Stephanie Pospichal

Certified Coding Associate (CCA) and Medical Coding Specialist II with 15+ years of healthcare experience spanning inpatient and outpatient medical coding, medical record review, revenue cycle management, claims processing, auditing, reimbursement, and healthcare operations. Experienced in reviewing complex medical records and claims for coding accuracy, documentation integrity, regulatory compliance, and appropriate reimbursement. Advanced knowledge of CPT, ICD-10-CM, HCPCS, payer guidelines, LCDs, NCDs, UB-04, and CMS-1500.

Extensive experience supporting transplant, cardiothoracic, vascular, trauma, surgical, and acute care services. Proven ability to identify coding and documentation discrepancies, conduct detailed audits, research reimbursement issues, collaborate with clinical and revenue cycle teams, and implement corrective actions. Contributed to a 15% reduction in claim denials through coding discrepancy resolution and reimbursement process improvement.

Medical Coding Specialist II - UW HEALTH — REVENUE CYCLE - Madison, WI

(2021-07)

• Review and accurately code high-volume inpatient and outpatient medical records using CPT and ICD-10-CM coding guidelines.
• Review complex surgical and acute care documentation to support accurate code assignment, compliant claims, and appropriate reimbursement.
• Code and validate transplant, cardiothoracic, vascular, trauma, and acute care services while applying coding and payer guidelines.
• Apply advanced knowledge of ICD-10-CM, CPT, and HCPCS to evaluate medical records and claims for coding accuracy, documentation support, and regulatory compliance.
• Conduct detailed medical record and coding audits to identify errors, documentation discrepancies, and opportunities for corrective action.
• Identify and resolve coding discrepancies through detailed documentation review and collaboration with clinical, billing, and revenue cycle teams.
• Research coding and documentation issues and apply payer requirements to support accurate reimbursement and reduce claim risk.
• Collaborated with healthcare providers and billing teams to resolve coding discrepancies and optimize reimbursement processes, contributing to a 15% reduction in claim denials.
• Perform retrospective reviews of medical documentation to verify coding accuracy and adherence to applicable coding and payer guidelines.
• Maintain quality and productivity standards while independently managing remote revenue cycle workflows in a high-volume healthcare environment.
• Support data integrity and compliant reimbursement through accurate code assignment, detailed documentation review, and identification of coding errors.

Transplant Pharmacy Technician - UW HEALTH — SPECIALTY MAIL ORDER PHARMACY - Middleton, WI

(2019-12 - 2021-07)

• Processed prescriptions and resolved complex insurance claims for Medicare, Medicaid, and commercial insurance plans.
• Investigated coverage, billing, and claim issues and coordinated resolutions among payers, patients, and clinical staff.
• Obtained prior authorizations and assisted with financial assistance programs to reduce patient out-of-pocket expenses.
• Maintained accurate patient and prescription information within Epic systems while supporting high-volume specialty pharmacy operations.
• Collaborated with healthcare teams and insurance payers to resolve reimbursement and coverage issues.

Patient Account Representative - SSM HEALTH — CENTRAL BILLING OFFICE - Fitchburg, WI

(2019-03 - 2019-12)

• Processed and billed UB-04 and CMS-1500 claims to support accurate and timely reimbursement.
• Reviewed rejected claims, identified errors, corrected claim issues, and resubmitted claims to improve first-pass acceptance.
• Analyzed payment discrepancies and researched payer requirements to resolve reimbursement issues.
• Prepared and submitted claim appeals using CPT, ICD-10-CM, LCD, and NCD knowledge.
• Researched medical billing and coding issues and collaborated with payers and internal teams to resolve claim discrepancies.

Inventory Specialist / Pharmacy Technician / Shift Supervisor - CVS PHARMACY

(2011-12 - 2019-03)

• Processed prescriptions and resolved insurance claim issues in a high-volume healthcare environment.
• Investigated insurance coverage issues and claim rejections while communicating effectively with patients and insurance plans.
• Managed inventory, scheduling, cash handling, and daily pharmacy operations while maintaining accuracy and compliance.
• Trained employees and maintained operational procedures and quality standards.

68J — Medical Logistics Specialist - U.S. ARMY RESERVES

(2006-08 - 2014-08)

• Managed receipt, storage, inventory, and distribution of Class VIII medical supplies supporting medical readiness.
• Prepared medical supply bags supporting overseas combat medical operations with a high degree of accuracy.
• Provided logistics support for time-sensitive medical supply requests in high-pressure environments.
• Maintained accurate inventory records and ensured medical supplies were available to meet operational requirements.

Medical Billing and Coding Certificate (2018-12)

Certificate Program - Purdue University Global (2018-02)