LiveCareer
LiveCareer
  • Dashboard
  • Jobs
  • Resumes
  • Cover Letters
  • Resumes
    • Resumes
    • Resume Builder
    • Resume Examples
      • Resume Examples
      • Nursing
      • Education
      • Administrative
      • Medical
      • Human Resources
      • View All
    • Resume Search
    • Resume Templates
      • Resume Templates
      • Nursing
      • Education
      • Medical
      • Human Resources
      • Customer Service
      • View All
    • Resume Services
    • Resume Formats
    • Resume Review
    • How to Write a Resume
    • CV Examples
    • Resume Objectives
  • Cover Letters
    • Cover Letters
    • Cover Letter Builder
    • Cover Letter Examples
      • Cover Letter Examples
      • Education
      • Medical
      • Human Resources
      • Customer Service
      • Business Operations
      • View All
    • Cover Letter Services
    • Cover Letter Templates
    • Cover Letter Formats
    • How to Write a Cover Letter
  • Jobs
    • Mobile App
    • Job Search
    • Job Apply Tool
    • Salary Calculator
    • Business Letters
    • Job Descriptions
  • Questions
  • Resources
  • About
  • Contact
  • 0Notifications
    • Notifications

      0 New
  • jane
    • Settings
    • Help & Support
    • Sign Out
  • Sign In
Member Login
  • LiveCareer
  • Resume Search
  • DRG Validation
Please provide a type of job or location to search!
SEARCH

DRG Validation Resume Example

Resume Score: 60%

Love this resume?Build Your Own Now
DRG VALIDATION
Professional Summary
Certified Medical Auditor/Coder with 18 years experience in hospital and nursing facilities. Accurate and detail-oriented with knowledge of coding, validation, and appeals. ​Organized DRG Validation with foundation in records management. Experienced in billing and collection procedures. Advanced medical terminology knowledge.
Skills/System Experience
  • ICD-10 (International Classification of Disease Systems)
  • Inpatient records coding/Auditing proficiency  
  • Familiar with commercial and private insurance carriers  
  • Excellent problem solver
  • Close attention to detail
  •  Excellent knowledge of 3M, Quantum, Quadramed, CAC, Clintegrety360 coding systems.   
  • Medical terminology expert
  • ​Patient chart auditing ability
  • ​DRG and PC grouping
  • ​Office management professional
  • ​Adept multi-tasker
  • ​Excellent verbal communication
  • ​Excellent knowledge using Meditech, HPF, HDM,EPIC and many more home grown systems.
  • ​Resourceful and reliable worker
Work History
DRG ValidationMedPartners HIM/CDI - Mount Sinai Hospital, New York, NY(Remote)04/2012 - Current
  • Code/Validate inpatient charts at a rate of 2 per hour or 20 per 10 hour workday.
  • Meticulously identified and rectified inconsistencies, deficiencies and discrepancies in medical documentation.
  • Maintain updated knowledge of coding requirements, through continuing education and certification renewal.
  • Audit/Code high dollar and high volume complex inpatient records(Transplants, Cardiac, Interventional Radiology, Cancer, Neurology, OB, Newborn, Gastrointestinal,Trauma etc).
DRG ValidationContract Auditing/Coding - St. Lukes Cornwall Hospital10/2008 - Current
  • Meticulously identify and rectify inconsistencies, deficiencies and discrepancies in medical documentation.
  • Correctly code and bill medical claims for various hospital and nursing facilities.
  • Validate inpatient charts at a rate of 2 per hour or 10 per day as needed per facility(Number of hours vary from week to week).
  • Maintain updated knowledge of coding requirements, through continuing education and certification renewal.
  • Review and process Medicare, Medicaid, Commercial insurance, and RAC denials and appeal if necessary.
  • Perform monthly compliance reviews and educate coders in needed areas based on reviews.
  • Communicate directly with physicians and director regarding queries, documentation etc.
  • Act as Liaison between coders and CDI.
Inpatient Coder/AuditorWestchester Medical Center - Valhalla, New York09/2002 - 04/2012
  • Coded/Audited inpatient charts at a rate of 3 per hour or 24 per 8 hour work day.
  • Assisted in the maintenance of medical charts and/or electronic medical record (filing, Op Reports, test results, home care forms).
  • Meticulously identified and rectified inconsistencies, deficiencies and discrepancies in medical documentation.
  • Maintained updated knowledge of coding requirements, through continuing education and certification renewal.
  • Resourcefully used various coding books, procedure manuals and on-line encoders.
  • Served as Taskforce Manager for Clinical Documentation Program.
  • Coded/Audited inpatient Rehabilitation records using the IRF-PAI payment method.
Inpatient/Outpatient CoderOlean General Hospital - Olean, New York06/1996 - 09/2002
  • Reviewed, analyzed and managed coding of diagnostic and treatment procedures contained in outpatient medical records.
  • Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy.
  • Actively maintained current working knowledge of CPT and ICD-9 coding principles, government regulation, protocols and third party requirements regarding billing.
  • Coded inpatient charts at a rate of 3 per hour or 24 per 8 hour workday.
  • Coded/Audited Emergency room records at 5 per hour on average using E & M coding.
  • Coordinated and managed the development of chargemaster.
  • ​
Coder/AuditorIndependent Contract Coding/Auditing - New York Presbyterian Hospital07/2006 - 08/2010
  • Coded/AuditedEmergency roomcharts at a rate of 5 per hour using E & M codes and current coding guidelines.
  • Meticulously identified and rectified inconsistencies, deficiencies and discrepancies in medical documentation.
  • Maintained updated knowledge of coding requirements, through continuing education and certification renewal.
Contract Coder/AuditorClinical Coding Solutions - Remote for Geisenger Medical Center01/2008 - 06/2008
  • Meticulously identified and rectified inconsistencies, deficiencies and discrepancies in medical documentation.
  • Maintained updated knowledge of coding requirements, through continuing education and certification renewal.
  • Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy.
  • Conscientiously reviewed medical record information to identify appropriate coding based on CMS HCC categories.
Education
Associate of Science: Health Information ManagementState University of New York College of Technology at Alfred - Alfred, New York1999
  • Health Information Technician (RHIT) coursework
  • Coursework in Business, Accounting and Healthcare Administration
  • Coursework in Healthcare Management
Certifications
  • Registered Health Information Technician (RHIT), November 2007.
  • ​Certified Coding Specialist - Hospital Based(CCS), June 2004.
  • AHIMA approved ICD-10-CM/PCS Trainer, October 2011.
Build Your Own Now

