LaDonna Mayfield
Puyallup
Summary
Coding Consultant Manager with extensive experience in Health Information Management, specializing in documentation and coding compliance and education. Successfully enhanced revenue cycle management outcomes through effective collaboration. Strong critical thinking and problem-solving skills contribute to high-quality deliverables. Acknowledged for strong adaptability and communication skills that enhance team performance.
Overview
18
18
years of professional experience
1
1
Certification
Work History
Coding Consultant Manager – Health Information Management
Group Health Cooperative/Kaiser Permanente
Renton
04.2015 - Current
- Company Overview: Kaiser Foundation Health Plan of Washington’s (KFHPW)
- Designs, develops and administers the coding consultation program to support the Kaiser Foundation Health Plan of Washington’s (KFHPW) Documentation and Coding Initiative and other standard Coding Consultant work.
- Assures that coding consultation and quality checks are performed according to industry-standard coding and documentation practices, national coding guidelines and compliance standards.
- Participates in the development of written coding instructions and guidelines consistent with industry-standard coding rules, Medicare and other payer guidelines, and KFHPW policies in collaboration with the Coding Education Department.
- Collaborates with within Health Information Management to review and update documentation standards and policies.
- Fosters development of teamwork and provides inter-department job shadowing opportunities to staff within Health Information Management to add to their knowledge, growth and development.
- Directs work and business decisions as directed by the Director.
- Develops data reports to monitor documentation and coding trends to identify potential compliance issues.
- Collaborates with delivery system leaders to plan documentation and coding support activities.
- Identifies areas of high-risk to the organization, and assures that coding support work is prioritized appropriately.
- Kaiser Foundation Health Plan of Washington’s (KFHPW)
Interim Manager – Enterprise Revenue Assurance
Kaiser Permanente
Renton
09.2022 - 01.2025
- Focus on ethical business practices and policies to achieve three organizational imperatives: operational efficiency, compliance, and optimal earned reimbursement/payment.
- Designed and launched the Revenue Assurance Action Plan (RAAP) Tracker tool.
- Monitor implementation of issues and findings impacting areas of Revenue Assurance using the Revenue Assurance Action Plan (RAAP) Tracker.
- Monitor charge router alignment work across the enterprise.
- KPWA Data Integrity Throughput Taskforce Member.
- Investigate, monitor, and remediate Revenue Cycle processes. Focus on ensuring appropriate risk adjustment diagnosis capture and improve process flows from encounter to claim and accurate risk adjustment submission.
- Continuously identify gaps and recommend solutions/process improvements.
Senior Coding Consultant Lead
Group Health Cooperative
Tukwila
10.2014 - 04.2015
- Serve as a mentor to a team of 11 specialty coding consultants.
- Provide guidance and advice on policies and procedures, coding issues and concerns.
- Serve as a liaison between departments and direct consultants to the appropriate staff for inter-departmental issues.
- Assist in preparing meeting agendas and work planning.
Senior Coding Consultant
Group Health Cooperative
Tukwila
08.2011 - 04.2015
- Successfully maintained and achieved provider coding and accuracy standards according to the Provider Interventional Matrix. 90% of the providers successfully met or exceeded expectations.
- Ensure that professional services coding and documentation for assigned areas meet Group Health compliance and quality standards.
- Serve as a coding resource to staff throughout the Group Health delivery system.
- Perform needs assessment and implement coding education for practitioners, ancillary staff, business operation and clinical informatics staff.
- Research complex coding issues and maintain a knowledge base regarding policies and guidelines from CMS and other payers.
- Teach complex coding issues and concepts.
- Evaluate medical record documentation against coding and billing compliance standards and provide detailed reports of findings.
- Develop and implement coding improvement plans.
- Consult with providers and business office to staff to advise on coding issues.
- Project manager for coding issues.
Coding Compliance Educator
Pacific Medical Centers
Seattle
09.2007 - 08.2011
- Achieved provider coding accuracy and completeness standards of 90% set by Corporate Compliance Work Plan.
- Audited medical chart documentation for compliance with Federal guidelines and fraud laws.
- Provided coding support and education to clinical staff, providers, and business office personnel.
- Developed new provider orientation and annual training on coding and documentation standards.
- Collaborated with auditing and coding teams to improve operational efficiency.
- Delivered feedback to compliance officer and chief medical officer on provider compliance risks.
- Managed project for encounter form updates and audit purging process.
Education
Bachelor of Science - Business Management
UNIVERSITY OF PHOENIX
Tukwila, WA01.2010
Criminal Justice -
SEATTLE UNIVERSITY
Seattle, WA01.1981
Skills
- Coding compliance
- Revenue cycle management
- Documentation standards
- Process improvement
- Effective communication
- Health records review
- Data privacy
- Team building
- HIPAA compliance
- Conflict resolution
- Problem-solving
- Budget management
- Project management
- Training development
- Customer Relationships
- Employment Law
- ICD-10 & CPT Coding
- Public Relations
- Regulatory Compliance Issues
- Project Management
- Mentoring
- Financial Analysis & Budgets
- Process Redesign/Streamlining
- Conflict Resolution
- Strong written and verbal communication skills
- Performance Systems
- HIPAA regulations and policies
- Global Business Strategies
- Root Cause Analysis
Certification
- CPC
- AAPC ICD-10 Certified
Tools and Technology
Microsoft Office (Word, Excel, Power Point), Lucidchart
Coding Assisted Software iiCA GeBBs, MDaudit, Intellicode, Code Correct, Encoder Pro, Custom Coder, Super Coder
Electronic Medical Record Systems EPIC, Cerner, IDX, Flowcast Centricity, NextGen, Misys
Timeline
Interim Manager – Enterprise Revenue Assurance
Kaiser Permanente
09.2022 - 01.2025
Coding Consultant Manager – Health Information Management
Group Health Cooperative/Kaiser Permanente
04.2015 - Current
Senior Coding Consultant Lead
Group Health Cooperative
10.2014 - 04.2015
Senior Coding Consultant
Group Health Cooperative
08.2011 - 04.2015
Coding Compliance Educator
Pacific Medical Centers
09.2007 - 08.2011
Bachelor of Science - Business Management
UNIVERSITY OF PHOENIX
Criminal Justice -
SEATTLE UNIVERSITY
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