Summary
Overview
Work History
Education
Skills
Certification
Timeline
Generic

Melissa Harkins Sparks

Sacramento

Summary

Dedicated professional with extensive experience in medical coding and billing. Skilled in conducting audits and identifying discrepancies, ensuring adherence to regulatory standards. Committed to improving coding accuracy and operational efficiency to drive financial success.

Quality-focused professional, prepared to ensure top-notch standards in quality assurance and control. Brings valuable experience in streamlining processes and maintaining compliance. Known for team collaboration and adaptability to changing needs, with expertise in quality assessments and regulatory standards.

Overview

15
15
years of professional experience
1
1
Certification

Work History

Coding Quality Associate

R1 Rcm
Chicago, IL
11.2022 - Current

Evaluate and implement charge requests with appropriate CPT/HCPS codes, revenue codes, and pricing, ensuring alignment with clinical services and coding/billing guidelines.

Conducts charge capture audits: Review and analyze patient records,billing data, and financial statements to ensure charge and coding compliance.

Identify discrepancies or errors and place on excel spreadsheet for management and CFO review

Charge Edit Coding Auditor

Sutter Shared Services
Roseville, CA
07.2015 - 11.2022
  • Conducted thorough audits to ensure compliance with regulatory standards and internal policies.
  • Evaluated financial records for accuracy, identifying discrepancies and correcting account in regards to coding and billing guidelines.
  • Collaborated with cross-functional teams to identify areas of risk and implement charge corrections based on coding/billing guidelines.

Health Record Analyst and Medicare Lead Biller

Sutter Health
Sacramento, CA
02.2013 - 07.2015
  • Analyzed healthcare data to identify trends and support decision-making processes.
  • Mentored Medcare billers and providing guidance on best practices and analytical methods.
  • Educated staff on Medicare billing guidelines to help employees improve production of claims.
  • Reviewed claim edits for billing and coding guidelines and made appropriate changes.
  • Reported Medicare payments daily to management.

Medical Billing and Coding Instructor

Anthem College
Sacramento, CA
05.2011 - 11.2012
  • Developed and delivered comprehensive curriculum on medical billing and coding standards.
  • Evaluated student performance and provided constructive feedback to enhance learning outcomes.
  • Implemented updated coding guidelines and compliance regulations to ensure accuracy in instruction.
  • Mentored students in practical applications of coding software and billing procedures.
  • Facilitated learning by integrating hands-on activities that reinforced fundamental principles of medical billing and coding processes.
  • Led dynamic group discussions on complex medical billing topics, fostering critical thinking skills among students.
  • Delivered comprehensive instruction on medical billing and coding practices, resulting in increased student proficiency.
  • Evaluated student progress regularly through assessments, adjusting teaching strategies as needed to address areas of weakness or confusion.
  • Improved student understanding of medical billing and coding concepts by incorporating engaging, real-world examples into lesson plans.
  • Worked closely with academic advisors to track student progress and identify any necessary interventions or accommodations.
  • Supervised and monitored students' use of tools and equipment.
  • Provided instructional handouts, texts, audiovisual aids and other materials to facilitate learning.

Education

Medical Coding Certificate - Medical Coding

Asher College
Sacramento, CA
10-2010

Skills

  • Documentation review
  • Physician & Hospital billing experience
  • Private/Managed Care/HMO/ Government Insurance reimbursement/collections/appeals
  • extensive knowledge of medical terminology across a broad range of medical practices
  • Highly skilled in CPT, HCPCs m, ICD-10, and NCCI edits
  • Excellent knowledge of anatomy,physiology and pharmacology
  • proficient in Medical billling software
  • Detail-oriented
  • Decision-making
  • Verbal and written communication
  • AAPC Member

Certification

  • Certified CPC, AAPC - 2011-current 01166517

Timeline

Coding Quality Associate

R1 Rcm
11.2022 - Current

Charge Edit Coding Auditor

Sutter Shared Services
07.2015 - 11.2022

Health Record Analyst and Medicare Lead Biller

Sutter Health
02.2013 - 07.2015

Medical Billing and Coding Instructor

Anthem College
05.2011 - 11.2012

Medical Coding Certificate - Medical Coding

Asher College
Melissa Harkins Sparks