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The document provides information on various medical coding certifications including the RHIA, RHIT, CCA, and CCS certifications. It outlines the eligibility requirements for each certification such as educational and experience requirements. The document also provides details on the types of courses and experience needed to sit for each certification exam.

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MEDICAL CODING PORTFOLIO ABSTRACT If you reallywantsomething,goafterit. Don’tlet someone stopyoufromachievingyourdreams. Heather Elkins HS292-01 BillingandCodingPracticum
1 TABLE OF CONTENTS Reference Page…………………………………………………. 2 Cover Page …………………………………………………….. 4 Resume…………………………………………………………. 5 Professional References………………………………………… 7 Research Page…………………………………………………... 10 Job Search Resources Page……………………………………… 19 Mock Interview Questions………………………………………. 20 Summary of Mock Interview Questions………………………… 21
2 References Career Opportunities. (n.d.). Retrieved from https://career4.successfactors.com/career?company=GHS Explore millions of jobs… with just one search. (n.d.). Retrieved from http://www.simplyhired.com/ Find the right job. Right now. (n.d). Retrieved from http://www.careerbuilder.com/ Get Found. (n.d.). Retrieved from http://www.monster.com/ Greenville jobs – craigslist. (n.d.). Retrieved from https://greenville.craigslist.org/search/jjj Hire great hourly employees. (n.d.). Retrieved from http://www.snagajob.com/ Jobseekes. (n.d.). Retrieved from - http://www.sces.org/jobs-land.asp Job Search – Job.com. (n.d.). Retrieved from http://www.job.com/ Job Search – one search. all jobs. Indeed.com. (n.d.) Retrieved from http://www.indeed.com/ LinkedIn Jobs. (.n.d.). Retrieved from https://www.linkedin.com/job/home Medical Certification Overview. (n.d.) Retrieved from https://www.aapc.com/certification/ SC Works – Bringing Employers and Job Seekers Together. (n.d.). Retrieved from https://scworks.org/
3 Types of Certifications. (n.d.) Retrieved from http://www.ahima.org/certification/exams?tabid=him
4 Heather Elkins 105 Carlissa Court Easley, SC 29640 hmelkins1977@gmail.com May 18, 2016 Mike Castill Human Resources Manager Greenville Health System 300 E McBee Street Greenville, SC 29605 Dear Mike Castill, I am contacting you regarding the open Certified Coding Specialist position with the Greenville Health System. My educational background in Medical Billing and Coding, along with my professional experience, makes me an excellent candidate for this position. As you will see from the enclosed resume, I have about a year of experience in the field of Medical Billing and Coding but have been with Greenville Health System for 6 years. My resume shows that I have been consistently rewarded for hard work with promotions and increased responsibilities. These rewards are a direct result of my expertise in the medical health field, my commitment to personal and professional excellence, and my excellent written and oral communication skills. I would very much like to discuss opportunities with Greenville Health System. To schedule an interview, please call me at 864-720-9010. The best time to reach me is between 8:00 a.m. and 6:00 p.m., but you can leave a voice message at any time, and I will return your call. Thank you for taking the time to review my resume. I look forward to talking with you. Sincerely, Heather M. Elkins Enclosure
5 105 Carlissa Ct, Easley, SC 29640(864) 720-7010hmelkins1977@gmail.com Heather M. Elkins Objective Inpatient and outpatient records coding specialist with ICD-10, CPT and HCPCS Codes, and ASC coding expertise. Familiar with commercial and private insurance carriers. Seeks a position of increased responsibility and authority. Experience June 2012 - Present Patewood Memorial Hospital Greenville, SC Material Specialist  Prepared case carts for next day surgeries.  Ordered supplies for the OR.  Prepared repair orders and sent off damaged instruments.  Received receipts in for supplies.  Demonstrated knowledge of HIPAA Privacy and Security Regulations by appropriately handling patient information. Oct 2010 – June 2012 Greenville Memorial Hospital Greenville, SC Materials ATS System Specialist  Responsible for movement of case carts, supplies, instruments, detent, etc to and from the ORand all nursing areas in Greenville Memorial Medical Campus.  Responsible for all ATS computers and equipment.  Coordinates activities of employees performing AGV functions.  Dispatching of AGV computer system as well as data entry, ordering, receiving, restocking, distribution functions for ORcase cases, supplies, equipment, and linen.  Controls inventory processes, inclusive of but not limited to stock additions, changes, deletes, pick confirmations, issue corrections, replenishment verifications. Oct 2007 – July 2010 Langenscheidt Publishing Group Duncan, SC Administrative Assistant/Order Processor  Data entry and processing of domestic and international orders from customer service division.  Run reports for supervisor (Inventory, Order Status Reports and Smart List).  Tracking international shipments from Expeditors.  Record daily meeting notes.  Arrange domestic and international shipments.  Invoicing and billing.  FEDEX and UPS call tags and return requests.
6  Investigation of missing, damaged, or not shipped products. July 2007 – Oct 2007  Administrative Assistant/Order Processor  Data entry and processing of domestic and international orders from customer service division.  Run reports for supervisor (Inventory, Order Status Reports and Smart List).  Tracking international shipments from Expeditors.  Record daily meeting notes.  Arrange domestic and international shipments.  Invoicing and billing.  FEDEX and UPS call tags and return requests.  Investigation of missing, damaged, or not shipped products. Education Aug 2015 – June 2016 Kaplan University Chicago, IL Certificate: Medical Coding and Billing 4.0 GPA Aug 2000 – May 2001 Tri-County Technical College Pendleton, SC NA: Criminal Justice April 1996 – July 1998 United States Army United States Certificate: Communications References References are available on request.
