Researching and identifying epic build issue with anesthesia/pain management module , causing inappropriate billing of claim with improper modifier and CPT mapping of anesthesia services.

• Contract ICD-10 Implementation Trainer for all Lahey Clinic facilities (Lahey Burlington, Lahey Beverly and Lahey Winchester Hospitals and outpatient centers) in the Boston metropolitan area
• Assess ICD-10 Implementation & Training needs for each hospital specialty department working with department Chiefs/Chairs to ensure all areas of ICD-10 impact have been addressed.
• Coordinate and develop Physicians multi-specialty ICD-10 Clinical Documentation Improvement Training
• Development of ICD-9 multi-specialty ICD-10 translation coding tools
• Specialty Clinical Documentation Improvement Training for ICD-10 Specificity and Granularity

• Contract Consultant with Texan Plus Medicare Advantage Plan with responsibilities of implementation of contracted provider education program to improve documentation and coding to Medicare standards for capturing diagnosis for HCC submission.
• Goal to improve documentation by education of the CMS HCC methodology and RADV audit proof documentation and Texan Plus program Annual Physical Program requirements, Official ICD-9 CM coding guidelines as well as analysis of documented Annual Physical and feedback to improve documentation.
• Develop and design of Texan Plus Health Assessment Tool Education program processes and procedure
• Design of data mining tools and documentation and education material

• Performs coding and auditing of professional fee services in all areas including Evaluation and Management and outpatient hospital services
• Performs APC reimbursement and RBRVS reimbursement and data quality/accuracy and compliance audits
• Offers training and education to physicians, coders, and various clinical staff
• Supports Compliance Program by demonstrating adherence to all relevant compliance policies and procedures as evidenced by in-service attendance and daily practice; notifying management when there is a compliance concern or incident

• HIM /Revenue Cycle consultant specializing in meeting client needs in Coding, Auditing, SMART Audits, CDM analysis, Rate analysis, Quality Review, Charge Capture and Coding Denial Management, Documentation Education, Revenue Cycle Process/Performance Improvement and HIM college recruitment
• Present current status of deliverable’s to C-Suite Executives and project engagement directors throughout project lifecycle
• Orthopedic auditing ambulatory surgery and clinic visits containing e/m levels, modifiers, diagnosis codes and any minor procedures performed.
• Coding all inpatient profee services for all specialties including inpatient profee surgical services such as urology and Cath lab.
• CDM Optimization
• Performance improvement/Process Redesign analysis