tehmina11
New
Tehmina S. Irfan, CPC_________________________
1435 N.W. 22nd Ave, Delray Beach, Florida 33445, E-Mail: tehmina66@gmail.com Phone: (561) 843-8978
CAREER SUMMARY
• MRA Dept. team leader
• Train billers/coders, general staff, and PCPs for documentation, E&M, MRA, HEDIS, & PQRS (for original Medicare) guidelines
• Continue EHR experience: Practice Fusion, MD 2000, Soap Notes, E-clinical works, Kareo, Medisoft, GPRO, & Athena
• Possess the combination of years of organizational and administrative skills coupled with expertise in medical coding and instructing physicians and their staffs in compliance.
• Earned various certifications including in A+, CPC, and ICD-10 Proficiency certifications (currently pursuing CPMA) which make for a valuable asset to every team.
• Contribute to the workplace major strengths: critical thinking skills, problem solving, maintaining target goals and completing projects while accommodating path adjustments, a determined thirst for knowledge, excellent interpersonal skills and customer service.
• Master essential communication and technical areas while possessing and an eye for detail.
• Embrace the challenge of data integrity through planning, maintenance, and employee training, which is (Humana) and has been relevant throughout my professional career.
• Perform secretarial duties along with mentoring new members as the Secretary of AAPC Palm Beach Chapter
Work History
Medical Specialists of the Palm Beaches, Inc.
HCC CODER/Auditor/Educator
January ‘9th – Current
• Reviewed medical records and practice management code data to determine if the medical record is complete, accurate, and in support of individual patient risk adjustment score accuracy.
• Sequenced and assigning codes from ICD-10 methodology based on the code which most accurately describes each documented diagnoses.
• Educated providers and their practice staff in Medicare coding guidelines, focusing on revenue enhancement opportunities.
• Collaborated with other departments to develop plans and materials that support education and system changes to meet practice and revenue goals.
Humana
MRA Coder/Auditor
March ‘15 – December 21st 2016
• Reviewed medical record information to identify all appropriate coding based on CMS HCC categories.
• Complete appropriate paperwork/documentation/system entry regarding claim/encounter information.
• Provided support, education, and training related to the quality of documentation, level of service, and diagnostic coding consistent with established coding guidelines and standards.
• Extended real time support and coordination with Primary Care Providers and Care Coordinators for MRA coding, HEDIS, and STARS.
• Coordinated with clinical leadership in the development of provider training plans and for active support in the training process.
• Organized and schedule periodic training as indicated from chart review results, and/or as requested by medical leadership or CBO management.
• Monitored coding modifications to ensure that the most current information is available.
• Facilitated coding support to CBO as requested.
Outcomes Health Information Solutions
December ‘14- May ‘15: Remote HCC Coder/Auditor
• Auditing/Coding charts for Compliance/MRA
TSI Billing & Coding of USA
February ‘12- /current: Medical Billing / Internal Auditing services
• Medical Billing and Auditing records for local Physicians
Primus Health Network Inc., LLC
September ‘12- November ‘14: Coding Specialist/Auditor
• Audited charts for MRA, HEDIS, & PQRS for G-PRO
• Trained physicians & staff in documentation compliance
• Assisted physician & staff capturing HEDIS measures
• Supervised billing staff with the coding process
American Academy of Professional Coders (AAPC)
January ’17 - Current: Secretary of Palm Beach Chapter
• Perform secretarial duties along with mentoring new members
March ‘12- January ’13: New Member Development Officer of Palm Beach Chapter
• Performed duties as a mentor
Dr. Saleem A. Haq, M.D
November ‘98 – April ‘12: Office Manager/ Medical Biller & Coder
• Managed all office matters
• Medical billing and coding for all types of payers
• Referral Coordinator
• MD credentialing
• Assisted in hiring process
• Maintained all office computer systems
• , maintenance, and employee training, which is (Humana) and has been relevant throughout my professional career.
