Adjunct instructor for the Medical Assistant Program for Kaplan University Maine, providing instruction both at on-ground locations and online for medical terminology, medical coding & billing, medical office management and professionalism in healthcare courses for the medical assistant program.

Service Work Secretary / Treasurer Lewiston Chapter of American Academy of Professional Coders

January 2012 – December 2012 Treasure Lewiston Chapter of American Academy of Professional Coders.

January 2011 – December 2011

Honors & Awards

Graduated Summa Cum Laude – January 2013 Kaplan University

National Society of Collegiate Scholars – 2011Kaplan University

Alpha Beta Kappa National Honor Society – September 2011Kaplan University – Delta Zeta Chapter