Samantha Fowler

Samantha Fowler is a goal and result oriented person. She is educated and trained extensively as a Certified Professional Coder (CPC) with exceptional expertise in the anesthesia and pain management specialties; among other areas. She is equally energetic and intensely focused on success with the ability to identify problem areas and develop efficient solutions. She possesses unique management skills that promote quality work through efficient processes of organization and calculation. 

Skills

• Samantha experience includes efficiency planning, production and quality goals, implementing and maintaining effective workflows and medical coding and compliance
• Analyzing reimbursement trends  and doing medical records audits
• Analyzing and negotiating managed care contracts and practice management
• An approved Professional Medical Coding Curriculum (PMCC) instructor (CPC-I)

Work Experience

• Experience in internal medicine, podiatry, adult and pediatric surgery practices and anesthesia and pain management
• Experience also includes facilitating on-line coding, compliance and reimbursement curriculums; overseeing the quality and efficiency of 30+ coders, and educating hundreds of physicians and other providers  about changes in regulatory trends, documentation, and medical necessities; among many others subjects
• Code or review physician/professional documentation completely, efficiently, accurately, and within the budget set while effectively identifying potential problem areas and providing feedback to optimize reimbursement on future documentation practices
• Oversee day-to-day operations of a 16 member team and the related coding functions and services; including, but not limited to, ensuring compliance with federal, state, local, and payer specific rules.
• Provide consulting and auditing services to physician practices including, but not limited to, provider education, operational efficiencies, documentation and coding audits, and reimbursement reviews. Client satisfaction, as well as compliance with government, state, and local regulations are the top priorities
• Educate providers regarding documentation requirements, billing rules, and coding specifications. Educate insurance carriers regarding compliance, coding, and policies. Oversee Quality Control Program and its staff
• Conducting audits and resolving all issues within coding and billing areas, including responsibility for overseeing the quality assurance of more than 30 coders, evaluating and educating them on documentation for 600+ physicians within a multi-specialty group
• Managed all aspects of a business office for three physicians, which included directing coding and billing tasks according to CMS and local carrier guidelines for all office, nursing home, hospital and other professional services, including the follow up on claims for payment, rejection and reimbursement issues. Excellent patient care was the top priority in every circumstance.
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Accomplishments

• Redesigned the coding workflow and the related processes: quality/production goals were tailored to meet facility specifics such as, type of documentation and services provided
• Implemented an education program for both coders and providers. Topics are related to audit findings, claim rejections, and suggestions form the coders and providers
• Implemented a claim follow up for coding related rejections as well as an appeals process driven by the coding department.
• Reviewed practices’ operations for efficiency and recommended policy and procedural improvements
• Helped maintain and continue development of an efficient and compliant billing, management and consulting firm, including hiring and training six coders. 
• Redesigned anesthesia records to meet medical direction and other compliance concerns for multiple groups throughout the nation
• Implemented sophisticated imaging product with automated workflow, document recognition and data capture with SQL database for ease of access reports, pivot tables, etc., allowing production, quality and efficiency standards to be measured with ease
• Conducted government related (i.e. CIA) audits and reports
• Reviewed practices’ operations for efficiency and recommended policy and procedural improvements for various anesthesia groups
• Conducted speaking/presentations at a variety of conference events
• Maintain high client satisfaction through quality communication and service, provider education and effective pro-active steps in advising and assisting in project management
• Evaluation and advices on various practice management issue with successful results
• Negotiated managed care contract far above the national median
• Assisted in the implementation of a custom rules engine
• Improved overall quality of documentation and billing standards by 3-5%
• Coordinated improvement in PQRI data capture

Associations

• Currently serving on the Anesthesia Specialty Advisory Board for the Board of Medical Specialty Coding (BMSC).
• Held the position of President-Elect and President for the local chapter of the American Academy of Professional Coders (Magic City Coders)
• Active member of the Medical Group Management Association (MGMA) and the MGMA focus group, Anesthesia Administration Assembly (AAA)
• Active member of the Board of Medical Specialty Coding (BMSC)
  2005 and 2006 BAMC Anesthesia Specialty Board Member
• Speaker for various events on coding education since 2002