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