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radiation billing and coding compliance auditor resume example with 20+ years of experience

Jessica Claire
, , 609 Johnson Ave., 49204, Tulsa, OK 100 Montgomery St. 10th Floor
Home: (555) 432-1000 - Cell: - resumesample@example.com - - -
Summary

Self- motivated Billing and Compliance auditor with upwards of 20 years of extensive educational experience and training in all facets of Radiation Therapy. Assists the practices in multiple aspects of education, program development, compliance, through the development of quality solutions and tools. Provides practices with a systematic, objective analysis of billing, coding and documentation activities in the field of radiation oncology. Furnishes recommendations concerning the activities reviewed to add value, improve operations and mitigate risk to an organization. Committed to monitoring compliance with laws, regulations, and policies.

Skills
  • Interpersonal and written communication
  • Electronic medical records (IKnowMed, ARIA, MOSAIQ, Centricity, Tiger)
  • Thorough/detailed knowledge of ICD-10 and CPT coding systems
  • Identify regulatory compliance issues including supervision guidelines, incident to, shared services, etc.
  • Maintains current knowledge of CMS, NCD and LCD’s guidelines
  • Proficient in Microsoft office including Word and Excel
  • Cross functional collaboration
  • Relationship building
  • Training and Development
Experience
03/2013 to Current
Radiation Billing and Coding Compliance Auditor The University Of Kansas Hospital Lee's Summit, MO,
  • Ensure effective auditing of billing and coding activities in Radiation Oncology across the US Oncology Network, that has over 225 Radiation Oncologists, by evaluating charge capture to ensure that all services are documented in the patient’s medical record.
  • Detect areas of billing inefficiencies, internal control weaknesses and noncompliance with departmental and/or company policies/procedures and ensure corrective action plans are developed as needed.
  • Review code utilization by individual providers as compared to the Network average.
  • Utilize data files obtained from the data warehouse to apply specific code testing across the Network to identify outliers.
  • Draft written reports in accordance with audit reporting standards.
  • Ensure that all audit findings, exceptions, proposed adjustments and work papers are well defined and explained or included in the report.
  • Create formal recommendations for physician practices to enhance compliant coding and documentation practices.
  • Monitor audit issues to resolution/ closure with input from Executive Directors, Practice Presidents, Business Office and Practice Administrators.
  • A liaison between the company and practice personnel.
  • Work with management in all areas to define the audit function as it relates to overall business activities.
  • Work with other teams to include, Regional Senior Vice Presidents, Revenue Cycle Management, Coding Quality Review and Education within McKesson to provide support to the Network.
  • Presented audit results to practice management teams, delivering information in non-technical terms for easy understanding.
05/2004 to 02/2013
Working Chief Therapist The University Of Kansas Hospital Saint Joseph, MO,
  • Working Chief Therapist, administered ionizing radiation treatments
  • Performed quality assurance of treatment delivery machines, clinical plans and patient charts
  • Supervised and evaluated radiation therapists and ancillary radiation staff
  • Clinical educational coordinator, trained and evaluated Radiation Therapy students from SUNY Upstate Medical College, Syracuse
  • Fostered relationship with Fulton Montgomery Community College Radiologic Technology program to have students rotate through Radiation Therapy and mobile PET/CT unit at NYOH Amsterdam
  • Maintained weekly billing and statistics
  • Conducted weekly chart rounds to ensure quality care of patients treatment and completed weekly chart checks
  • Facilitated quarterly Quality Assurance meetings for site
  • Reported Radiation Pathways to US Oncology for New York Oncology Hematology
  • Amsterdam Site Safety Officer, maintained monthly logs and directed fire drills
  • Abstract and Data entry into CNext for New York State Tumor Registry
  • Served as key liaison between Nathan Littauer and St. Mary Hospitals to facilitate quarterly tumor board meetings
11/2001 to 03/2004
Staff Radiation Therapist St. Peters Hospital City, STATE,
  • Delivered and recorded ionizing radiation treatments utilizing MOSAIQ
  • Performed Stereotactic Radiosurgery
  • Brachytherapy procedures
  • Son Array Ultrasound localization
  • Custom block cutting with Huestis block cutter.
01/1997 to 10/2001
Staff Radiation Therapist New York Oncology Hematology City, STATE,
  • Delivered daily ionizing radiation treatments
  • Simulated patients on the Ximatron
  • Custom block cutting with Huestis block cutter.
Education and Training
Expected in 2003 to to
Bachelors: Health Care Management
George Washington University - ,
GPA:
Expected in 1996 to to
Associate of Applied Science: Radiation Therapy
SUNY Upstate Medical College - Syracuse,
GPA:

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Resume Overview

School Attended

  • George Washington University
  • SUNY Upstate Medical College

Job Titles Held:

  • Radiation Billing and Coding Compliance Auditor
  • Working Chief Therapist
  • Staff Radiation Therapist
  • Staff Radiation Therapist

Degrees

  • Bachelors
  • Associate of Applied Science

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