7 Heather M Elkins 105 Carlissa Court Easley, SC 29640 864-720-9010 hmelkins1977@gmail.com References: Vicki Greene, Materials Manager Patewood Memorial Hospital 175 Patewood Dr., Greenville, SC 29615 W: (864) 797-0111 C: (864) 640-6540 Greg Garrett, Materials Coordinator Patewood Memorial Hospital 175 Patewood Dr., Greenville, SC 29615 W: (864) 797-0111 C: (864) 884-2829 Susan Connelly, Materials Supervisor Greenville Memorial Hospital 701 Grove Rd., Greenville, SC 29605 W: (864) 455-5012 C: (864) 270-4150
8 Kelli Gandy, BSN, RN, Central Supply Supervisor Patewood Memorial Hospital 175 Patewood Dr., Greenville, SC 29615 C: (864) 419-1692 Sandra Turner, RN, Implant Coordinator Patewood Memorial Hospital 175 Patewood Dr., Greenville, SC 29615 W: (864) 797-0114 C: (864) 430-7615 Theresa K. Watt, Surgical Technician Patewood Memorial Hospital 175 Patewood Dr., Greenville, SC 29615 W: (864) 797-1166 C: (864) 378-1204 Bridgette Baylor, Pharmacy Technician Patewood Memorial Hospital 175 Patewood Dr., Greenville, SC 29615 W: (864) 797-0081 C: (864) 901-2986 Scott Sisk, Certified Anesthesia Technician Patewood Memorial Hospital 175 Patewood Dr., Greenville, SC 29615 W: (864) 797-1162 C: (864) 373-1357
9 Mark Henderson, Materials Specialist Greenville Memorial Hospital 701 Grove Rd., Greenville, SC 29605 W: (864) 455-6445 C: (864) 640-2178 Melissa Medlin, Materials Specialist Patewood Memorial Hospital 175 Patewood Dr., Greenville, SC 29615 W: (864) 797-0111 C: (864) 915-8809 Steve Price, Lead Materials Specialist Greenville Memorial Hospital 701 Grove Rd., Greenville, SC 29605 W: (864) 455-6507 Chris Elkins, Electrical Engineer BMW 1400 Highway 101 South, Greer, SC 29651 C: (864) 386-0448
10 Types of Certifications AHIMA has several certifications that are offered. In HIM credentials there are 2 types of certifications. One is RHIA and RHIT. RHIA means Registered Health Information Administrator. RHIA applicants must meet one of the following eligibility requirements: *Successfully complete the academic requirements, at the baccalaureate level, of an HIM program accredited by the Commission on Accreditation for Health Informatics and Information Management Education (CAHIIM). *Successfully complete the academic requirements, at the master’s level, of an HIM program accredited by CAHIIM and following a specific set of criteria. *Master’s level candidates must use the Master’s Program Exam Application below graduate from an HIM program approved by a foreign association with which AHIMA has a reciprocity agreement. The exam fees are $229 for members and $299 for non-members. Another certification is Registered Health Information Technician (RHIT®). RHIT applicants must meet one of the following eligibility requirements: *Successfully complete the academic requirements, at an associate's degree level, of an HIM program accredited by the Commission on Accreditation for Health Informatics and Information Management Education (CAHIIM) *Graduate from an HIM program approved by a foreign association with which AHIMA has a reciprocity agreement. The exam fees are $229 for members and $299 for non-members. The academic qualifications of each candidate will be verified before a candidate is deemed eligible to take the examination. All first-time applicants must submit an official transcript from their college or university. There are several certifications for coding. One certification is Certified Coding Associate (CCA®). High School Diploma or equivalent is required but here are some things that are recommended but not required. *6 months coding experience directly applying codes; * completion of an AHIMA approved coding program; *completion of other coding training program to include anatomy & physiology, medical terminology, Basic ICD diagnostic/procedural and Basic CPT coding.
11 Certified Coding Specialist (CCS®) Candidates must meet one of the following eligibility requirements:  By Credential: RHIA®, RHIT®, or CCS-P® OR  By Education: The following courses MUST be completed; anatomy & physiology, pathophysiology, pharmacology, medical terminology, reimbursement methodology, intermediate/advanced ICD diagnostic/procedural and CPT coding; OR  By Experience: Minimum of two (2) years of related coding experience directly applying codes; OR  By Credential with Experience: CCA® plus one (1) year of coding experience directly applying codes; OR  Other Coding credential from other certifying organization plus one (1) year coding experience directly applying codes.  Member Price: $299 Non-member price: $399 Certified Coding Specialist- Physician-based(CCS-P®)-Explore Further Coding Opportunities through Professional Certification Candidates must meet one of the following eligibility requirements:  By Credential: RHIA®, RHIT®, or CCS® OR  By Education: The following courses MUST be completed; anatomy & physiology, pathophysiology, pharmacology, medical terminology, reimbursement methodology, intermediate/advanced ICD diagnostic/procedural and CPT coding; OR  By Experience: Minimum of two (2) years of related coding experience directly applying codes; OR  By Credential with Experience: CCA® plus one (1) year of coding experience directly applying codes; OR  Other Coding credential from other certifying organization plus one (1) year coding experience directly applying codes.  Member Price: $299 Non-member price: $399 Speciality Certified Health Data Analyst (CHDA®) Candidates must meet one of the following eligibility requirements to sit for the CHDA examination:  Healthcare information management credential (RHIT®) and minimum of three (3) years of healthcare data experience  Baccalaureate degree and a minimum of three (3) years of healthcare data experience  Healthcare information management credential (RHIA®)
12  Master’s in Heath Information Management (HIM) or Health Informatics from an accredited school  Master's or higher degree and one (1) year of healthcare data experience  Member Price: $259 Non-member price: $329 Certified in Healthcare Privacy and Security (CHPS®) Candidates must meet one of the following eligibility requirements for the CHPS examination  Associate’s degree and six (6) years’ experience in healthcare privacy or security management  Healthcare information management credential (RHIT®) and minimum of four (4) years of experience in healthcare privacy or security management.  Baccalaureate degree and a minimum of four (4) years’ experience in healthcare privacy or security management  Healthcare information management credential (RHIA®) and minimum of two (2) years of experience in healthcare privacy or security management  Master's or related degree (JD, MD, or PhD) and two (2) years of experience in healthcare privacy or security management  Member Price: $259 Non-member price: $329 Certified Documentation Improvement Practitioner (CDIP®) Candidates who would like to sit for the CDIP exam must meet one of the eligibility requirements below:  An RHIA®, RHIT®, CCS®, CCS-P®, RN, MD or DO and two (2) years’ experience in clinical documentation improvement  An Associate’s degree or higher and three (3) years of experience in clinical documentation improvement (candidates must also have completed coursework in Medical Terminology and Anatomy and Physiology)  Member Price: $259 Non-member price: $329 Certified Healthcare Technology Specialist (CHTS) Recommended (not required): Training and Recommendations  Individuals trained through short-duration (typically six months) non-degree health IT workforce development programs, OR  Members of the workforce with relevant experience or other types of training. (Types of Certifications. (n.d.))
