Highly organised individual with strong attention to detail.Strong analytical skills coupled with clear communication and documentation in medical records.Detailed report preparation for individual department heads and broad summary reports for the Compliance Committee.
Knowledge of CPT and ICD-9 coding
Report preparation skills
Knowledge of federal and state compliance regulations
July 2008 to June 2014 Crambdon Community Hospital Â– Crambdon OH Medical Auditor
Reduced incidence of governmental investigational auditors by 30 percent over five years, whilst case load increased by 55 percent for the same time period.
Performed audits specifically targeting and evaluating procedural diagnosis code selection.
Presented audit findings and identified opportunities within the organisation for training.
Identified fraudulent claims.
Identified and corrected problems before government and insurance payers could challenge incorrect coding.
February 2003 to June 2008 South East Physicians Â– Akron OH Medical Auditor
Reviewed medical claims to detect unlawful or incorrect Medicare payments.
Conducted quality assurance assessments and reviewed statistical samples.
October 1998 to January 2003 Midwest Physicians Â– London Medical Auditor
Utilised CPTS, ICD-9 and other coding systems, with emphasis on compliance and regulatory standards.
Communicated results and findings.
1998 Charity Hospital Â– London Externship Â– Medical Auditor
Applied coding concepts.
Provided medical records support services.
1999 English Academy of Professional Coders Certified Professional Medical Auditor (CPMA) 1998 London Community College, London, England Associate Degree, Health Information Technology