Coder, Coding Consultant, Coding Supervisor

Posted on: 2006-11-01

Leslie Johnson 17417 Red Oak Drive #133 Houston TX 77090 832-286-4830 Note: Co-workers often refer to me as "Sherlock Holmes" because I'm often the one who answers the difficult questions & finds the difficult information. AREAS OF EXPERTISE: * 5 years Anesthesiology Surgical and Crosswalk coding * 3+ years Cardiology Anesthesiologist Surgical and Crosswalk coding * 3+ years Pain Management coding * 10+ years experience with PPO, Managed Care (HMO), Cap plans, IPA, Medicare billing * 10+ years experience with billing, payment posting, appeals, collections * Member of several coding, compliance and HIPAA email List Serves * Member of Anesthesia Coding Alert coding magazine Article/Editorial Review Board * Created compliance & procedures manuals, written articles and working tools to assist in effective coding, billing and collections processes * CCS-P Certification * CPC Certification * TX Work Force Instructor Certification in Medical Insurance Coding and Billing EMPLOYMENT EXPERIENCE: MD Consulting, Chicago IL 02/006 to 8/31/2006 Full-time remote coder for billing company for 23 anesthesiologists; Coded approximately 350-450 charts per day; ICD-9, CPT surgical and anesthesia crosswalk coding from anesthesia chart notes and surgical operative notes for Cardiology, Ophthalmology, Orthopedics and other specialties River Oaks Imaging and Diagnostics, Houston TX 02/2005 to 2/2006 Coding and Data Entry Supervisor; Directly assisted Director of Billing and Collections with management and direction of over 40 billing staff and 8 coders; wrote coding dept. compliance plan; conducted audits to measure and identify coder skill and productivity; identified documentation and coding compliance discrepancies per ACR, OIG and CMS guidelines; established new processes with payment posters to identify billing and coding errors vs. arbitrary write-offs, resulting in the recovery of an average of $75,000/month in previously considered lost revenue; created, reviewed and analyzed payment reports to identify coding errors and payer trends resulting in the recovery of approximately $250,000/month in previously considered lost revenue; prepared educational materials and manuals with local coverage decisions for the coders, collectors and radiologists to maintain compliance and ethics in documentation, billing, and coding; teamed with collections dept. to insure incoming payments were consistent with contractual agreements; updated and maintained charge master system and superbills; MedFax accounting software, Excel and Microsoft Word used Medical Income Concepts, Inc. Houston TX 07/2001 to 02/2005 Full-time certified coder for billing company for 14 major anesthesiologist groups; Coded approximately 350-400 charts per day using ICD-9, CPT surgical and anesthesia crosswalk from anesthesia chart notes and surgical operative notes for Cardiology, Ophthalmology, Orthopedics, Pain management and other specialties; created and published Central Venous Access Device and Catheter coding tool; created policies and procedures manual for coding department; educated the cardiology account manager in recognizing the documentation elements to effectively pursue claims appeals resulting in a significant increase in number of appeals won; assisted other account managers to generate appeals for denied or rejected claims Medical Career Training, Inc., Houston TX 07/2000 to 03/2005 Part-time certified Instructor for Medical Coding and Insurance Billing; Created a modular program for billing and coding proprietary school. Courses included, but not limited to hands-on training with the following: Front office procedures such as: new patient information & customer service; Insurance identification and verification; Managed care, commercial and government payer guidelines and coverage policies; TWCC rules and guidelines; ICD-9, CPT, HCPCS coding; OIG, CMS, HIPAA and Tx Medicaid compliance rules, regulations; billing electronic claims and reading output reports; Payment posting and EOB analysis; aged claims and capitation reports,; Patient and insurance collections with samples of letters of medical necessity and appeal letters; Medisoft Accounting software Pin Oak Medical Surgical Associates Katy TX 01/1999 to 04/2001 Full-time Biller for four IM and FP physicians, PA and NP Created and trained billing department from scratch, duties included: Coding from