13 AAPC Certifications AAPC also has several certifications for coding professionsal. Some are listed below. CPC Medical Coding Certification Requirements  We recommend having an associate’s degree.  Pay examination fee at the time of application submission.  Maintain current membership with the AAPC. o New members must submit membership payment with examination application. o Renewing members must have a current membership at the time of submission and when exam results are released.  All exams will be reported with exact scores and areas of study (65% or less). A CPC must have at least two years medical coding experience (members with an apprentice designation are not required to have two years medical coding experience.) Membership is required to be renewed annually and 36 Continuing Education Units (CEU's) must be submitted every two years for verification and authentication of expertise. COC Medical Coding Certification Requirements  We recommend having an associate’s degree.  Pay examination fee at the time of application submission.  Maintain current membership with the AAPC. o New members must submit membership payment with examination application. o Renewing members must have a current membership at the time of submission and when exam results are released.  All exams will be reported with exact scores and areas of study (65% or less). A COC (formerly CPC-H) must have at least two years medical coding experience (members with an apprentice designation are not required to have two years medical coding experience.) Membership is required to be renewed annually and 36 Continuing Education Units (CEU's) must be submitted every two years for verification and authentication of expertise. CIC
14 Medical Coding Certification Requirements While there is no experience requirement, we strongly recommend that the candidate have at least two years of experience in inpatient coding or an inpatient coding course. Please be aware that this is a difficult, high-level examination which is not meant for individuals with little, limited or no inpatient coding experience or training.  We recommend having an associate’s degree.  Pay examination fee at the time of application submission.  Maintain current membership with the AAPC. o New members must submit membership payment with examination application. o Renewing members must have a current membership at the time of submission and when exam results are released.  All exams will be reported with exact scores and areas of study (65% or less). CRC Risk Adjustment Coding Certification Requirements  We recommend having an associate's degree  Pay examination fee at the time of application submission  Maintain current membership with the AAPC o New members must submit membership payment with examination application o Renewing members must have a current membership at the time of submission and when exam results are released  All exams will be reported with exact scores and areas of study (65% or less) We strongly recommend that the candidate have at least two years of experience in risk adjustment coding or a risk adjustment coding course. Membership is required to be renewed annually and 36 Continuing Education Units (CEU's) must be submitted every two years for verification and authentication of expertise. CPC-C Medical Coding Certification Requirements  We recommend having an associate’s degree.  Pay examination fee at the time of application submission.  Maintain current membership with the AAPC. o New members must submit membership payment with examination application.
15 o Renewing members must have a current membership at the time of submission and when exam results are released.  All exams will be reported with exact scores and areas of study (65% or less). A CPC-P must have at least two years medical coding experience (members with an apprentice designation are not required to have two years medical coding experience.) Membership is required to be renewed annually and 36 Continuing Education Units (CEU's) must be submitted every two years for verification and authentication of expertise. Certified Professional Biller (CPB™)  We recommend having an associate’s degree.  Pay examination fee at the time of application submission.  Maintain current membership with the AAPC. o New members must submit membership payment with examination application. o Renewing members must have a current membership at the time of submission and when exam results are released.  All exams will be reported with exact scores and areas of study (65% or less). $350 ($290 AAPC Students) Certified Professional Medical Auditor (CPMA®) Exam Requirements While there is no experience requirement, we strongly recommend that the candidate have at least two years of experience in medical auditing. Please be aware that this is a difficult, high-level examination which is not meant for individuals with little, limited or no audit experience or training Other requirements:  We recommend having an associate's degree  Pay examination fee at the time of application submission  Maintain current membership with the AAPC o Renewing members must have a current membership at the time of submission and when exam results are released. o Renewing members must be current at the time of application submission as well as when results are sent  Materials to bring: o Current CPT® (AMA Standard or Professional versions only) o ICD-10-CM
16 o HCPCS Level II Exam Recommendation The CPMA® examination is recommended for a certified coder or medical record auditor who has experience auditing physician services or significant coding experience and is well versed with a variety of different types of audits including but not limited to E/M services. Auditing involves compliance and regulatory issues in its day to day work, and the examinee will be tested on these concepts in addition to coding, modifiers, NCCI usage, and more. Maintaining Certification Membership is required to be renewed annually and 36 Continuing Education Units (CEU's) must be submitted every two years for verification and authentication of expertise. For CEU requirements please see our CEU Information page. The fee exam is $350. Certified Documentation Expert Outpatient (CDEO®) Exam Requirements While there is no experience requirement, we strongly recommend that the candidate have at least two years of experience in clinical documentation improvement. Please be aware that this is a difficult, high-level examination which is not meant for individuals with little, limited or no clinical documentation improvement Other requirements:  We recommend having an associate's degree  Pay examination fee at the time of application submission  Maintain current membership with the AAPC o Renewing members must have a current membership at the time of submission and when exam results are released. o Renewing members must be current at the time of application submission as well as when results are sent  Materials to bring: o Current CPT® (AMA Standard or Professional versions only) o ICD-10-CM o HCPCS Level II o One reference book of your choice Exam Recommendation The CDEO™ examination is recommended for a certified coder, medical record auditor or clinical documentation improvement professional who has experience reviewing documentation for outpatient services and extensive knowledge of coding and quality measure reporting.
