l fox 6-2016 resume

3
Laura Fox 1205 Queen Anne Ave N Apt 103 Seattle, WA, 98109 (253) 230-0237 [email protected] Objective To obtain a challenging position that utilizes my health information knowledge and my practical skills, as well as one that allows me to continue to grow professionally. Qualifications Achieved RHIT in September 2005, credentials maintained Coded outpatient and radiology accounts utilizing ICD-9 and CPT coding Perform medical necessity reviews, denials, and appeals using Interqual and MCG guidelines Prepare reports and distribute to appropriate management Provide education to colleagues and physicians Excellent communication and organizational skills Utilize multiple databases to store and record information Experience May 2012 - May 2016 Franciscan Health System, Tacoma, WA - Utilization Management Specialist Apply Interqual and MCG criteria to complete medical necessity reviews Work denials and appeals to achieve optimal reimbursement Collaboratively work with attending MDs and Care Management team creating policies and procedures and provide education EPIC, MCCM, Indicia experience Jan 2009 - May 2013 CARE Communications, Chicago, IL - Coding Quality and Review Educator; Coding Consultant Reported errors, inconsistent documentation, and over/under coding as it affected reimbursement and compliance Operated with Research Department on HMO Medicare and Medicaid risk adjustment HCC projects throughout the US Abstracting healthcare research projects for companies and government Other special projects as contracts were obtained

Upload: laura-fox

Post on 25-Jan-2017

43 views

Category:

Documents


3 download

TRANSCRIPT

Page 1: L Fox 6-2016 Resume

Laura Fox

1205 Queen Anne Ave N Apt 103 Seattle, WA, 98109 (253) 230-0237 [email protected]

Objective To obtain a challenging position that utilizes my health information knowledge and my practical skills,

as well as one that allows me to continue to grow professionally.

Qualifications Achieved RHIT in September 2005, credentials maintained

Coded outpatient and radiology accounts utilizing ICD­9 and CPT coding

Perform medical necessity reviews, denials, and appeals using Interqual and MCG guidelines

Prepare reports and distribute to appropriate management

Provide education to colleagues and physicians

Excellent communication and organizational skills

Utilize multiple databases to store and record information

Experience May 2012 - May 2016

Franciscan Health System, Tacoma, WA - Utilization Management Specialist

Apply Interqual and MCG criteria to complete medical necessity reviews

Work denials and appeals to achieve optimal reimbursement

Collaboratively work with attending MDs and Care Management team creating policies and

procedures and provide education

EPIC, MCCM, Indicia experience

Jan 2009 - May 2013

CARE Communications, Chicago, IL - Coding Quality and Review Educator; Coding

Consultant

Reported errors, inconsistent documentation, and over/under coding as it affected

reimbursement and compliance

Operated with Research Department on HMO Medicare and Medicaid risk

adjustment HCC projects throughout the US

Abstracting healthcare research projects for companies and government

Other special projects as contracts were obtained

Page 2: L Fox 6-2016 Resume

Laura Fox

Jan 2009 - Sept 2009

Franciscan Health System, Tacoma, WA - Coder II Lead

Served as a reference and aide to any questions/help needed regarding coding

questions

Educated and trained new hires or promoted employees

Coded outpatient accounts; Applied CPT, E&M levels, ICD­ codes

Worked closely with upper level management and compliance department to ensure

appropriate compliance and application of government rules and regulations

Oct 2006 - Jan 2009

Franciscan Health System, Tacoma, WA - Charge Capture Reconciliation Specialist

Review Radiology accounts to ensure accurate coding and billing for four hospitals

Provide training and education to coding, radiology technicians, physicians, and management to

ensure procedures were understood and charges were correctly documented

Develop and maintain, in collaboration with finance, radiology chargemaster for the four

hospitals

Worked closely with upper level management and compliance department to ensure

appropriate compliance and application of government rules and regulations

May 2006 - Oct 2006

Franciscan Health System, Tacoma, WA - Coder I

Coded ER and outpatient accounts

Applied CPT, E&M levels, ICD­9 codes

Billed for any procedures done in ER

May 2002 - May 2006

Franciscan Health System, Tacoma, WA - Diagnostic Imaging Representative

Answered phones and voicemails, order entry, filing, copied and released radiology reports and

films

Worked closely with MDs and technologists to communicate planned, on­call, and

add­on schedules during normal and after regular business hours to ensure appropriate patient

care

Page 3: L Fox 6-2016 Resume

Laura Fox

Education

Jan 2016 - June 2018 (Predicted graduation)

Western Governors University, Salt Lake City, UT - Online College of Information

Technology - B.S. Health Informatics

Sept 2002 - June 2005

Tacoma Community College, Tacoma, WA - Health Information Management Technician -

Associates in Applied Sciences

Vice President of HIM class 2005

Head Chair for Spring Leadership Conference