SlideShare a Scribd company logo
1 of 2
RESUME
EVELYN KIM
5903 Babcock Road #103 ● San Antonio, Texas 78240
210.296.5549 ● ekkim1958@yahoo.com
CODING MANAGER
Passionate coding professional with 14 years of experience improving coding procedures by directing coders on
new guidelines and modifications to existing policies. Talented leader who educates medical professionals on
proper documentation to ensure optimal accuracy during audits. Consistently reduces data entry and coding
backlogs by developing outsourcing policies. Develop key relationships with patients and medical office
personnel to streamline claims submissions.
Coding ● Report Generation ● Policies and Procedures ● Coding Guidelines ● Insurance Claims
Team Leadership ● Data Management ● Relationship Development ● Documentation ● Auditing
Financial Reports ● Physician Education ● HEDIS Standards ● Risk Adjustment Coding Certification
EPIC ● ECW ● Greenway ● Care Tracker ● SRS ● 3M ● Encoder Pro ● ICD-10 Certified
PROFESSIONAL EXPERIENCE
NORTHEAST ORTHOPEDICS AND SPORTS MEDICINE, San Antonio, Texas ● 2016
Orthopedics medical office with approximately 1,000 patient visits and up to 50 surgeries a week.
Revenue Cycle Supervisor
Managed revenue cycle by billing and coding daily visits, surgeries, and DME products. Collaborated with
collectors during appeals process. Generated reports on productivity for providers. Prepared and submitted
claims.
 Improved fee ticket process for hand specialist by ensuring accuracy and adjusting as needed.
 Created and implemented new dress code policy.
 Spearheaded coding of 100-150 daily office visits.
PARTNERS IN PRIMARY CARE, San Antonio, Texas ● 2014-2016
Humana-owned primary care clinic specializing in Medicare Advantage patients.
MRA Coder
Initiated daily coding for office visits and procedures while specializing in Hierarchal Condition Category (HCC)
coding. Administered coding for 3 physicians, 1 physician assistant, and 1 nurse practitioner. Consulted
providers on documentation issues, modified coding edits for MRA coders, and claims submitted after
corrections. Performed research on requirements for HEDIS and STARS.
 Achieved HEDIS standards by researching requirements and presenting to providers.
 Recognized with North Star Award for developing guidelines for MRA department to accomplish coding
documentation requirements.
 Enhanced coding process by mentoring coders and departments on coding issues.
 Obtained certification for risk adjustment coding (CRC).
CIGNA HEALTHSPRING, San Antonio, Texas ● 2011-2014
Health insurance company specializing in Medicare Advantage.
Network Operations Representative (2013-2014)
Administered support to primary care physician practices by resolving claims issues and monitoring submission
of HCC data. Generated HEDIS and STARS data as well as annual bonus information for each IPA POD.
 Supported physicians in determining medical loss ratio and number of Health Maintenance Reports
(HMR) by generating monthly financial reports, STARS data, and missing measures.
 Strengthened working relationships with medical professionals and offices.
Physician Education Specialist (2011-2013)
Led audits of physician records submitted for HCC codes. Generated annual reports for physicians to determine
codes needing addressed. Identified and advised on documentation issues and new HCC codes. Administered
support for transition to ICD-10. Supported physicians in properly completing HMR forms.
 Achieved average increase of 2 points in STAR scores for each provider in IPA POD assigned.
 Enhanced HMR submissions from 250 to 790 in first year and surpassed goal of 680.
RESUME
EVELYN KIM ● Page 2
210.296.5549 ● ekkim1958@yahoo.com
SENDERO IMAGING AND TREATMENT CENTER, San Antonio, Texas ● 2010-2011
Radiology center providing services to numerous facilities.
Coder / Auditor
Managed team of remote coders and performed audits to ensure accuracy and monitor number of daily
procedures completed for each assigned center. Developed and implemented policies and procedures for
remote coders.
 Streamlined introduction of new codes introduced by CPT by creating new policies.
LONE STAR CANCER ASSOCIATES, San Antonio, Texas ● 2010
Independent practice specializing in Oncology and Hematology.
Billing Supervisor
Oversaw payment posting, claims submissions, and appeals related to billing. Administered insura nce
verifications for patients and assisted with payment plans. Provided administrative support related to scheduling
appointments and handling telephone inquiries.
 Improved provider documentations by performing audits and recommending adjustments as needed.
UT MEDICINE, San Antonio, Texas ● 2002-2010
Multi-specialty practice with more than 300 medical professionals.
Acting Manager Coding and Charge Entry (2009-2010)
Directed team of 50 employees performing coding and charge entry. Presented weekly updates to management
related to backlog of coding. Acted as super user for implementation of EPIC EMR.
 Reduced backlog of claims to be coded by 50% by establishing policies to outsource code.
 Achieved 50% decrease in time for data entry.
 Supported development of policies and procedures for numerous coding and data entry functions.
Coding Supervisor (2008-2009)
Oversaw coders from various departments by addressing progress and needs of each coder. Communicated
chances in codes to all coders. Implemented resolutions for coding issues.
Coder Educator (2006-2008)
Educated medical professionals on property documentation policies. Administered coding for surgical procedures
for all sub specialties.
 Developed program to educate residents on coding issues and proper documentation.
Team Lead Coding (2004-2006)
Performed coding for surgeries and clinic visits
 Contributed to development of coding guideline for new procedure.
 Created tracking document for surgical cases including payment outcomes.
Coder (2002-2004)
Initiated coding for all E & M visits for orthopedics department as well as surgeries.
 Reduced coding backlog from 10 days to 2 days.
 Accomplished 97% accuracy on audits.
EDUCATION
Master of Business Administration
University of Phoenix, San Antonio, Texas
Bachelor of Science in Healthcare Administration
University of Phoenix, San Antonio, Texas
CERTIFICATIONS
CPC and CRC

