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Jessica
Claire
resumesample@example.com
(555) 432-1000,
Montgomery Street, San Francisco, CA 94105
:
Professional Summary

Accomplished Certified Professional Coder with over 15 years experience. Highly efficient medical coder with experience in outpatient E/M and surgery coding as well as hospital admissions/discharges. Quality focused with extensive knowledge of medical coding, billing and office administration. Offer solid foundation in software applications, database management, and data entry. Motivated with a strong work ethic and determination to complete tasks in a timely manner and a demonstrated team player with a positive attitude.

Licenses

Certified Professional Coder - AAPC

Skill Highlights
  • Evaluation and Management, OB-GYN, Primary Care, Internal Medicine, Radiology, Anesthesia, Wound Care, Palliative Care, Orthopedics
  • Healthcare billing proficiency
  • In-depth claims knowledge
  • Knowledge of MCOs, Medicare, W/C and commercial insurances
  • ICD-9 coding
  • CPT and HCPCS coding
  • Claims analysis and review specialist
  • HIPAA compliance
  • Electronic Medical Record (EMR) software
  • Medical Manager Software
  • Extensive anatomy/physiology knowledge
  • Managed care contract knowledge
  • Clinical training
  • Technical expertise
  • Quality assessment of coded data
Education and Training
Professional Healthcare Institute of America Louisville, KY Expected in 2001 : Certified Professional Coder - GPA :
Watterson College Louisville, KY Expected in 1992 : Certified Medical Assistant - GPA :
Professional Experience
E Cancercare - Certified Professional Coder
Layton, UT, 04/2012 - Current

Evaluate the accuracy of provider charges, including dates of service, procedures, level of care, locations, patient identification and provider signature. Assigned additional diagnosis codes based on specific clinical findings (laboratory, radiology and, pathology reports in support of existing diagnoses. Provide administrative support for multiple medical practices. Quickly respond to staff and client inquiries regarding CPT & ICD-9 codes. Verify and abstract all medical data to assign appropriate codes for hospital inpatient/out-patient records. Analyze and interpret patient medical and surgical records to determine billable services. Added modifiers as appropriate, coded narrative diagnoses and verified diagnoses. Ensured timely and accurate charge submission through electronic charge capture, including the billing and account receivables (BAR) system and clearing house. Carefully reviewed medical records for accuracy and completion as required by insurance companies. Examined diagnosis codes for accuracy, completeness, specificity and appropriateness according to services rendered. Strictly followed all federal and state guidelines for release of information. Provided administrative support for multiple physicians & mid-level providers.

E Cancercare - Certified Professional Coder/Biller
Medina, OH, 10/2008 - 04/2012

Carefully reviewed medical records for accuracy and completion as required by insurance companies. Evaluated the accuracy of provider charges, including dates of service, procedures, level of care, locations, diagnoses, patient identification and provider signature. Liaison between the business department, billers and third party payers in resolving billing and reimbursement accuracy. Assigned additional diagnosis codes based on specific clinical findings (laboratory, radiology and, pathology reports as well as clinical studies) in support of existing diagnoses. Accurately entered office encounters at a rate of 100-120 per day into billing software. Appropriately and correctly identified errors and re-filed denied/rejected claims as they were received from third party payers. Thoroughly reviewed remittance codes from EOBS/AR's. Remained up-to-date with all insurance requirements, including the details of patient financial responsibilities, fee-for-service and managed care plans.

E Cancercare - Certified Professional Coder
New Iberia, LA, 09/2008 - 2008

Reviewed documentation & Assigned appropriate CPT & ICD-9 codes for the following clients:

Norton Audubon Anesthesia, Williams & Waggener Anesthesia, DuPont Surgery Center & Commonwealth Infectious Disease. Coded outpatient encounters at a rate of 160 per day. Accurately entered procedure codes, diagnosis codes and patient information into billing software. Balanced batch totals and corrected any errors. Followed up on all information requested but not received. Performed ongoing reviews of various coding publications to stay current on requirements of government and third party payers. I communicated concerns regarding compliance, coding, or source documentation to billing manager and compliance officer.

Women First Of Louisville - Certified Professional Coder
City, STATE, 01/1995 - 08/2003

Coded and charged all major/minor surgeries for nine Ob/Gyn Physicians. Examined diagnosis codes for accuracy, completeness, specificity and appropriateness according to services rendered, Assigned additional diagnosis codes based on specific clinical findings (laboratory, radiology and, pathology reports as well as clinical studies) in support of existing diagnoses. Scheduled surgeries and outside appointments. Quickly responded to staff and client inquiries regarding CPT codes. Efficiently performed insurance verification and pre-certification and pre-authorization functions. Assisted physicians in back office procedures and exams lab experience including phlebotomy, injections and controls. Telephone triage and patient education. Prepared prescription refill requests on behalf of the physician. Demonstrated knowledge of HIPAA Privacy and Security Regulations by appropriately handling patient information. Posted charges, payments and adjustments.

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School Attended

  • Professional Healthcare Institute of America
  • Watterson College

Job Titles Held:

  • Certified Professional Coder
  • Certified Professional Coder/Biller
  • Certified Professional Coder
  • Certified Professional Coder

Degrees

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