PROFESSIONAL SKILLS/ PREVIOUS JOB RESPONSIBILITIES
• Knowledge of Share point and clouds
• Auditing Humana, BCBS, United HealthCare, and Medicare, among other major insurance companies
• Earned certification from FHIMA for inpatient coding (Advanced ICD-10- CM & ICD-10 PCS)
• In depth knowledge of coding guidelines (ICD-9-CM, ICD-10-CM & PCS, CPT, and HCPCS), CMS regulations, state provider licensure and certification requirements, commercial insurance clinical and reimbursement policies, and audit and appeal techniques
• Flexible, detail-oriented ability to be a positive influence on others, skilled at working independently, willingness to take ownership of responsibilities, quality conscious, dependable, and ability to adapt well to change
• Proficiency with Microsoft Office Suite, including Word/Power Point/Excel
• Strong interpersonal and presentation skills
• Proficient in written and oral communication skills at all corporate levels
• Multilingual: English, Hindi, and Urdu
• 18+ years of billing and coding experience in outpatient settings
• Member of American Health Information Management Association (AHIMA) & American Academy of Professional Coders (AAPC)
EDUCATION/TRAINING
• CPMA (in progress)
• ICD-10 Proficiency Certification
• CPC
• 18+ years of coding and auditing experience in HCC & HEDIS and outpatient office setting
• BA in general studies
CONTINUING EDUCATION
• MRA education & Training Disease Specific
• 2017 CPT updates
• 2017 Professional Development for Officers
• Humana-based courses/certifications (a variety of skills)
• Clinical Documentation Improvement
• Experienced in coding/auditing E & M, HEDIS, MRA
• Data Breach Compliance and Response: “Preparing for the First 24 Hours of a Data Breach and Beyond”
• “How To Find Coding Info You Didn't Know You Needed To Know”
• “Pay for Performance: Putting the Pieces Together”
• “CDI, Coding and Your Physician Relationship…Be the Pack Leader”
• “ICD-10 The Good The Bad & The Ugly”
• “E & M: Navigating the Real World Record”
References: Upon Request
1435 N.W. 22nd Ave, Delray Beach, Florida 33445, E-Mail: tehmina66@gmail.com Phone: (561) 843-8978
CAREER SUMMARY
• MRA Dept. team leader
• Train billers/coders, general staff, and PCPs for documentation, E&M, MRA, HEDIS, & PQRS (for original Medicare) guidelines
• Continue EHR experience: Practice Fusion, MD 2000, Soap Notes, E-clinical works, Kareo, Medisoft, GPRO, & Athena
• Possess the combination of years of organizational and administrative skills coupled with expertise in medical coding and instructing physicians and their staffs in compliance.
• Earned various certifications including in A+, CPC, and ICD-10 Proficiency certifications (currently pursuing CPMA) which make for a valuable asset to every team.
• Contribute to the workplace major strengths: critical thinking skills, problem solving, maintaining target goals and completing projects while accommodating path adjustments, a determined thirst for knowledge, excellent interpersonal skills and customer service.
• Master essential communication and technical areas while possessing and an eye for detail.
• Embrace the challenge of data integrity through planning, maintenance, and employee training, which is (Humana) and has been relevant throughout my professional career.
• Perform secretarial duties along with mentoring new members as the Secretary of AAPC Palm Beach Chapter
Work History
Medical Specialists of the Palm Beaches, Inc.
HCC CODER/Auditor/Educator
January ‘9th – Current
• Reviewed medical records and practice management code data to determine if the medical record is complete, accurate, and in support of individual patient risk adjustment score accuracy.
• Sequenced and assigning codes from ICD-10 methodology based on the code which most accurately describes each documented diagnoses.
• Educated providers and their practice staff in Medicare coding guidelines, focusing on revenue enhancement opportunities.
• Collaborated with other departments to develop plans and materials that support education and system changes to meet practice and revenue goals.
Humana
MRA Coder/Auditor
March ‘15 – December 21st 2016
• Reviewed medical record information to identify all appropriate coding based on CMS HCC categories.
