Timothy Sak

About Timothy Sak

Visionary, highly tenacious, and quality-focused professional, offering extensive skills…

Experience

1. Manager, Fraud Waste and Abuse Services

   Cotiviti

   Mar 2018 — Present · Towson, MD, US

   Coordinates individual work activities with SIU Manager and Investigators, develops and presents findings and recommendations regarding the appropriateness of diagnosis and procedure codes submitted on provider service claims and supports over-payment recovery during a discussion with medical and behavioral health care providers- Coordinates coding and payment issues with other areas and departments as required- Provides detailed written review of audit findings to management, plan representatives and State Regulatory Agencies- Reviews medical records and independently codes, abstracts and analyzes inpatient and outpatient medical records using the most current International Classification of Diseases (ICD-9/ ICD-10), Current Procedural Terminology (CPT), Health Care Common Procedure Coding System (HCPCS), Universal Billing (UB) and other codes according to federal and state statutory, regulatory and contractual requirements, AMA guidelines, other regulatory agencies and generally accepted coding practice- Verifies and validates authorization of services, written clinical documentation of services received through physical health utilization management departments and information contained in the healthcare claims systems against claims, medical records and anomalies, abnormal billing patterns and other indicators (e.g, duplicate billing, services not rendered, up-coding, unbundling, etc.) of suspected fraud and abuse

Skills

• Medical Billing
• Healthcare Management
• Healthcare Information Technology (Hit)
• Matrix Environment Management
• Risk Assessment and Mitigation
• Healthcare
• Business Development
• Medicine
• Ndb
• Healthcare Consulting
• Medical Group Management
• Strategic Planning and Implementation
• Clinical Trials
• Healthcare Compliance
• Microsoft Office (Outlook, Powerpoint, Excel, Access, Visio, and Publisher)
• Medical Coding
• Business Analysis
• Hospitals
• Profit Maximization
• Quality Assurance
• Infopath
• Medical Coder
• Cross-Functional Collaboration
• Edi
• Healthcare Analytics
• Healthcare Reimbursement
• Healthcare Information Technology
• Continuous Process Improvemen
• Project Management
• Regulatory Compliance
• Customer Service
• Business Process Analysis
• Cosmos
• Clinical Research
• Ehr
• Sharepoint
• Sql Database
• Leadership
• Facets
• Healthcare Industry