17 Clinical documentation improvement involves compliance to documentation requirements and effective communication with providers to improve documentation. Maintaining Certification Membership is required to be renewed annually and 36 Continuing Education Units (CEU's) must be submitted every two years for verification and authentication of expertise. For CEU requirements please see our CEU Information page. Limited time Introductory price $175 ($145 AAPC Students) Certified Professional Compliance Officer - CPCO™ Compliance Certification Requirements While there is no experience requirement, we strongly recommend that the candidate have at least two years’ experience working with compliance programs and the associated laws and regulations. We recommend the individual also have at least an associate's degree in healthcare. The exam requires an understanding of a wide variety of compliance topics and issues, and practical application of those requirements to scenarios that is often gained through years of experience. Individuals who do not have compliance expertise or who have worked in limited compliance roles will need to become familiar with the different topics addressed on the exam breakdown tab on this page. Be aware that this is a challenging, high-level examination which is not meant for individuals with limited or no compliance experience or training. Other requirements:  Pay examination fee at the time of application submission  Maintain current membership with the AAPC  Renewing members must have a current membership at the time of application submission as well as when results are sent Certification Exam Recommendation The CPCO™ examination is recommended for individuals who have experience working in a compliance role or in a compliance department. The individual should be extremely familiar with the key elements required for compliance programs as well as the day-to-day operational aspects of compliance programs. Individuals should also be very familiar with the key laws and regulations impacting compliance programs, physician practices, and those used to address potential fraud and abuse, including their associated penalties and fines. Individuals should also know where to go and how to research information to identify correct practices to mitigate compliance risks.
18 Maintaining Certification Membership is required to be renewed annually and 36 Continuing Education Units (CEUs) must be submitted every two years for verification and authentication of expertise. For CEU requirements please see our CEU Information page. The fee for the exam is $350. Certified Physician Practice Manager (CPPM)  We recommend having an associate’s degree.  Pay examination fee at the time of application submission.  Maintain current membership with the AAPC. o New members must submit membership payment with examination application. o Renewing members must have a current membership at the time of submission and when exam results are released.  All exams will be reported with exact scores and areas of study (65% or less). Note: Each examination is separate and distinct. To obtain all certifications, each examination must be taken separately and passed. Continuing Education Unit (CEU) submissions are required for all certifications. For CEU requirements please see our CEU Information page. The fee for the exam is $350. References: Types of Certifications. (n.d.) Retrieved from http://www.ahima.org/certification/exams?tabid=him Medical Certification Overview. (n.d.) Retrieved from https://www.aapc.com/certification/
19 Job Search Resources 1. Indeed – The Number 1 Job Site http://www.indeed.com/ 2. Monster – Job Search, Career Advice, and Hiring Resources - http://www.monster.com/ 3. Careerbuilder - http://www.careerbuilder.com/ 4. Snagajob – Search Jobs/Post Jobs - http://www.snagajob.com/ 5. Greenville Health System Careers - https://career4.successfactors.com/career?company=GHS 6. Craigslist - https://greenville.craigslist.org/search/jjj 7. LinkedIn - https://www.linkedin.com/job/home 8. SimplyHired – Explore millions of jobs with one search – http://www.simplyhired.com/ 9. SCWorks – Bringing Employers and Job Seekers Together - https://scworks.org/ 10. Job.com - http://www.job.com 11. South Carolina Department of Employment and Workforce - http://www.sces.org/jobs- land.asp After doing some research on some of these sites, there are pros and cons to the jobs in my area. The Pros are: *CPC or CCS-P coding certification *CPC - A coding certification with coding experience *Strong organization and process management skills *Excellent verbal and written communication skills There are some cons when just graduating and being a Certified Medical Coder. Here are some cons that I have ran into when looking for coding jobs. *Prior experience in a fast paced insurance or health care setting *2+ years of medical coding experience *Associates or Bachelor’s Degree *Must live locally *Strongly preferred LPN, RN, or medical school graduate I have been with the health system I work for, for almost 6 years so I feel I have a better chance at getting a coding job. When the system is looking for employees, they look at internal candidates before external candidates.
20 Mock Questions  Tell me about the last claim you had denied. What happened, and how did you resolve it?  Are you familiar with Medicare and private payer regulations? If so, which payers?  What procedures have you most often coded?  Do you have a medical coding certification? If so, which one(s)  How do you stay updated on policy and code changes?  How many charts/cases do you typically code in one day?  Which type of software have you used: Epic, Medisoft or other programs?  How do you manage rejected or unpaid claims?  Do you know how to submit claims to a clearinghouse? Have you ever set up a provider with a clearinghouse or resolved claim submittal issues with them?
21 Mock Interview Summary I was supposed to interview Jody Claypool, who is over the patient’s access accounts at Patewood Medical School but ended up passing the questions to Stephanie Brown due to being out of town. Mrs. Brown’s certifications are CPC and CPC-I. When she has a denied claim she makes sure it was coded correctly. If need be she will contact the insurance company for any appeals. As a coder she determines justification regarding the denial, make changes or corrections if applicable. Reaches out to the physician if applicable. She also audits about 25 to 30 charts a day. She charts mostly Evaluation and Management services, and Pulmonary procedures. She is familiar with Medicare, Medicaid, BCBS, Cigna, Aetna, and many others. She knows how to submit clearhousing claims but never has had any problems with claims. She stays on top of updates by going to the websites AAPC, Palmetto GBA, and CMS. The main software her company uses is EPIC.

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Portfolio

  • 1.