• Complete appropriate paperwork/documentation/system entry regarding claim/encounter information.
• Provided support, education, and training related to the quality of documentation, level of service, and diagnostic coding consistent with established coding guidelines and standards.
• Extended real time support and coordination with Primary Care Providers and Care Coordinators for MRA coding, HEDIS, and STARS.
• Coordinated with clinical leadership in the development of provider training plans and for active support in the training process.
• Organized and schedule periodic training as indicated from chart review results, and/or as requested by medical leadership or CBO management.
• Monitored coding modifications to ensure that the most current information is available.
• Facilitated coding support to CBO as requested.
Outcomes Health Information Solutions
December ‘14- May ‘15: Remote HCC Coder/Auditor
• Auditing/Coding charts for Compliance/MRA
TSI Billing & Coding of USA
February ‘12- /current: Medical Billing / Internal Auditing services
• Medical Billing and Auditing records for local Physicians
Primus Health Network Inc., LLC
September ‘12- November ‘14: Coding Specialist/Auditor
• Audited charts for MRA, HEDIS, & PQRS for G-PRO
• Trained physicians & staff in documentation compliance
• Assisted physician & staff capturing HEDIS measures
• Supervised billing staff with the coding process
American Academy of Professional Coders (AAPC)
January ’17 - Current: Secretary of Palm Beach Chapter
• Perform secretarial duties along with mentoring new members
March ‘12- January ’13: New Member Development Officer of Palm Beach Chapter
• Performed duties as a mentor
Dr. Saleem A. Haq, M.D
November ‘98 – April ‘12: Office Manager/ Medical Biller & Coder
• Managed all office matters
• Medical billing and coding for all types of payers
• Referral Coordinator
• MD credentialing
• Assisted in hiring process
• Maintained all office computer systems
• , maintenance, and employee training, which is (Humana) and has been relevant throughout my professional career.
PROFESSIONAL SKILLS/ PREVIOUS JOB RESPONSIBILITIES
• Knowledge of Share point and clouds
• Auditing Humana, BCBS, United HealthCare, and Medicare, among other major insurance companies
• Earned certification from FHIMA for inpatient coding (Advanced ICD-10- CM & ICD-10 PCS)
• In depth knowledge of coding guidelines (ICD-9-CM, ICD-10-CM & PCS, CPT, and HCPCS), CMS regulations, state provider licensure and certification requirements, commercial insurance clinical and reimbursement policies, and audit and appeal techniques
• Flexible, detail-oriented ability to be a positive influence on others, skilled at working independently, willingness to take ownership of responsibilities, quality conscious, dependable, and ability to adapt well to change
• Proficiency with Microsoft Office Suite, including Word/Power Point/Excel
• Strong interpersonal and presentation skills
• Proficient in written and oral communication skills at all corporate levels
• Multilingual: English, Hindi, and Urdu
• 18+ years of billing and coding experience in outpatient settings
• Member of American Health Information Management Association (AHIMA) & American Academy of Professional Coders (AAPC)
EDUCATION/TRAINING
• CPMA (in progress)
• ICD-10 Proficiency Certification
• CPC
• 18+ years of coding and auditing experience in HCC & HEDIS and outpatient office setting
• BA in general studies
CONTINUING EDUCATION
• MRA education & Training Disease Specific
• 2017 CPT updates
• 2017 Professional Development for Officers
• Humana-based courses/certifications (a variety of skills)
• Clinical Documentation Improvement
• Experienced in coding/auditing E & M, HEDIS, MRA
• Data Breach Compliance and Response: “Preparing for the First 24 Hours of a Data Breach and Beyond”
• “How To Find Coding Info You Didn't Know You Needed To Know”
• “Pay for Performance: Putting the Pieces Together”
• “CDI, Coding and Your Physician Relationship…Be the Pack Leader”
• “ICD-10 The Good The Bad & The Ugly”
• “E & M: Navigating the Real World Record”
References: Upon Request