More Related Content

What's hot

Karen Hart resume 2016
Karen Hart resume 2016Karen Hart resume 2016
Karen Hart resume 2016
Karen Hart
 
Jennifer Resume 2016
Jennifer Resume 2016Jennifer Resume 2016
Jennifer Resume 2016
jenny peck
 
Medical Coding Resume
Medical Coding ResumeMedical Coding Resume
Medical Coding Resume
Pam Iverson
 
Pharmacy cv final jamie
Pharmacy cv final jamiePharmacy cv final jamie
Pharmacy cv final jamie
Jamie LeVieux
 
E Caldwell Resume February 2017
E Caldwell Resume February 2017E Caldwell Resume February 2017
E Caldwell Resume February 2017
EVONY CALDWELL
 
Sharon D. Bush Resume 1 (2)
Sharon D. Bush Resume 1 (2)Sharon D. Bush Resume 1 (2)
Sharon D. Bush Resume 1 (2)
Sharon Bush
 
Bryan Fox Resume
Bryan Fox ResumeBryan Fox Resume
Bryan Fox Resume
Bryan Fox
 
Terry K resume 12-8-16
Terry K resume 12-8-16Terry K resume 12-8-16
Terry K resume 12-8-16
Terry Knowlton
 

What's hot (20)

CodingResume.BDO
CodingResume.BDOCodingResume.BDO
CodingResume.BDO
 
Staci Bell Resume
Staci Bell ResumeStaci Bell Resume
Staci Bell Resume
 
Revised MZ RESUME
Revised MZ RESUMERevised MZ RESUME
Revised MZ RESUME
 
Msmith 062016 resume
Msmith 062016 resumeMsmith 062016 resume
Msmith 062016 resume
 
Patricia wright resume 2015
Patricia wright resume 2015Patricia wright resume 2015
Patricia wright resume 2015
 
Karen Hart resume 2016
Karen Hart resume 2016Karen Hart resume 2016
Karen Hart resume 2016
 
Physician Quality Reporting System
Physician Quality Reporting SystemPhysician Quality Reporting System
Physician Quality Reporting System
 
Jennifer Resume 2016
Jennifer Resume 2016Jennifer Resume 2016
Jennifer Resume 2016
 
PQRI Reporting
PQRI ReportingPQRI Reporting
PQRI Reporting
 
Medical Coding Resume
Medical Coding ResumeMedical Coding Resume
Medical Coding Resume
 
Resume 2016
Resume 2016Resume 2016
Resume 2016
 
A Comprehensive Review On Price Transparency - AZHHA
A Comprehensive Review On Price Transparency - AZHHAA Comprehensive Review On Price Transparency - AZHHA
A Comprehensive Review On Price Transparency - AZHHA
 