    MEDICAL CODING PORTFOLIO ABSTRACT If youreallywantsomething,goafterit. Don’tlet someone stopyoufromachievingyourdreams. Heather Elkins HS292-01 BillingandCodingPracticum
  • 2.
    1 TABLE OF CONTENTS ReferencePage…………………………………………………. 2 Cover Page …………………………………………………….. 4 Resume…………………………………………………………. 5 Professional References………………………………………… 7 Research Page…………………………………………………... 10 Job Search Resources Page……………………………………… 19 Mock Interview Questions………………………………………. 20 Summary of Mock Interview Questions………………………… 21
  • 3.
    2 References Career Opportunities. (n.d.).Retrieved from https://career4.successfactors.com/career?company=GHS Explore millions of jobs… with just one search. (n.d.). Retrieved from http://www.simplyhired.com/ Find the right job. Right now. (n.d). Retrieved from http://www.careerbuilder.com/ Get Found. (n.d.). Retrieved from http://www.monster.com/ Greenville jobs – craigslist. (n.d.). Retrieved from https://greenville.craigslist.org/search/jjj Hire great hourly employees. (n.d.). Retrieved from http://www.snagajob.com/ Jobseekes. (n.d.). Retrieved from - http://www.sces.org/jobs-land.asp Job Search – Job.com. (n.d.). Retrieved from http://www.job.com/ Job Search – one search. all jobs. Indeed.com. (n.d.) Retrieved from http://www.indeed.com/ LinkedIn Jobs. (.n.d.). Retrieved from https://www.linkedin.com/job/home Medical Certification Overview. (n.d.) Retrieved from https://www.aapc.com/certification/ SC Works – Bringing Employers and Job Seekers Together. (n.d.). Retrieved from https://scworks.org/
  • 4.
    3 Types of Certifications.(n.d.) Retrieved from http://www.ahima.org/certification/exams?tabid=him
  • 5.
    4 Heather Elkins 105 CarlissaCourt Easley, SC 29640 hmelkins1977@gmail.com May 18, 2016 Mike Castill Human Resources Manager Greenville Health System 300 E McBee Street Greenville, SC 29605 Dear Mike Castill, I am contacting you regarding the open Certified Coding Specialist position with the Greenville Health System. My educational background in Medical Billing and Coding, along with my professional experience, makes me an excellent candidate for this position. As you will see from the enclosed resume, I have about a year of experience in the field of Medical Billing and Coding but have been with Greenville Health System for 6 years. My resume shows that I have been consistently rewarded for hard work with promotions and increased responsibilities. These rewards are a direct result of my expertise in the medical health field, my commitment to personal and professional excellence, and my excellent written and oral communication skills. I would very much like to discuss opportunities with Greenville Health System. To schedule an interview, please call me at 864-720-9010. The best time to reach me is between 8:00 a.m. and 6:00 p.m., but you can leave a voice message at any time, and I will return your call. Thank you for taking the time to review my resume. I look forward to talking with you. Sincerely, Heather M. Elkins Enclosure
  • 6.
    5 105 Carlissa Ct,Easley, SC 29640(864) 720-7010hmelkins1977@gmail.com Heather M. Elkins Objective Inpatient and outpatient records coding specialist with ICD-10, CPT and HCPCS Codes, and ASC coding expertise. Familiar with commercial and private insurance carriers. Seeks a position of increased responsibility and authority. Experience June 2012 - Present Patewood Memorial Hospital Greenville, SC Material Specialist  Prepared case carts for next day surgeries.  Ordered supplies for the OR.  Prepared repair orders and sent off damaged instruments.  Received receipts in for supplies.  Demonstrated knowledge of HIPAA Privacy and Security Regulations by appropriately handling patient information. Oct 2010 – June 2012 Greenville Memorial Hospital Greenville, SC Materials ATS System Specialist  Responsible for movement of case carts, supplies, instruments, detent, etc to and from the ORand all nursing areas in Greenville Memorial Medical Campus.  Responsible for all ATS computers and equipment.  Coordinates activities of employees performing AGV functions.  Dispatching of AGV computer system as well as data entry, ordering, receiving, restocking, distribution functions for ORcase cases, supplies, equipment, and linen.  Controls inventory processes, inclusive of but not limited to stock additions, changes, deletes, pick confirmations, issue corrections, replenishment verifications. Oct 2007 – July 2010 Langenscheidt Publishing Group Duncan, SC Administrative Assistant/Order Processor  Data entry and processing of domestic and international orders from customer service division.  Run reports for supervisor (Inventory, Order Status Reports and Smart List).  Tracking international shipments from Expeditors.  Record daily meeting notes.  Arrange domestic and international shipments.  Invoicing and billing.  FEDEX and UPS call tags and return requests.
  • 7.
    6  Investigation ofmissing, damaged, or not shipped products. July 2007 – Oct 2007  Administrative Assistant/Order Processor  Data entry and processing of domestic and international orders from customer service division.  Run reports for supervisor (Inventory, Order Status Reports and Smart List).  Tracking international shipments from Expeditors.  Record daily meeting notes.  Arrange domestic and international shipments.  Invoicing and billing.  FEDEX and UPS call tags and return requests.  Investigation of missing, damaged, or not shipped products. Education Aug 2015 – June 2016 Kaplan University Chicago, IL Certificate: Medical Coding and Billing 4.0 GPA Aug 2000 – May 2001 Tri-County Technical College Pendleton, SC NA: Criminal Justice April 1996 – July 1998 United States Army United States Certificate: Communications References References are available on request.
  • 8.
    7 Heather M Elkins 105Carlissa Court Easley, SC 29640 864-720-9010 hmelkins1977@gmail.com References: Vicki Greene, Materials Manager Patewood Memorial Hospital 175 Patewood Dr., Greenville, SC 29615 W: (864) 797-0111 C: (864) 640-6540 Greg Garrett, Materials Coordinator Patewood Memorial Hospital 175 Patewood Dr., Greenville, SC 29615 W: (864) 797-0111 C: (864) 884-2829 Susan Connelly, Materials Supervisor Greenville Memorial Hospital 701 Grove Rd., Greenville, SC 29605 W: (864) 455-5012 C: (864) 270-4150
  • 9.
