Dave Durham

About Dave Durham

The Marvelously Awesome New Industry Standard Medical Coding Administrative Management…

Experience

1. Surgical Coder Ii - Complex Specialties

   Advocate Aurora Health

   Jan 2025 — Present · Raleigh, NC, US

   Coder II Coding Quality Chart Review Analyst• Professional auditing for Advocate and Aurora Health (Various Specialties)• Creation of and running PB Auditing reports for selected work queues/specialties• Exportation and customization of reports to Excel to insert appropriate coding audit commentary• Complex review process (Microsoft One Note for EM leveling, Lab reviews, operative note reviews, etc.) to determine correct coding• Determination of appropriate CPT Code charge selection (original charge vs charge submitted)• Insertion of differential findings via commentary on the spreadsheet to educate coders and facility regarding appropriate CPT/ICD-10 codes • Collaborate with internal staff via an auditing process (spreadsheet) to ensure appropriate professional/ facility coding protocol standardsCoder II Charge Review• Verifying charge review data (patient, billing provider, service provider, POS, insurance coverage, etc.)• Verification of duplicate charges via transactions on the patient guarantor account• Analyzation of the encounter, surgeries, procedures, labs, etc. in chart review• Complex review process (Microsoft One Note for EM leveling, Lab reviews, operative note reviews, etc.) to determine correct coding• Leveling of E/M encounters, in coordination with various procedures, Preventive visits (99381–97), and Annual Well Visits (G0402, G0438-9), etc.• Charge review of critical care encounters, teaching physician academic facilities and providers, split level coding for ER EM, critical care, etc.(review for both notes from both providers to gain full encounter), etc.• Appropriate use and insertion of all modifiers into appropriate line in charge review• Analyzation of records for correct ICD-10-CM codes for the highest degree of accuracy• Insertion of correct ICD-10-CM codes into charge review• Correction of EM leveling/procedures in charge review• Acceptance and resubmission (resubmit) in charge review

Education

• Virginia Western Community College

  Certificate, Health Records Coding

• Virginia Western Community College

  Certificate, Medical Office Assistant/Specialist

• Radford University

  Bachelor's degree, Economics

• Pfeiffer University

  Master's degree, Health/Health Care Administration/Management

• William Byrd High School

  Advanced Studies Degree

  1992 — 1996

Skills

• Healthcare Information Technology (Hit)
• Microsoft Office 2016
• Interdepartmental Training
• Outlook.com Linking Emails
• Healthcare Information Technology
• Video Editing
• Electronic Medical Record (Emr)
• Teamwork
• Icd-10
• Hipaa
• Html
• Anatomy & Physiology Self-Studies Program
• Cpr Plus Medical Billing Applications
• E/M Coding (99201-99214)
• Multitasking Skills
• Microsoft Office 2013
• Medical Coding
• Medical Billing Knowledge
• Smart Emr
• Windows 10
• Therapy Cpt Codes (97110–97546)
• Medical Records
• Leadership
• Medical Billing
• Changing Photo Pixel Size
• Healthcare Management
• Medicare Billing
• Microsoft Word Default Settings
• Online Data Entry
• Epic Electronic Medical Records Systems
• Adobe Connect
• Innovative Coding Solutions
• Customer Service
• Cpc
• Healthcare
• U.s. Health Insurance Portability and Accountability Act (Hipaa)
• Hcpcs
• Accurate Data Entry
• Microsoft Word 2013
• Opthamology Coding