tina Lors

Assigned and sequenced ICD-10-CM/PCS, CPT, and HCPCS codes for inpatient and outpatient records in the cardiovascular/cath lab setting, ensuring compliance with Medicare and AMA guidelines.

Managed coding staff and performed outpatient, ER, and inpatient coding reviews, correcting claims and educating clinicians to reduce denials and improve coding accuracy across specialties.

Performed ER coding, EM level assignment, infusion and procedure coding, and denials management while ensuring accurate sequencing and modifier use for claim reimbursement.

Conducted in-depth DRG inpatient record reviews to validate MCC/CC assignment, ROM/SOI/POA accuracy, mentored coders, and authored appeals for DRG-related denials.

Oversaw a coding and billing team of 10, improved processes and quality metrics, managed productivity reporting, and conducted coding audits to ensure documentation-supported coding.

Completed coursework in medical billing and coding with emphasis on DRG and outpatient coding; credentialed in related continuing education.

Completed training in billing, coding, medical secretarial duties, and compliance leading to certification in medical billing/coding.