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Cindy L. O’Neill

Expertise In: General Surgery

Name : Cindy L. O’Neill
Experience : 32
Specialty : General Surgery
Location : SiouxCity,IA
Description :

Cindy L. O’Neill  has extensive knowledge of auditing and coding of physician and hospital claims. Implemented coding and auditing guidelines for emergency clinic.  Proven results for reimbursement in the Emergency clinic, General Surgery, ENT practice, Behavioral Health Practices.  Increased revenue through correct coding and documentation by over 100% for a one-year period in Neonatology.
 
Skills:

• Extensive knowledge in the health insurance field with respect to coding, reimbursement and documentation
• Knowledge of Anatomy, pathology, physiology and medical terminology

Experience:

• Consulting to Physicians, Clinics, Therapists and Addiction Centers on correct coding, correct documentation. Education to allow for increased revenue and decrease accounts receivable and denials.
• Coding and Billing for Emergency Clinic, General Surgeons, ENT Physicians, Addiction Centers, and Behavioral Therapists.
• Auditing of Medical Coders and Physicians on correct coding, correct documentation and Compliance.
• Training and education to physicians on documentation of medical records for correct reimbursement and compliance.
• Resource person for the profitable retention of existing health groups and successful transition and implementation of new accounts to First Administrators.
•  Research, resolve and provide prompt and accurate responses primarily to group administrators, brokers and agents by phone, written correspondence, or e-mail.
• Educate customers on our products and services, and serve as a customer advocate to our company.
•  Evaluate and address the needs and requests of large group customers. Organize and participate internal meetings, group employee meetings, pre-renewal group meetings, Employer Forums, Benefit Fairs and broker training initiatives related to new agents and agency specific training. Coordination and preparation of new and renewal quotes for health insurance and stop loss insurance.
• Physician Education and training of Emergency Room Physicians and Neonatologist in medical record documentation and coding
• Auditing of physician charts to comply with correct coding and documentation.
• Coding of Peripheral Vascular charts, emergency room charts, and NICU charts.
• In one year I was able to increase billing by 160% from previous year, with reimbursement increase by 102% through accurate coding and documentation.
• Consultant to all departments on correct coding and documentation to be compliant.
• Training of the Cath Lab, Radiology, MRI, CT Scan and pathology on coding and documentation
• Review of Surgical/Operative Reports for CCI Edits and compliance with coding guidelines.
•  Review insurance claims for correct benefits
• CPT ,HCPCS, UB  and ICD-9 coding of claims
• Review medical records for appropriate level of benefits and medical necessity
• Price medical procedures for processing
• Processing and reviewing of Durable Medical Equipment claims and pharmacy claims.
• Determined prior approval of procedures and medical equipment that could possibly be cosmetic, investigational, experimental or not medically necessary
• Investigated fraudulent claims and providers.
• Provided Medical review for TPA business
• Provided Customer Service support for benefit and medical questions
• Review of Health Insurance Policies
• Determination of Health Insurance Benefits
• Pre-Certification and Prior Approval Review
• Blue Card Claims Medical Review
• Supervised claims department
• Reviewed quality assurance work in the department
• Trained claims personnel
• Subrogation and Coordination of benefits investigation
• Workman’s Comp investigation
• Process and Payment of all types of health insurance claims including Medicare and Coordination of Benefits
• Investigation and payment of disability claims
• Serviced customers, physicians, hospitals and home health providers
• Processed and investigated underwriting applications for life insurance and disability insurance
• Supervised 12 full time claims examiners for the Claims Department. Including health, death, death and waiver of premium claims
• Responsible for payment of Health and Life claims both on group and individual basis and disability claims for credit insurance.
• Balanced accounts for the department
• Supervised Beneficiary Change and Settlement Option department when combined with the claims department
• Hired claims personnel

Certifications:
• Advance Coding for Peripheral and Coronary Interventional Procedures. Advanced Coding for Lower Extremity and Abdominal Angiography. Physician Reimbursement Strategies: Physician Documentation for Cardiovascular Procedures. Cardiology Coalition Renal Angiography Coding. HC Pro Medicare Boot Camp for Physician and Hospital Services. Successful Evaluation and Management Auditing Guidelines, Rules and Reality
• Attended and successfully passed Medical Terminology, Anatomy, Pathology and Physiology classes
• AS Program/Psychology Western Iowa Community College, Sioux City Iowa
Affiliations
• Past Board Member American Heart Association
• Past Board Member Caring Foundation
• Past Volunteer Girls, Inc.
• Past Volunteer Siouxland Y
• Past Chairperson Board of Adjustments, City of Sioux City, Iowa
• Current Board Member Awesome Biker Nights
• Current Commissioner and Chairperson of The  Planning and Zoning Commission City of Sioux City
• Current Board Member of The Board of Adjustments, City of Sioux City