    8 Kelli Gandy, BSN,RN, Central Supply Supervisor Patewood Memorial Hospital 175 Patewood Dr., Greenville, SC 29615 C: (864) 419-1692 Sandra Turner, RN, Implant Coordinator Patewood Memorial Hospital 175 Patewood Dr., Greenville, SC 29615 W: (864) 797-0114 C: (864) 430-7615 Theresa K. Watt, Surgical Technician Patewood Memorial Hospital 175 Patewood Dr., Greenville, SC 29615 W: (864) 797-1166 C: (864) 378-1204 Bridgette Baylor, Pharmacy Technician Patewood Memorial Hospital 175 Patewood Dr., Greenville, SC 29615 W: (864) 797-0081 C: (864) 901-2986 Scott Sisk, Certified Anesthesia Technician Patewood Memorial Hospital 175 Patewood Dr., Greenville, SC 29615 W: (864) 797-1162 C: (864) 373-1357
  • 10.
    9 Mark Henderson, MaterialsSpecialist Greenville Memorial Hospital 701 Grove Rd., Greenville, SC 29605 W: (864) 455-6445 C: (864) 640-2178 Melissa Medlin, Materials Specialist Patewood Memorial Hospital 175 Patewood Dr., Greenville, SC 29615 W: (864) 797-0111 C: (864) 915-8809 Steve Price, Lead Materials Specialist Greenville Memorial Hospital 701 Grove Rd., Greenville, SC 29605 W: (864) 455-6507 Chris Elkins, Electrical Engineer BMW 1400 Highway 101 South, Greer, SC 29651 C: (864) 386-0448
  • 11.
    10 Types of Certifications AHIMAhas several certifications that are offered. In HIM credentials there are 2 types of certifications. One is RHIA and RHIT. RHIA means Registered Health Information Administrator. RHIA applicants must meet one of the following eligibility requirements: *Successfully complete the academic requirements, at the baccalaureate level, of an HIM program accredited by the Commission on Accreditation for Health Informatics and Information Management Education (CAHIIM). *Successfully complete the academic requirements, at the master’s level, of an HIM program accredited by CAHIIM and following a specific set of criteria. *Master’s level candidates must use the Master’s Program Exam Application below graduate from an HIM program approved by a foreign association with which AHIMA has a reciprocity agreement. The exam fees are $229 for members and $299 for non-members. Another certification is Registered Health Information Technician (RHIT®). RHIT applicants must meet one of the following eligibility requirements: *Successfully complete the academic requirements, at an associate's degree level, of an HIM program accredited by the Commission on Accreditation for Health Informatics and Information Management Education (CAHIIM) *Graduate from an HIM program approved by a foreign association with which AHIMA has a reciprocity agreement. The exam fees are $229 for members and $299 for non-members. The academic qualifications of each candidate will be verified before a candidate is deemed eligible to take the examination. All first-time applicants must submit an official transcript from their college or university. There are several certifications for coding. One certification is Certified Coding Associate (CCA®). High School Diploma or equivalent is required but here are some things that are recommended but not required. *6 months coding experience directly applying codes; * completion of an AHIMA approved coding program; *completion of other coding training program to include anatomy & physiology, medical terminology, Basic ICD diagnostic/procedural and Basic CPT coding.
  • 12.
    11 Certified Coding Specialist(CCS®) Candidates must meet one of the following eligibility requirements:  By Credential: RHIA®, RHIT®, or CCS-P® OR  By Education: The following courses MUST be completed; anatomy & physiology, pathophysiology, pharmacology, medical terminology, reimbursement methodology, intermediate/advanced ICD diagnostic/procedural and CPT coding; OR  By Experience: Minimum of two (2) years of related coding experience directly applying codes; OR  By Credential with Experience: CCA® plus one (1) year of coding experience directly applying codes; OR  Other Coding credential from other certifying organization plus one (1) year coding experience directly applying codes.  Member Price: $299 Non-member price: $399 Certified Coding Specialist- Physician-based(CCS-P®)-Explore Further Coding Opportunities through Professional Certification Candidates must meet one of the following eligibility requirements:  By Credential: RHIA®, RHIT®, or CCS® OR  By Education: The following courses MUST be completed; anatomy & physiology, pathophysiology, pharmacology, medical terminology, reimbursement methodology, intermediate/advanced ICD diagnostic/procedural and CPT coding; OR  By Experience: Minimum of two (2) years of related coding experience directly applying codes; OR  By Credential with Experience: CCA® plus one (1) year of coding experience directly applying codes; OR  Other Coding credential from other certifying organization plus one (1) year coding experience directly applying codes.  Member Price: $299 Non-member price: $399 Speciality Certified Health Data Analyst (CHDA®) Candidates must meet one of the following eligibility requirements to sit for the CHDA examination:  Healthcare information management credential (RHIT®) and minimum of three (3) years of healthcare data experience  Baccalaureate degree and a minimum of three (3) years of healthcare data experience  Healthcare information management credential (RHIA®)
  • 13.