physician chart notes, generating paper and electronic claims; posting payments; counseling patients regarding overdue accounts and balances; generating, delegating and working aged-claims and capitation reports, successfully reducing outstanding A/R from well over 120 days and approximately $100,000 to 90-120 days or less and to $20,000 within 6 months; identifying denied, rejected claims and correspondences for appeals, resubmissions and/or write-offs; maintaining and updating provider contracts and credentials; creating and updating superbill system; assisting with insurance verification; generating practice management reports to identify and track provider productivity and payer trends; organizing physician meetings regarding A/R, billing department policies and direction; weekly back-up and maintenance of system computers; CMeds/MedsAmerica and Medisoft accounting program Quin-Center Optical Brockton MA 03/1996 to 06/1998 Burton Cowan, OD (deceased), David Bondar, OD and David Horner, Optician Full-time Receptionist Insurance billing; Insurance verification; aged-claims follow-up; Medicare, MassHealth (medicaid), and commercial insurance and patient collections; scheduled appointments; ordered ophthalmic lenses and frames Shore Eye Associates, Indra Mohindra, OD Paddy Kalish, OD Brockton and Hanover MA 07/1994-01/1996Contracted A/R Specialist for Dr. Mohindra; Created policies and procedures manuals with the different payer guidelines; Recouped old A/Rs previously considered uncollectible; payment posting; negotiated physician credentialing and contracts; assumed payroll accounting duties and A/P while doctor was away on vacation; acted as liaison between for vendor contracts, payments, and ophthalmic supplies; ordered ophthalmic frames and lenses; assisted doctors with various diagnostic testing, Visual Fields and other duties. Full-time Office Manager/Receptionist for Dr. Kalish; Hired six optometrists and trained staff of four for three optometric offices; billed insurance companies; posted payments; conducted aged A/R follow-up; scheduled appointments; assisted the CFO with accounts payable and receivables; assisted doctor with various optometric diagnostic tests and procedures Assisted in the creation of The EyeSaver Foundation (now defunct) which was designed to offer CEUs to optometrists in New England, Illinois and Maryland; organized speaker outlines for CEU approval to the American Board of Optometry in Maryland; created database of seminar attendees; scheduled and assisted guest speakers; created mailers and brochures; arranged seminar set-up and in-house catering details; trained and managed Foundation staff Premium Eye Care Brockton MA 09/1992 to 03/1994 Part-time Receptionist; Scheduled appointments; Posted patient payments; Prepared accounts for billing to Medicare, MassHealth and Blue Cross/Blue Shield. CONSULTING EXPERIENCE Independent Consultant 06/2001 to Present - Speaker for advanced billing & coding for physician practices and hospitals - Analyzed billing and coding techniques of different specialty areas to create the most effective teaching program with tools and guidelines to maximize reimbursement - Instructed in Texas state laws and regulations regarding managed care refund requests, insurance recoupments/offsets, and timely payment deadlines - Reviewed and submitted articles for Coding Alert’s Anesthesia & Pain Management; - Created mini-coding course for graduating MD Residents; - Audited physicians’ practices and hospital documentation for compliance; - Analyzed denied claims for billing and coding accuracy - Created & maintained website for educational purposes - Remote contract coding - general surgery, anesthesia PUBLICATIONS: 03/2005 – Coding Alert Anesthesia and Pain Management magazine; Field Avoidance 07/2004 – General Surgery Pink Sheet Publication; Central Venous Access Chart - 2004 Codes; Published 03/2004 – ICD-9/CPT CodingPro Online Publications; Coder's Work Tool, Central Venous Access Chart – CVA and Anesthesia 2004 Codes; Published 02/2004 – Anesthesia and Pain Management Online Pink Sheet Publication; Central Venous Access Chart, Anesthesia – 2004 Codes; Published CERTIFICATES: 09/2004 – Certified Coding Specialist – Physician-based, AHIMA, Chicago IL 11/2002 – Certified Professional Coder certification; AAPC, Salt Lake City, UT 03/2001 – TX Workforce Commission Certification; Instructor for Medical Insurance Coding and Billing