Timothy Look has over 18 years of experience as a coding manager in multi-specialty physician practices. He has managed coding teams and ensured accurate coding according to Medicare, Medicaid, and commercial payer guidelines. His experience includes coding for internal medicine, family practice, pediatrics, and other specialties. He maintains current knowledge of coding practices and regulatory guidelines.
1. Timothy Patrick Look, CPC-P
Long Beach, CA 90802
Cell: 562-212-3875 Email: tlook55@hotmail.com
PROFESSIONAL SUMMARY
Experienced hands-on Coding Manager with over 18 years’ experience in multi-specialty physician coding.
Maintains current and sound understanding of all coding practices, compliance and regulatory guidelines.
CORE QUALIFICATIONS
Multi-Specialty Physician Coding
In-Patient and Outpatient
Internal Medicine, Family Practice
& Pediatrics
Medicare, Medi-Cal, CCS
Medicare Advantage & Commercial
Strong Revenue Cycle Capabilities
Electronic Coding & EMR Systems
EPIC, NextGen, IDX & Athena
Physician In-Servicing
Policy and Program Development
Skilled Communicator
Excellent Organizational Skills
PROFESSIONAL EXPERIENCE
Children’s Hospital Los Angeles Medical Group; - Los Angeles, CA 11/2012 – 02/2015
Pediatric Management Group
Coding Manager
Provides Physician coding oversight for the largest Pediatric academic multidisciplinary medical
group in the in the United States.
Responsible for planning, organizing and supervising the coding department to provide optimum
coding in accordance with set procedures, goals and standards; oversees proper CPT and ICD-9
coding on a daily basis; and serves as a liaison between the Coders and the Director of Compliance,
to include communication with appropriate physicians, office managers and staff.
Responsible for ensuring that diagnoses and procedural codes and all pertinent information on
charge sheets arecorrect for proper coding.
Serves as a resource to Medical Group Physicians providing answers to complex coding questions
Codes services that staff are unsure of and reviews proper coding with individuals involved.
Works closely with the Director of Compliance in communicating and assessing productivity and
results.
Works closely with numerous departments, CHLA heads and office managers in problem solving
and identifying opportunities for physician revenue enhancement.
Remains current on all changes in legislative regulations that affect the reimbursement area.
Participates in professional development activities to keep current with trends and practices in
health care administration.
Manages daily activities of 11 certified Coders including determining specific employee work
assignments; reviewing employee activities for completeness, accuracy and effectiveness;
monitoring conformity with policies and procedures; and monitoring individual staff
productivity.
Manages key personnel activities including preparing employee performance reviews;
disciplinary actions, job interviewing and hiring decisions; and recommends raises, promotions,
transfers and terminations
Competencies in Medicare, Medi-Cal, CCS and Commercial programs
2. Timothy Patrick Look, CPC-P
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Memorial Care Medical Foundation –Tustin, CA 11/2008 – 10/2012
Coding Manager
Responsible for Coding and Management of Coding team which includes 16 Certified
Coders (Informatics and AR Departments) utilizing both NextGen and Epic platforms
Coding of; Family Practice, InternalMedicine and Pediatrics (In-Patient & Out-Patient)
encounters for Memorial Hospitals and contracted facilities
Coding of Pediatric encounters at; Miller Children’s and contracted referrals to CHOC
Competencies in Medicare, Medi-Cal, CCS and Commercial programs
Clinical repositories using ICD-9CM and CPT-4 for Medicare Advantage Health plans
Audit outpatient and Inpatient encounters to ensure documentation and coding are in
compliance with CMS and federal regulations
Develop policies and procedures necessary to determine areasfor reimbursement improvement
Identify risk areas and trends based on audit findings
Implemented HCC/P4P Hedis measures and coding guidelines for physician practice
Conduct Physician In-Servicing for documentation and coding guidelines
Instrumental in the development of EMR (NextGen) Physician Documentation Templates
to meet Coding Regulatory Guidelines
LSU Health Care Network – New Orleans, LA 02/2000 – 08/2008
(Medical Network comprised of 400+ Physicians representing 40 different Specialties)
Coding Manager
Coding and Management responsibilities for multi-specialty Physician encounters which included
both in-patient and out-patient utilizing the IDX platform
Managed team of 15 Coders (10 in-house and 5 off-site)
Conducted formal and informal auditing of billing forms and supporting medical documentation
Created and implemented individual and group education session for faculty and residents
Review standard billing and service activity reports in order to identify areas of concern with
regard to billing compliance
Clarified billing rules and regulations for Medicare, Medicaid, and private carriers
Acted as liaison between Compliance Director and Physician compliance officers
Health Management Systems – New York, NY 05/1999 – 02/2000
Coding Manager
Managed, directed and monitored reimbursement/coding activities on all medical services for
multi-specialties practice
Performed regular and ad-hoc research, reporting on Medicare, Medicaid, Commercial insurance
carriers and provider regulations, policy and administrative guidelines for HMS clients
Managed coding staff of 18 and conducted quality control and performance studies
AdvantageHealth Plan – New Orleans, LA 01/1997 – 05/1999
Claims Trainer
Plan, organize and coordinate the activities of training and resource material for the claims
department to ensure staff needs and departmental goals are met
Select appropriate instructional procedures or methods such as individual training, group
instruction and computer based training
Document and maintain all claims department policies and procedures
Facilitate overall cross-functional improvement through involvement with all claims production units
3. Timothy Patrick Look, CPC-P
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University of New Orleans – New Orleans, LA 06/1997 – 08/2005
Adjunct Instructor
Instructed students on the subject of Introduction of Health care Insurance, ICD-9 and CPT-4 coding
systems which included; Medical terminology and Anatomy & Physiology
OchsnerFoundation and Hospital – New Orleans, LA 01/1990 – 01/1997
Coding Specialist
Ensured optimum reimbursement for medical services delivered through interpretation
of medical records for appropriate ICD-9 and CPT coding systems
Extensive knowledge of main frame information systems used to track and organizeaudit of
medical documentation.
Interfaced with medical staff for medical documentation
EDUCATION
University of New Orleans, 1995
Associate of Science Degree
CERTIFICATIONS
Preparation for ICD-10 Certification; Inprogress.
Health Care Compliance Association-CPC-P Coding Certification
American Academy of Procedural Coder (AAPC) Member