    12  Master’s inHeath Information Management (HIM) or Health Informatics from an accredited school  Master's or higher degree and one (1) year of healthcare data experience  Member Price: $259 Non-member price: $329 Certified in Healthcare Privacy and Security (CHPS®) Candidates must meet one of the following eligibility requirements for the CHPS examination  Associate’s degree and six (6) years’ experience in healthcare privacy or security management  Healthcare information management credential (RHIT®) and minimum of four (4) years of experience in healthcare privacy or security management.  Baccalaureate degree and a minimum of four (4) years’ experience in healthcare privacy or security management  Healthcare information management credential (RHIA®) and minimum of two (2) years of experience in healthcare privacy or security management  Master's or related degree (JD, MD, or PhD) and two (2) years of experience in healthcare privacy or security management  Member Price: $259 Non-member price: $329 Certified Documentation Improvement Practitioner (CDIP®) Candidates who would like to sit for the CDIP exam must meet one of the eligibility requirements below:  An RHIA®, RHIT®, CCS®, CCS-P®, RN, MD or DO and two (2) years’ experience in clinical documentation improvement  An Associate’s degree or higher and three (3) years of experience in clinical documentation improvement (candidates must also have completed coursework in Medical Terminology and Anatomy and Physiology)  Member Price: $259 Non-member price: $329 Certified Healthcare Technology Specialist (CHTS) Recommended (not required): Training and Recommendations  Individuals trained through short-duration (typically six months) non-degree health IT workforce development programs, OR  Members of the workforce with relevant experience or other types of training. (Types of Certifications. (n.d.))
  • 14.
    13 AAPC Certifications AAPC alsohas several certifications for coding professionsal. Some are listed below. CPC Medical Coding Certification Requirements  We recommend having an associate’s degree.  Pay examination fee at the time of application submission.  Maintain current membership with the AAPC. o New members must submit membership payment with examination application. o Renewing members must have a current membership at the time of submission and when exam results are released.  All exams will be reported with exact scores and areas of study (65% or less). A CPC must have at least two years medical coding experience (members with an apprentice designation are not required to have two years medical coding experience.) Membership is required to be renewed annually and 36 Continuing Education Units (CEU's) must be submitted every two years for verification and authentication of expertise. COC Medical Coding Certification Requirements  We recommend having an associate’s degree.  Pay examination fee at the time of application submission.  Maintain current membership with the AAPC. o New members must submit membership payment with examination application. o Renewing members must have a current membership at the time of submission and when exam results are released.  All exams will be reported with exact scores and areas of study (65% or less). A COC (formerly CPC-H) must have at least two years medical coding experience (members with an apprentice designation are not required to have two years medical coding experience.) Membership is required to be renewed annually and 36 Continuing Education Units (CEU's) must be submitted every two years for verification and authentication of expertise. CIC
  • 15.
    14 Medical Coding CertificationRequirements While there is no experience requirement, we strongly recommend that the candidate have at least two years of experience in inpatient coding or an inpatient coding course. Please be aware that this is a difficult, high-level examination which is not meant for individuals with little, limited or no inpatient coding experience or training.  We recommend having an associate’s degree.  Pay examination fee at the time of application submission.  Maintain current membership with the AAPC. o New members must submit membership payment with examination application. o Renewing members must have a current membership at the time of submission and when exam results are released.  All exams will be reported with exact scores and areas of study (65% or less). CRC Risk Adjustment Coding Certification Requirements  We recommend having an associate's degree  Pay examination fee at the time of application submission  Maintain current membership with the AAPC o New members must submit membership payment with examination application o Renewing members must have a current membership at the time of submission and when exam results are released  All exams will be reported with exact scores and areas of study (65% or less) We strongly recommend that the candidate have at least two years of experience in risk adjustment coding or a risk adjustment coding course. Membership is required to be renewed annually and 36 Continuing Education Units (CEU's) must be submitted every two years for verification and authentication of expertise. CPC-C Medical Coding Certification Requirements  We recommend having an associate’s degree.  Pay examination fee at the time of application submission.  Maintain current membership with the AAPC. o New members must submit membership payment with examination application.
  • 16.
    15 o Renewing membersmust have a current membership at the time of submission and when exam results are released.  All exams will be reported with exact scores and areas of study (65% or less). A CPC-P must have at least two years medical coding experience (members with an apprentice designation are not required to have two years medical coding experience.) Membership is required to be renewed annually and 36 Continuing Education Units (CEU's) must be submitted every two years for verification and authentication of expertise. Certified Professional Biller (CPB™)  We recommend having an associate’s degree.  Pay examination fee at the time of application submission.  Maintain current membership with the AAPC. o New members must submit membership payment with examination application. o Renewing members must have a current membership at the time of submission and when exam results are released.  All exams will be reported with exact scores and areas of study (65% or less). $350 ($290 AAPC Students) Certified Professional Medical Auditor (CPMA®) Exam Requirements While there is no experience requirement, we strongly recommend that the candidate have at least two years of experience in medical auditing. Please be aware that this is a difficult, high-level examination which is not meant for individuals with little, limited or no audit experience or training Other requirements:  We recommend having an associate's degree  Pay examination fee at the time of application submission  Maintain current membership with the AAPC o Renewing members must have a current membership at the time of submission and when exam results are released. o Renewing members must be current at the time of application submission as well as when results are sent  Materials to bring: o Current CPT® (AMA Standard or Professional versions only) o ICD-10-CM
  • 17.
    16 o HCPCS LevelII Exam Recommendation The CPMA® examination is recommended for a certified coder or medical record auditor who has experience auditing physician services or significant coding experience and is well versed with a variety of different types of audits including but not limited to E/M services. Auditing involves compliance and regulatory issues in its day to day work, and the examinee will be tested on these concepts in addition to coding, modifiers, NCCI usage, and more. Maintaining Certification Membership is required to be renewed annually and 36 Continuing Education Units (CEU's) must be submitted every two years for verification and authentication of expertise. For CEU requirements please see our CEU Information page. The fee exam is $350. Certified Documentation Expert Outpatient (CDEO®) Exam Requirements While there is no experience requirement, we strongly recommend that the candidate have at least two years of experience in clinical documentation improvement. Please be aware that this is a difficult, high-level examination which is not meant for individuals with little, limited or no clinical documentation improvement Other requirements:  We recommend having an associate's degree  Pay examination fee at the time of application submission  Maintain current membership with the AAPC o Renewing members must have a current membership at the time of submission and when exam results are released. o Renewing members must be current at the time of application submission as well as when results are sent  Materials to bring: o Current CPT® (AMA Standard or Professional versions only) o ICD-10-CM o HCPCS Level II o One reference book of your choice Exam Recommendation The CDEO™ examination is recommended for a certified coder, medical record auditor or clinical documentation improvement professional who has experience reviewing documentation for outpatient services and extensive knowledge of coding and quality measure reporting.
