Summary
Overview
Work History
Education
Skills
Accomplishments
Affiliations
Certification
Timeline
Generic

Shawna Toler

Moncks Corner

Summary

Dynamic Outpatient Coder with expertise in ICD-10-CM and a proven track record at Ensemble Health Partners, enhancing coding accuracy and reducing claim denials. Skilled in training and mentoring, I excel in regulatory compliance and revenue cycle management, ensuring documentation completeness while fostering team collaboration for optimal results.

Healthcare coding professional with proven track record in outpatient coding, ensuring precise and compliant medical record documentation. Known for strong collaborative skills and commitment to achieving accurate results. Reliable team player with flexibility to adapt to changing needs, proficient in ICD-10, CPT, and HCPCS coding systems.

Overview

12
12
years of professional experience
1
1
Certification

Work History

Outpatient Coder

Ensemble Health Partners
08.2021 - Current
  • Reviewed medical documentation for accurate coding and compliance with regulations.
  • Assisted in the identification and resolution of coding discrepancies to ensure accuracy.
  • Utilized coding software to input and validate patient data efficiently.
  • Collaborated with healthcare providers to clarify information for precise coding assignments.
  • Maintained up-to-date knowledge of coding guidelines and healthcare regulations.
  • Supported team members in understanding coding processes and standards through collaboration.
  • Participated in continuing education opportunities to maintain professional growth and stay current with best practices in outpatient coding.
  • Reduced claim denials by ensuring accurate assignment of appropriate ICD-10 codes to diagnoses and CPT codes to procedures.
  • Mentored fellow coders to enhance their skillset and productivity within the team environment.

Emergency Room Coder

Roper St. Francis Hospital
02.2020 - 08.2021
  • Reviewed medical documentation for accurate coding and compliance with regulations.
  • Assisted in the identification and resolution of coding discrepancies to ensure accuracy.
  • Utilized coding software to input and validate patient data efficiently.
  • Collaborated with healthcare providers to clarify information for precise coding assignments.
  • Maintained up-to-date knowledge of coding guidelines and healthcare regulations.
  • Supported team members in understanding coding processes and standards through collaboration.
  • Participated in continuing education opportunities to maintain professional growth and stay current with best practices in outpatient coding.
  • Reduced claim denials by ensuring accurate assignment of appropriate ICD-10 codes to diagnoses and CPT codes to procedures.
  • Mentored fellow coders to enhance their skillset and productivity within the team environment.

Financial Service Representative

Roper St. Francis Hospital
07.2013 - 02.2020

▪ Experience with Windows and PC, PHS, STAR, APM, ECW, Pulse Point, Microsoft Outlook, RevRunner, AHIQA, Teletracking, Viewpoint

▪ Flexibility in days and hours worked including flexibility in working different facilities and ability to prioritize work and meet deadlines

▪ Patient registration includes the ability to greet and interview patients, obtaining correct demographics including insurance, placing radiology orders, obtaining required forms, placing patient in assigned rooms for admissions including labor and delivery, and nursery, the ability to register different types of services at multiple locations

▪ Financial responsibilities include ability to process all forms of payments, supply patients with bills, refer patients to necessary benefits counselors for additional assistance, collect past due balance, and collect self and prompt pay payments, insurance verifications, charge reconciliation

▪ Additional responsibilities and abilities have included volunteering in assisting in training multiple new hires, patient scheduling, ability to give guidance to coworkers, volunteering for green spots, volunteering to join Access on Call Team, Peer Interviewing Team, volunteering for project assisting quality assurance team to verify insurance, knowledge of the multiple tools and resources available to effectively complete job

Education

Associate of Arts - Child And Adolescent Developement

Diablo Valley College
Pleasant Hill, CA
12-2004

Skills

  • Effective organizational and multitasking skills
  • Expertise in ICD-10-CM diagnosis coding
  • ICD-10-CPT including procedures and medication administration coding skills
  • Medical abstracting proficiency
  • Training and mentoring
  • Expertise in Microsoft applications
  • Skilled in EPIC and Solventum software
  • Revenue cycle management knowledge
  • Ensure completeness of documentation
  • Resolving coding errors including LCD, NCD, NCCI, and Medical Necessity Edits
  • Proficient in computer applications
  • Regulatory guidelines

Accomplishments

  • Coding Ambassador serving as point of contact to associates in need of help
  • Associate of the Month Quarter 1 2025
  • Completed the Mentor/Mentee program as a mentee
  • Accepted into the SMART (Specialized Mentor and Revcycle Trainer) program

Affiliations

AHIMA - American Health Information Management Association

AAPC - American Academy of Professional Coders

HFMA - Healthcare Financial Management Association

Certification

  • CCS - Certified Coding Specialist
  • CEDC - Certified Emergency Department Coder

Timeline

Outpatient Coder

Ensemble Health Partners
08.2021 - Current

Emergency Room Coder

Roper St. Francis Hospital
02.2020 - 08.2021

Financial Service Representative

Roper St. Francis Hospital
07.2013 - 02.2020

Associate of Arts - Child And Adolescent Developement

Diablo Valley College
Shawna Toler