Pharmacy cv final jamie
Pharmacy cv final jamiePharmacy cv final jamie
Pharmacy cv final jamie
 
Risk Adjustment: Determining Risk Determines Reward
Risk Adjustment: Determining Risk Determines RewardRisk Adjustment: Determining Risk Determines Reward
Risk Adjustment: Determining Risk Determines Reward
 
E Caldwell Resume February 2017
E Caldwell Resume February 2017E Caldwell Resume February 2017
E Caldwell Resume February 2017
 
Top 10 Dental Clinics in Mexico 2016
Top 10 Dental Clinics in Mexico 2016Top 10 Dental Clinics in Mexico 2016
Top 10 Dental Clinics in Mexico 2016
 
Sharon D. Bush Resume 1 (2)
Sharon D. Bush Resume 1 (2)Sharon D. Bush Resume 1 (2)
Sharon D. Bush Resume 1 (2)
 
Bryan Fox Resume
Bryan Fox ResumeBryan Fox Resume
Bryan Fox Resume
 
Inside Sales Representative
Inside Sales RepresentativeInside Sales Representative
Inside Sales Representative
 
Terry K resume 12-8-16
Terry K resume 12-8-16Terry K resume 12-8-16
Terry K resume 12-8-16
 

Viewers also liked (10)

meeting_management
meeting_managementmeeting_management
meeting_management
 
TzeiraFortune- Resume
TzeiraFortune- ResumeTzeiraFortune- Resume
TzeiraFortune- Resume
 
Brochure moda e bellezza
Brochure moda e bellezzaBrochure moda e bellezza
Brochure moda e bellezza
 
Documento libera mente gioia
Documento libera mente gioiaDocumento libera mente gioia
Documento libera mente gioia
 
TonyaHoldrenResume
TonyaHoldrenResumeTonyaHoldrenResume
TonyaHoldrenResume
 
Uso do WhatsApp pelas Assessorias de Imprensa
Uso do WhatsApp pelas Assessorias de ImprensaUso do WhatsApp pelas Assessorias de Imprensa
Uso do WhatsApp pelas Assessorias de Imprensa
 
Programma completo brochure (4)
Programma completo brochure (4)Programma completo brochure (4)
Programma completo brochure (4)
 
Ilustrar con Power Point
Ilustrar con Power PointIlustrar con Power Point
Ilustrar con Power Point
 
Ataquecardacodefinitivo 090705182915-phpapp02
Ataquecardacodefinitivo 090705182915-phpapp02Ataquecardacodefinitivo 090705182915-phpapp02
Ataquecardacodefinitivo 090705182915-phpapp02
 
Algas 2
Algas 2Algas 2
Algas 2
 

Similar to KIM_Evelyn102616_Resume

Timothy Look Resume
Timothy Look ResumeTimothy Look Resume
Timothy Look Resume
Timothy Look
 
SENA JOLLIFFI Resume.....
SENA JOLLIFFI Resume.....SENA JOLLIFFI Resume.....
SENA JOLLIFFI Resume.....
sena Jolliffi
 
Frank Spencer Resume 2017
Frank Spencer Resume 2017Frank Spencer Resume 2017
Frank Spencer Resume 2017
Frank Spencer
 
Melissa Monreal Resume 2014
Melissa Monreal Resume 2014Melissa Monreal Resume 2014
Melissa Monreal Resume 2014
Melissa Monreal
 
Harris_Zachary Professional CPC Resume.doc 2-3-16
Harris_Zachary Professional CPC Resume.doc 2-3-16Harris_Zachary Professional CPC Resume.doc 2-3-16
Harris_Zachary Professional CPC Resume.doc 2-3-16
Zachary Harris, CPC
 
Sonyas most recent resume
Sonyas most recent resumeSonyas most recent resume
Sonyas most recent resume
Sonya Donnelly
 
ResumeUpd02-16-16
ResumeUpd02-16-16ResumeUpd02-16-16
ResumeUpd02-16-16
Diane Carr
 
Melissa Monreal, MBA Resume
Melissa Monreal, MBA ResumeMelissa Monreal, MBA Resume
Melissa Monreal, MBA Resume
Melissa Monreal
 

Similar to KIM_Evelyn102616_Resume (20)

DwallworkUpdate
DwallworkUpdateDwallworkUpdate
DwallworkUpdate
 
Timothy Look Resume
Timothy Look ResumeTimothy Look Resume
Timothy Look Resume
 
SENA JOLLIFFI Resume.....
SENA JOLLIFFI Resume.....SENA JOLLIFFI Resume.....
SENA JOLLIFFI Resume.....
 
