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Jessica Claire
  • Montgomery Street, San Francisco, CA 94105
  • H: (555) 432-1000
  • C:
  • resumesample@example.com
  • Date of Birth:
  • India:
  • :
  • single:
Summary

Highly efficient Medical Biller/ coder CPC with experience in multi- surgery and office billing. Excellent multi-tasker and demonstrated team player with positive attitude, and strong attention to detail.

Skills
  • Strong work ethic
  • Bilingual English/Spanish
  • Team player with positive attitude
  • Strong planning skills
  • Maintains strict confidentiality
  • Knowledge of HMOs, Medicare, Workers compensation
  • ICD-10 Coding
  • CPT and HCPS coding
  • HIPAA compliance
  • Medical billing/coding software NEXTGEN, Misys PCM, Onstaff, Gateway, Surgisource
  • Good written communication skills
  • Patient-focused care
  • Billing, Written communication skills
  • Team player
  • Billing procedures
  • Insurance billing
  • Broad medical terminology knowledge
  • Medical coding capability
  • Strong medical ethic
  • Understands medical procedures
Experience
BUSINESS OFFICE LEAD, 10/2017 to Current
Bethesda Health Oakville, MO,
  • Code and bill for a busy ASC facility, coding a broad range of surgical procedures, around 20-30 per day, depending on the volume of patients seen.
  • Code ophthalmology, gynecology, orthopedics, podiatry, pain management, otorhinolaryngology (ENT), and plastic surgery.
  • Actively maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third party requirements regarding billing.
  • Review account information to confirm patient and insurance information is accurate and complete.
  • Maintain updated knowledge of coding requirements, which included continuing education and certification renewal.
  • Assigned value codes and modifiers to provide specific information for services provided.
  • Accurately assign codes using software and official print copy of code book.
  • Responds to coding questions from callers and other internal departments.
  • Review clinical data from medical records to assign ICD, CPT and HCPCS codes.
  • Assigned procedure and diagnosis codes for insurance billing using SIS system.
  • Do month end make sure all charts are for the month, run a report to confirm everything is entered.
  • Communicate with insurance companies to provide patient information if the insurance is not paying or if there is a problem.
MEDICAL BILLER/CODER, 05/2017 to 08/2017
Docgo Inc. Willingboro, NJ,
  • Examine charges for 6 ENT Drs.
  • Making sure claims were clean to be billed out.
  • Posting daily payments and balancing to that.
  • Taking patient calls regarding their medical bills and phone payments.
  • Investigated denials and collaborated with internal team members and third-party representatives to identify solutions.
  • Submitted claims to insurance companies.
  • Reviewed account information to confirm patient and insurance information is accurate and complete.
  • Applied HIPAA Privacy and Security Regulations while handling patient information.
  • Collected, posted and managed patient account payments.
  • Filed and submitted insurance claims.
  • Flagged return claims and dealt with insufficient payments.
  • Managed 25-30 accounts at once.
  • Researched and communicated insurance requirements, including patient financial responsibilities and fee-for-service
  • Audited medical records and diagnosis codes for accuracy and completion.
  • Answered desk phone and handled phone calls and questions.
  • Completed and submitted appeals.
MEDICAL BILLER/CODER, 07/2014 to 05/2017
Docgo Inc. New York, NY,
  • Examine charges for 6 nephrology Drs.
  • Making sure all diagnosis codes are accurate and complete for insurance processing usually 60 patients a day, enter hospital charges into system coding the diagnosis and cpt code of patients seen in the emergency room.
  • Posting monthly insurance payments 2 days out of the week and balancing to that.
  • Send monthly patient statements.
  • Making new patient charts on a daily basis; faxing medical records to home health care facilities.
  • Reviewed account information to confirm patient and insurance information is accurate and complete.
MEDICAL BILLER, 03/2007 to 12/2013
Exagen Inc. Vista, CA,
  • Examined diagnosis codes for accuracy, completeness, specificity and appropriateness according to charges rendered.
  • Reviewed diagnostic and procedural terminology for consistency with acceptable medical compliances.
  • Consistently ensured proper coding, sequencing of diagnoses and procedures.
  • Demonstrated knowledge of HIPAA privacy and Security Regulations by appropriately handling patient information.
  • Appropriately and correctly identified errors and re-filed denied/rejected claims as they were received.
  • Added modifiers as appropriate according to the insurance regulations and changes, coded and verified diagnoses.
  • Posted charges and personal payments, made monthly reports for Drs.
  • Faxed medical records to offices, took patient calls and patient payments over the phone and tried to solve a payment plan if patient wasn't able to pay financially.
  • Performed quality control of the data entry system to verify that claims and payments were posted correctly.
  • Performed full cycle medical billing in a fast paced medical billing environment.
  • Carefully prepared, reviewed and submitted patient statements.
Education and Training
: CERTIFIED PROFESSIONAL CODER, Expected in 04/2018
to
AAPC - Long Beach, CA,
GPA:
Medical Insurance Billing, Coding and Claims Administration program: , Expected in 2014
to
Harbor College - ,
GPA:
Ca. Diploma: Gendarme Institute- computerized Medical Billing, Expected in 2004
to
- ,
GPA:
Pico Rivera, Ca. coursework in computerized medical billing. AAPC coding class. Prep for CPC exam
High School Diploma: , Expected in 2002
to
Banning High School - Wilmington, Ca
GPA:
Activities and Honors
Certifications
  • Current CPC certification

Member ID: 0140483

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Resume Overview

School Attended
  • AAPC
  • Harbor College
  • Banning High School
Job Titles Held:
  • BUSINESS OFFICE LEAD
  • MEDICAL BILLER/CODER
  • MEDICAL BILLER/CODER
  • MEDICAL BILLER
Degrees
  • Medical Insurance Billing, Coding and Claims Administration program
  • Ca. Diploma
  • High School Diploma

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