  • 18.
    17 Clinical documentation improvementinvolves compliance to documentation requirements and effective communication with providers to improve documentation. Maintaining Certification Membership is required to be renewed annually and 36 Continuing Education Units (CEU's) must be submitted every two years for verification and authentication of expertise. For CEU requirements please see our CEU Information page. Limited time Introductory price $175 ($145 AAPC Students) Certified Professional Compliance Officer - CPCO™ Compliance Certification Requirements While there is no experience requirement, we strongly recommend that the candidate have at least two years’ experience working with compliance programs and the associated laws and regulations. We recommend the individual also have at least an associate's degree in healthcare. The exam requires an understanding of a wide variety of compliance topics and issues, and practical application of those requirements to scenarios that is often gained through years of experience. Individuals who do not have compliance expertise or who have worked in limited compliance roles will need to become familiar with the different topics addressed on the exam breakdown tab on this page. Be aware that this is a challenging, high-level examination which is not meant for individuals with limited or no compliance experience or training. Other requirements:  Pay examination fee at the time of application submission  Maintain current membership with the AAPC  Renewing members must have a current membership at the time of application submission as well as when results are sent Certification Exam Recommendation The CPCO™ examination is recommended for individuals who have experience working in a compliance role or in a compliance department. The individual should be extremely familiar with the key elements required for compliance programs as well as the day-to-day operational aspects of compliance programs. Individuals should also be very familiar with the key laws and regulations impacting compliance programs, physician practices, and those used to address potential fraud and abuse, including their associated penalties and fines. Individuals should also know where to go and how to research information to identify correct practices to mitigate compliance risks.
  • 19.
    18 Maintaining Certification Membership isrequired to be renewed annually and 36 Continuing Education Units (CEUs) must be submitted every two years for verification and authentication of expertise. For CEU requirements please see our CEU Information page. The fee for the exam is $350. Certified Physician Practice Manager (CPPM)  We recommend having an associate’s degree.  Pay examination fee at the time of application submission.  Maintain current membership with the AAPC. o New members must submit membership payment with examination application. o Renewing members must have a current membership at the time of submission and when exam results are released.  All exams will be reported with exact scores and areas of study (65% or less). Note: Each examination is separate and distinct. To obtain all certifications, each examination must be taken separately and passed. Continuing Education Unit (CEU) submissions are required for all certifications. For CEU requirements please see our CEU Information page. The fee for the exam is $350. References: Types of Certifications. (n.d.) Retrieved from http://www.ahima.org/certification/exams?tabid=him Medical Certification Overview. (n.d.) Retrieved from https://www.aapc.com/certification/
  • 20.
    19 Job Search Resources 1.Indeed – The Number 1 Job Site http://www.indeed.com/ 2. Monster – Job Search, Career Advice, and Hiring Resources - http://www.monster.com/ 3. Careerbuilder - http://www.careerbuilder.com/ 4. Snagajob – Search Jobs/Post Jobs - http://www.snagajob.com/ 5. Greenville Health System Careers - https://career4.successfactors.com/career?company=GHS 6. Craigslist - https://greenville.craigslist.org/search/jjj 7. LinkedIn - https://www.linkedin.com/job/home 8. SimplyHired – Explore millions of jobs with one search – http://www.simplyhired.com/ 9. SCWorks – Bringing Employers and Job Seekers Together - https://scworks.org/ 10. Job.com - http://www.job.com 11. South Carolina Department of Employment and Workforce - http://www.sces.org/jobs- land.asp After doing some research on some of these sites, there are pros and cons to the jobs in my area. The Pros are: *CPC or CCS-P coding certification *CPC - A coding certification with coding experience *Strong organization and process management skills *Excellent verbal and written communication skills There are some cons when just graduating and being a Certified Medical Coder. Here are some cons that I have ran into when looking for coding jobs. *Prior experience in a fast paced insurance or health care setting *2+ years of medical coding experience *Associates or Bachelor’s Degree *Must live locally *Strongly preferred LPN, RN, or medical school graduate I have been with the health system I work for, for almost 6 years so I feel I have a better chance at getting a coding job. When the system is looking for employees, they look at internal candidates before external candidates.
  • 21.
    20 Mock Questions  Tellme about the last claim you had denied. What happened, and how did you resolve it?  Are you familiar with Medicare and private payer regulations? If so, which payers?  What procedures have you most often coded?  Do you have a medical coding certification? If so, which one(s)  How do you stay updated on policy and code changes?  How many charts/cases do you typically code in one day?  Which type of software have you used: Epic, Medisoft or other programs?  How do you manage rejected or unpaid claims?  Do you know how to submit claims to a clearinghouse? Have you ever set up a provider with a clearinghouse or resolved claim submittal issues with them?
  • 22.
    21 Mock Interview Summary Iwas supposed to interview Jody Claypool, who is over the patient’s access accounts at Patewood Medical School but ended up passing the questions to Stephanie Brown due to being out of town. Mrs. Brown’s certifications are CPC and CPC-I. When she has a denied claim she makes sure it was coded correctly. If need be she will contact the insurance company for any appeals. As a coder she determines justification regarding the denial, make changes or corrections if applicable. Reaches out to the physician if applicable. She also audits about 25 to 30 charts a day. She charts mostly Evaluation and Management services, and Pulmonary procedures. She is familiar with Medicare, Medicaid, BCBS, Cigna, Aetna, and many others. She knows how to submit clearhousing claims but never has had any problems with claims. She stays on top of updates by going to the websites AAPC, Palmetto GBA, and CMS. The main software her company uses is EPIC.