KMG resume
KMG resumeKMG resume
KMG resume
 
Frank Spencer Resume 2017
Frank Spencer Resume 2017Frank Spencer Resume 2017
Frank Spencer Resume 2017
 
M P Andrews BS CPC CCS-P
M P Andrews BS CPC CCS-PM P Andrews BS CPC CCS-P
M P Andrews BS CPC CCS-P
 
Kertz, Angie Resume
Kertz, Angie ResumeKertz, Angie Resume
Kertz, Angie Resume
 
Resume - 20035377
Resume - 20035377Resume - 20035377
Resume - 20035377
 
Aida_Resume 4
Aida_Resume 4Aida_Resume 4
Aida_Resume 4
 
Melissa Monreal Resume 2014
Melissa Monreal Resume 2014Melissa Monreal Resume 2014
Melissa Monreal Resume 2014
 
Ruthy E. Montalbano 2016
Ruthy E. Montalbano 2016Ruthy E. Montalbano 2016
Ruthy E. Montalbano 2016
 
Ruthy E. Montalbano 2016
Ruthy E. Montalbano 2016Ruthy E. Montalbano 2016
Ruthy E. Montalbano 2016
 
Harris_Zachary Professional CPC Resume.doc 2-3-16
Harris_Zachary Professional CPC Resume.doc 2-3-16Harris_Zachary Professional CPC Resume.doc 2-3-16
Harris_Zachary Professional CPC Resume.doc 2-3-16
 
Sonyas most recent resume
Sonyas most recent resumeSonyas most recent resume
Sonyas most recent resume
 
ChawlaBinduResume 2017
ChawlaBinduResume 2017ChawlaBinduResume 2017
ChawlaBinduResume 2017
 
Joy Hanford - 2-20-2014
Joy Hanford - 2-20-2014Joy Hanford - 2-20-2014
Joy Hanford - 2-20-2014
 
ResumeUpd02-16-16
ResumeUpd02-16-16ResumeUpd02-16-16
ResumeUpd02-16-16
 
The Most Recent Trends In Medical Coding.pptx
The Most Recent Trends In Medical Coding.pptxThe Most Recent Trends In Medical Coding.pptx
The Most Recent Trends In Medical Coding.pptx
 
How Northwestern Medicine is Leveraging Epic to Enable Value-Based Care
How Northwestern Medicine is Leveraging Epic to Enable Value-Based CareHow Northwestern Medicine is Leveraging Epic to Enable Value-Based Care
How Northwestern Medicine is Leveraging Epic to Enable Value-Based Care
 
Melissa Monreal, MBA Resume
Melissa Monreal, MBA ResumeMelissa Monreal, MBA Resume
Melissa Monreal, MBA Resume
 

