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

Medical coding professional with experience in insurance billing, audit coding of disease and injury diagnoses, acuity of care, and procedures, medical terminology, anatomy and physiology References used for coding include the current International Classification of Diseases (ICD), Clinical Modification; American Medical Association Physicians' Current Procedural Terminology (CPT); Health Care Common Procedure Coding System (HCPCS) Key strengths: communication, leadership and interpersonal skills; multi-tasking and overall resourcefulness

Skills
  • ICD 10, CPT and HCPCS proficient
  • HIPAA Compliance
  • Knowledge of private, governmental and worker's compensation insurances and guidelines
  • Team player with positive attitude
  • Exercises good judgement
  • Maintains strict confidentiality
  • Strong work ethic
  • Deadline driven
  • Motivated and fast learner
Work History
06/2011 to Current
Charge Entry Specialist/ Coder/ Regional Coding and Compliance Specialist Carestream Va, VA,
  • Carefully reviews medical records for accuracy and completion as required by insurance companies
  • Examine diagnosis codes for accuracy, completeness, specificity and appropriateness according to services rendered
  • Accurately enter procedure codes, diagnosis codes and patient information into GE Centricity
  • Consistently ensures proper coding, sequencing of diagnoses and procedures, add modifiers as appropriate, codes narrative diagnoses and verifies diagnoses
  • Analyze and interpret patient medical records to determine billable services, entering all required modifiers based on CPT and CMS coding guidelines
  • Provides routine feedback to clinicians regarding the quality of the visit documentation submitted using established processes and forms
  • Assists in training new colleagues
  • Responsible for reviewing level 5 and level 1 evaluation and management queues for accuracy
  • Review and correct claim edits created by Optum Claims Manager
  • Responsible for post bill audits for worker compensation claims for the east zone
  • Responsible for provider training with coding evaluation and management
  • Assists central billing office with proper coding on claims denied by payers
  • Facilitates financial and operational audits, working with internal and external managers to communicate recommendations or issues surrounding audits
  • Reviews charts and flagged incomplete or inaccurate information
  • Used classification manuals to gain additional knowledge of disease and diagnoses processes
  • Maintained accuracy, completeness and security for medical records and health information; demonstrating knowledge of HIPAA Privacy and Security Regulations by appropriately handling patient information
10/2010 to 06/2011
Contractor Hlp Solutions City, STATE,
  • Contracted urgent care charge entry specialist for Concentra Urgent care
  • Entered Occurrence and Diagnosis Code information
  • Entered Insurance and Demographic Information
  • Read EOB's and manually posted to proper accounts if not auto-posted by Researched payments and applied them to proper accounts Researched accounts using ACE and PBAR unidentified accounts Utilized On-Demand for bank reports daily to correct bank keying errors and force
05/2008 to 08/2010
Support Representative II/ Payment Poster Tenet/Conifer Health Solutions City, STATE,
  • Processed incoming mail and distributed accordingly
  • Processed credit card payments through Passport
  • Created and maintained reports for management using Excel
  • Scanned documentation into VI WEB
  • Managed large volumes of data efficiently and with great care on daily basis
  • Accurately posted payments and adjustments both electronically and manually
  • Communicated effectively with others through active listening and dynamic interpersonal skills
  • Processed payments that had been received from insurance companies and Medicare
  • Supported operations by communicating with customers, filing documents and managing data
  • Identified overpayments and processed refunds for insurance carriers and patients
  • Verified deposits, rectified discrepancies and processed end-of-day paperwork
Education
Expected in 2021
Associate of Applied Business: Business Management Health Management Focus
Eastern Gateway Community College - Steubenville, OH
GPA:
  • President's List Fall 2019
  • President's List Spring 2020
  • Member of Phi Theta Kappa Honor Society
  • Current GPA: 4.0
Expected in 2013
Medical Coding and Billing Specialist: Coding and Billing:
US Career Institute - Fort Collins, CO,
GPA:
Expected in 1999
High School Diploma:
Sykes Academy - Fort Worth, TX,
GPA:
Certifications
  • Certified Professional Coder (CPC)
  • Certified Documentation Expert Outpatient (CDEO)
  • Certified Professional Medical Auditor (CPMA)
  • Certified Evaluation and Management Coder (CEMC)
  • Certified Evaluation and Managemnet Auditor of Orthopaedics
Affiliations
  • American Academy of Professional Coders (AAPC)
  • National Alliance of Medical Auditing Specialists (NAMAS)

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Resume Overview

School Attended

  • Eastern Gateway Community College
  • US Career Institute
  • Sykes Academy

Job Titles Held:

  • Charge Entry Specialist/ Coder/ Regional Coding and Compliance Specialist
  • Contractor
  • Support Representative II/ Payment Poster

Degrees

  • Associate of Applied Business
  • Medical Coding and Billing Specialist: Coding and Billing
  • High School Diploma

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