Paula Skrzypek
Mentor,OH
Summary
MEDICAL RECORDS ADMINISTRATION WITH EMPHASIS ON CODING, TRAINING AND QUALITY ASSURANCE.
ACCREDITED RECORD TECHNICIAN AND CERTIFIED PROCEDURAL CODER WITH 44 YEARS OF EXPERIENCE IN MEDICAL RECORDS ADMINISTRATION. Innovative, hard working, quality minded initiator and team worker.
Overview
53
53
years of professional experience
Work History
Quilts and Sew Forth
Mentor, OH
12.2020 - 10.2022
- Interaction with customers and helped select fabrics for upcoming projects
- Cut fabric, did the register, did procedure manual for the shop, replaced fabric bolts to stock, took out inventory and updated stock in office system, gift cards and all other functions that a local small business of this type performed.
- Assisted with day-to-day operations, working efficiently and productively with all team members.
Department of Coding and Compliance - Evaluation & Management Coding Analyst
Cleveland Clinic Foundation
09.2005 - 12.2013
- Involved in E & M and CPT review based on determined risk areas
- Utilizing Intelicode for E&M code assignment, EpicCare for encounter notes, SMS for verifying NPI number and specialty listed
- For the CPT reviews, access HBO if necessary to verify charges
- The information is analyzed and presented with outcome reports
- Involved in training and education sessions in regards to documentation rules and guidelines.
Coding and Reimbursement - Division of Laboratory Medicine and Pathology
Cleveland Clinic Foundation
09.2003 - 09.2005
- Responsible for monitoring, updating Chargemaster maintenance coding for compliance with CPT changes
- Denial database appeal process for various payor groups
- Worked Claim Track edits for UB92 (laboratory)
- Reported trend findings and recommendations to avoid these in future
- Responsible for keeping current with various Newsletters that impact coding and reimbursement in all payor classes and all places of service
Coding and Reimbursement – Division of Regional Medical Practice
Cleveland Clinic Foundation
03.2002 - 09.2003
- Responsible for monitoring, updating Chargemaster maintenance and charge tickets for all Family Health Centers
- E&M coding for compliance and physician education
- Denial database appeal process for various payor groups
- Work Claim Track edits for UB92 (laboratory and PT/OT) for all Family Health Centers and assist with backlog in HCFA 1500 for various FHC
- Report trend findings and recommendations to avoid these in future
- Monitor and work as assigned for FHC where necessary to maintain project deadlines
- Responsible for keeping current with various Newsletters that impact coding and reimbursement in all payor classes and all place of service.
Professional Coder
Cleveland Clinic Foundation
08.2001 - 03.2002
- Responsible for charge collection and verification of documentation for designated Departments
- Verify all government payors for Teaching Physician Guidelines as outlined by HCFA
- Review, interpret and verify E&M and other CPT procedural codes according to the physician’s documented progress notes and orders located in the medical record
- Utilized ICD-9-CM coding books to accurately code the diagnoses based on the physician’s documented diagnosis
- Utilizes Intelicode E&M monitoring system to abstract information and provide feedback via email to the physicians on findings obtained from the monitoring process to further educate the physicians in the documentation process.
Supervisor Professional Coding
Cleveland Clinic Foundation
04.1998 - 07.2001
- Manages all attendance records including timekeeping and scheduled PTO
- Assigns workload to professional coding staff to assure maximum level of coding verification occurs
- Performs audits of coders’ work according to coding and documentation guidelines to determine quality of CPT and ICD-9-CM coding
- Performs billing audits of charge entry personnel
- Enters various data collected in Access data base system and Excel spreadsheets
- Assists Director in a multitude of various projects
- Responsible for getting employees proper computer access for various network systems
- Involved with training of personnel.
Psychiatry utilization and reimbursement
Cleveland Clinic Foundation
01.1996 - 04.1998
- Coordinates procedures and protocol for establishment of new foundation services (i.e
- Observation unit)
- Creation on how to bill profession/technical components source of billing etc
- Perform internal audit and conduct reimbursement surveys
- Provides training to physicians and administrator on correct CPT coding techniques and data requirements for correct billing of services rendered
- Completes and verifies the Master file and charge tickets
- In the absence of the billing specialist performed ticket entry for SMS/HBO
- Is backup for the outpatient certification process in psychiatry.
Utilization review coordinator
Cleveland Clinic Foundation
01.1987 - 01.1996
- Review of patient care records for various payors and insurance carriers using medical necessity criteria/Interqual
- The Primary service I was responsible for since 1989 for adult and pediatric psychiatry
- I covered chemical dependency and pain management in the absence of the nurse reviewer…
- I also initiated the certification of outpatient psychiatric services
- I was responsible to communicate to carriers to obtain approval for extensions on hospital stays and outpatient visits
- I maintained statistical reports for internal and external distribution
- I informed the administration of patterns of inappropriate admissions, tests or treatments and did quality review on these cases.
DRG Quality Control Coordinator
Cleveland Clinic Foundation
01.1984 - 01.1987
- Monitored accuracy of ICD-9-CM coding and DRG assignment
- Researched coding questions
- Developed and implemented a system to monitor the productivity of employees engaged in coding
- Devised a standard tumor registry system for updating patient information, which significantly reduced the time required to obtain this data.
Consulting Auditor
Rondale Nursing Home and the Ball Pavilion Skilled Nursing Facility
01.1980 - 01.1984
- Conducted quarterly accreditation audits to assess the quality of the medical records at these facilities
- Reported my findings to the respective Directors.
Code Analyst
Millcreek Community Hospital
01.1970 - 01.1981
- Coded discharge according to ICD-8 and ICD-9-CM
- Compiled and submitted monthly reports to the Hospital Utilization Project in Pittsburgh, PA
- Typed correspondence, transcribed hospital reports, maintained insurance requests, birth and death certificates
- Maintained Tumor Registry and periodicals and journals in the Medical Library
- Trained all new employees in the Medical Records Department and supervised in the absence of the Director
- Served as Secretary of the Mortality Review and Medical Record Committee.
Education
High School Diploma -
St. Benedictd Academy
Erie, PA06.1970
Skills
- Cultural Awareness
- Basic Math
- Networking
- Microsoft Word
- Conflict Resolution
- Data Entry
- Task Prioritization
- Clerical Support
Retired Date
12/31/13
Timeline
Quilts and Sew Forth
Mentor, OH
12.2020 - 10.2022
Department of Coding and Compliance - Evaluation & Management Coding Analyst
Cleveland Clinic Foundation
09.2005 - 12.2013
Coding and Reimbursement - Division of Laboratory Medicine and Pathology
Cleveland Clinic Foundation
09.2003 - 09.2005
Coding and Reimbursement – Division of Regional Medical Practice
Cleveland Clinic Foundation
03.2002 - 09.2003
Professional Coder
Cleveland Clinic Foundation
08.2001 - 03.2002
Supervisor Professional Coding
Cleveland Clinic Foundation
04.1998 - 07.2001
Psychiatry utilization and reimbursement
Cleveland Clinic Foundation
01.1996 - 04.1998
Utilization review coordinator
Cleveland Clinic Foundation
01.1987 - 01.1996
DRG Quality Control Coordinator
Cleveland Clinic Foundation
01.1984 - 01.1987
Consulting Auditor
Rondale Nursing Home and the Ball Pavilion Skilled Nursing Facility
01.1980 - 01.1984
High School Diploma -
St. Benedictd Academy
Code Analyst
Millcreek Community Hospital
01.1970 - 01.1981
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