DISCLAIMER

Resumes, and other information uploaded or provided by the user, are considered User Content governed by our Terms & Conditions. As such, it is not owned by us, and it is the user who retains ownership over such content.

Resume Overview

Companies Worked For:

  • MedPartners HIM/CDI
  • Contract Auditing/Coding
  • Westchester Medical Center
  • Olean General Hospital
  • Independent Contract Coding/Auditing
  • Clinical Coding Solutions

School Attended

  • State University of New York College of Technology at Alfred

Job Titles Held:

  • DRG Validation
  • Inpatient Coder/Auditor
  • Inpatient/Outpatient Coder
  • Coder/Auditor
  • Contract Coder/Auditor

Degrees

  • Associate of Science : Health Information Management

Create a job alert for [job role title] at [location].

×

Advertisement

Similar Resumes

View All
DRG-Coordinator-resume-sample

DRG Coordinator

Carewise Health

Louisville, Kentucky

Validation-Technician-resume-sample

Validation Technician

SAFC Carlsbad

Colorado Springs, Colorado

Validation-Engineer-resume-sample

Validation Engineer

Beckman Coulter

Minneapolis, Minnesota

About
  • About Us
  • Privacy Policy
  • Terms of Use
  • Sitemap
Help & Support
  • Work Here
  • Contact Us
  • FAQs
Languages
  • EN
  • UK
  • ES
  • FR
  • IT
  • DE
  • NL
  • PT
  • PL
Customer Service
customerservice@livecareer.com
800-652-8430 Mon- Fri 8am - 8pm CST
Sat 8am - 5pm CST, Sun 10am - 6pm CST
  • Stay in touch with us
Site jabber winner award

© 2021, Bold Limited. All rights reserved.