KIM_Evelyn102616_Resume

  • 1. RESUME EVELYN KIM 5903 Babcock Road #103 ● San Antonio, Texas 78240 210.296.5549 ● ekkim1958@yahoo.com CODING MANAGER Passionate coding professional with 14 years of experience improving coding procedures by directing coders on new guidelines and modifications to existing policies. Talented leader who educates medical professionals on proper documentation to ensure optimal accuracy during audits. Consistently reduces data entry and coding backlogs by developing outsourcing policies. Develop key relationships with patients and medical office personnel to streamline claims submissions. Coding ● Report Generation ● Policies and Procedures ● Coding Guidelines ● Insurance Claims Team Leadership ● Data Management ● Relationship Development ● Documentation ● Auditing Financial Reports ● Physician Education ● HEDIS Standards ● Risk Adjustment Coding Certification EPIC ● ECW ● Greenway ● Care Tracker ● SRS ● 3M ● Encoder Pro ● ICD-10 Certified PROFESSIONAL EXPERIENCE NORTHEAST ORTHOPEDICS AND SPORTS MEDICINE, San Antonio, Texas ● 2016 Orthopedics medical office with approximately 1,000 patient visits and up to 50 surgeries a week. Revenue Cycle Supervisor Managed revenue cycle by billing and coding daily visits, surgeries, and DME products. Collaborated with collectors during appeals process. Generated reports on productivity for providers. Prepared and submitted claims.  Improved fee ticket process for hand specialist by ensuring accuracy and adjusting as needed.  Created and implemented new dress code policy.  Spearheaded coding of 100-150 daily office visits. PARTNERS IN PRIMARY CARE, San Antonio, Texas ● 2014-2016 Humana-owned primary care clinic specializing in Medicare Advantage patients. MRA Coder Initiated daily coding for office visits and procedures while specializing in Hierarchal Condition Category (HCC) coding. Administered coding for 3 physicians, 1 physician assistant, and 1 nurse practitioner. Consulted providers on documentation issues, modified coding edits for MRA coders, and claims submitted after corrections. Performed research on requirements for HEDIS and STARS.  Achieved HEDIS standards by researching requirements and presenting to providers.  Recognized with North Star Award for developing guidelines for MRA department to accomplish coding documentation requirements.  Enhanced coding process by mentoring coders and departments on coding issues.  Obtained certification for risk adjustment coding (CRC). CIGNA HEALTHSPRING, San Antonio, Texas ● 2011-2014 Health insurance company specializing in Medicare Advantage. Network Operations Representative (2013-2014) Administered support to primary care physician practices by resolving claims issues and monitoring submission of HCC data. Generated HEDIS and STARS data as well as annual bonus information for each IPA POD.  Supported physicians in determining medical loss ratio and number of Health Maintenance Reports (HMR) by generating monthly financial reports, STARS data, and missing measures.  Strengthened working relationships with medical professionals and offices. Physician Education Specialist (2011-2013) Led audits of physician records submitted for HCC codes. Generated annual reports for physicians to determine codes needing addressed. Identified and advised on documentation issues and new HCC codes. Administered support for transition to ICD-10. Supported physicians in properly completing HMR forms.  Achieved average increase of 2 points in STAR scores for each provider in IPA POD assigned.  Enhanced HMR submissions from 250 to 790 in first year and surpassed goal of 680.
  • 2. RESUME EVELYN KIM ● Page 2 210.296.5549 ● ekkim1958@yahoo.com SENDERO IMAGING AND TREATMENT CENTER, San Antonio, Texas ● 2010-2011 Radiology center providing services to numerous facilities. Coder / Auditor Managed team of remote coders and performed audits to ensure accuracy and monitor number of daily procedures completed for each assigned center. Developed and implemented policies and procedures for remote coders.  Streamlined introduction of new codes introduced by CPT by creating new policies. LONE STAR CANCER ASSOCIATES, San Antonio, Texas ● 2010 Independent practice specializing in Oncology and Hematology. Billing Supervisor Oversaw payment posting, claims submissions, and appeals related to billing. Administered insura nce verifications for patients and assisted with payment plans. Provided administrative support related to scheduling appointments and handling telephone inquiries.  Improved provider documentations by performing audits and recommending adjustments as needed. UT MEDICINE, San Antonio, Texas ● 2002-2010 Multi-specialty practice with more than 300 medical professionals. Acting Manager Coding and Charge Entry (2009-2010) Directed team of 50 employees performing coding and charge entry. Presented weekly updates to management related to backlog of coding. Acted as super user for implementation of EPIC EMR.  Reduced backlog of claims to be coded by 50% by establishing policies to outsource code.  Achieved 50% decrease in time for data entry.  Supported development of policies and procedures for numerous coding and data entry functions. Coding Supervisor (2008-2009) Oversaw coders from various departments by addressing progress and needs of each coder. Communicated chances in codes to all coders. Implemented resolutions for coding issues. Coder Educator (2006-2008) Educated medical professionals on property documentation policies. Administered coding for surgical procedures for all sub specialties.  Developed program to educate residents on coding issues and proper documentation. Team Lead Coding (2004-2006) Performed coding for surgeries and clinic visits  Contributed to development of coding guideline for new procedure.  Created tracking document for surgical cases including payment outcomes. Coder (2002-2004) Initiated coding for all E & M visits for orthopedics department as well as surgeries.  Reduced coding backlog from 10 days to 2 days.  Accomplished 97% accuracy on audits. EDUCATION Master of Business Administration University of Phoenix, San Antonio, Texas Bachelor of Science in Healthcare Administration University of Phoenix, San Antonio, Texas CERTIFICATIONS CPC and CRC