Mary Pasciak, RHIT, has been in the Health Information Management (HIM) field for 18 years. Since 2023 she has been an Outpatient Coder, on the facility-side, with Garnet Health System in Middletown NY. Mary has a strong background in outpatient coding, as well as medical record analysis. Her role has expanded considerably over time, “the more I know, the better I feel, I don’t like doing the same thing all the time.” Her responsibilities include ICD-10 diagnosis and CPT procedural coding in emergency room, interventional radiology, observation, same day surgeries, and cardiac catheterization procedures, and corrects claim edits. In addition to her work role, Mary is an active volunteer with AHIMA, NYHIMA, RRHIMA, and AAPC. Mary has been on the Board of Directors with RRHIMA for the past 8 years, serving in various positions and director roles. She also volunteers on the NYHIMA committee House of Delegates. Mary donates to the Ronald McDonald House and the Open-door Mission. “My big thing was helping people most of my life. I like doing things for people more than for myself.”
Prior to this role, she had been a registered health information technician/Outpatient Coder with Rochester General Health Systems (RGH) for 15 years. When she landed her first HIM position at RGH she explains, “I felt overwhelmed, knowing I worked hard in school and was able to get my first HIM job.” At first, she was given the role of working with paper charts and paper signatures and soon after started coding emergency room visits.
When contemplating what initially drew her to the field of HIM, she states: “it hit me one day, I had a picture of the digestive system on the back of my door in my room. I always looked at it but never thought much about it. I realized I want to get into healthcare. This is what I want to do.” Mary has a diverse background, working in different types of roles. Prior to college, Mary worked in the hospitality field as a waitress for years. “I cared about who my customers were and what they wanted from me.” After high school in 1984, Mary moved to NY, went to college at Bryant and Stratton and got a certificate in Administrative Secretarial business. She then spent time working in finance and did secretarial work for an attorney.
To complete her degree, Mary attended Monroe Community College (MCC) for 2+ years, working full time and going to school full time. She sympathizes with students who are going to school and working at the same time. Mary contemplated her joy in helping others, complicated by her inability to become a nurse or radiologist due to being unable to lift patients. While in school, she sought career guidance from the Director of MCC, Sharon Insero, who pointed her in the direction of HIM. Mary became the president of MCC’S health information technology club for 2 years. She also completed two internships with UR Thompson and Finger Lakes Health in Geneva from 2004 to 2006, which led to a position as a medical record analyst with both organizations. In 2007, a peer helped her get an interview with RGH. “You always keep in contact with people you went to school with because they may be able to help you get a job.” Mary reflects on her experience at MCC, “I learned a lot and I made a lot of friends.” In Mary’s college years, she confides she was an introvert, but she became a people person when she entered the field of HIM. She is interested in furthering her education by earning the AHIMA micro credentials, OP record credential and revenue cycle credential.
While at RGH, Oncology began to transition into the HIM department, and when Mary was asked to assist, she agreed when many others said no. “There were about 40 other coders. I got to know all of them. I got to learn how to do Oncology. You don’t get to see the backend of things unless you actually go see for yourself.” She also took on a supervisory position for 6 months as Coding Coordinator for Oncology, training other coders and mentoring students. Among Mary’s many achievements is an award from AHIMA for her involvement in mentorship while at RGH.
Denials management is the process of identifying, reviewing, and resolving claim denials. A claim is denied when a healthcare insurance payer does not agree to reimburse a provider for services rendered to a patient. Claim reconciliation is the process of analyzing and resolving denied insurance claims. There is a strategic process to determine the cause of the denial and prevent its reoccurrence. Mary took on the additional responsibility of claim edits, part of the denials management process. “If a denial comes in under your name, it is sent to you, with instructions on how to resolve it.” She would also clear National Correct Coding Initiative Edits (NCCI) on charts created by the Centers for Medicare and Medicaid Services (CMS) to promote correct coding methodology on Medicare Part B services. NCCI edits include Procedure to procedure edits (PTP) and medically unlikely edits (MUEs). Sometimes these can be resolved by adding a modifier to a code. She also collaborates with the revenue cycle department. “If a chart comes back from billing with a concern, then the bill is adjusted.”
Mary explains one of the most difficult parts of her work can be getting the information she needs and keeping track of new updates in ICD-10 and CPT rules and guidelines. Often, she has been able to get the right information through her professional network and RRHIMA. Another challenge in her work is completing a certain number of accounts in a period, and coding records she is unfamiliar with. “Sometimes I need to take the extra time to look up how to code something, Organizations want quality and quantity.”
While at RGH, Mary worked part time for E-Clad, a family-owned company, in a contract position as a coding specialist. She was then sent to St. Lukes hospital out of PA, performing strictly outpatient coding. There she was able to complete many accounts in one hour as “they were easy.” When RGH let her go, she worked full time for E-Clad but desired to find a position that paid the salary that better reflected her nearly 18 years of experience in coding. She then found her current role which she still holds today with Garnet Health Systems. As an HIM professional, it is important to keep an open mind and agree to opportunities for professional development. “When you start a job and you want to learn more, never say no, always say yes, and be persistent about it.”
“Coding is a great area to get into, you are sitting at a desk, looking at a chart, and you feel like you are right there in the room with the patient and the doctor. And that’s what makes it interesting. As a coder, you are given tools by your employer, such as utilizing reference books and tools on EPIC on the job. You learn either from organizations such as AHIMA or your employer.” As an HIM professional, Mary keeps her skills updated by staying current with AHIMA’s and NYHIMA’s webinars and educational articles.
To be successful in HIM, “it’s important to be easy going, professional, and ask a lot of questions.” Mary’s advises students to “follow your dreams. If you have a dream of being a coder or a manager, follow that dream and pursue it. You’ll feel good about yourself. HIM is a very tight knit community. You get to know people; you know where they are working, and that’s how you get information coming to you about jobs.” She advises HIM students to “join a club in school, go to the director or who’s in charge, and talk to them about opportunities.”
Mary grew up in Buffalo, then moved to Farmington, where she’s lived for the past 35 years. She has a husband and a daughter. Her favorite past time is travelling with her husband to other countries and learning about different cultures. She states, “we have a lot of friends, there’s always something new to learn.”
Sarah Hasselstrom, RHIT
