Coding Analyst Resume Example Lehigh Valley Physican Groupallentown

CODING ANALYST

Professional Summary

Inpatient and outpatient records coding specialist/Analyst with ICD-9, ICD-10 and coding. Proficient with commercial and private insurance carriers. Excellent multi-tasker and demonstrated team player with a positive attitude. Seeking a position where I can contribute significantly to the growth and continued success of the company.

Skill Highlights

Claims analysis and review specialistProblem resolution ability Healthcare billing proficiencyAccounts receivable professionalIn-depth claims knowledge CPT and HCPCS codingSuperior research skillsStrong work ethicPersonal and professional integrity Results-oriented Self-motivated professionalDeadline-drivenRelationship and team buildingExercises good judgmentStaff training and developmentProven patience and self-discipline

Professional Experience

Coding Analyst06/2011 to 01/2013Lehigh Valley Physican GroupAllentown

Consistently ensured proper coding, sequencing of diagnoses and procedures.
Reviewed diagnostic and procedural terminology for consistency with acceptable medical nomenclature.
Appropriately and correctly identified errors ofre-filed denied/rejected claims as they were received from the Patient Account Representative.
Added modifiers as.
appropriate, coded narrative diagnoses and verified diagnoses.
Analyzed and interpreted patient medical and surgical.
records to determine billable services.
Interpreted medical reports to apply appropriate ICD-9, CPT-4 and HCPCScodes.
Evaluated the accuracy of provider charges, including dates of service, procedures, level of care, locations,diagnoses, patient identification and provider signature.
Meticulously tracked and resolved underpayments or deniedclaims.
Quickly responded to staff and client inquiries regarding CPT codes.
Retrieved physician correspondence from dictation service and made edits when necessary.
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.
Lend support to practices with charge entry, coding quidelines and education when needed.
Identify problems with unpaid claims and education or make changes where appropriate.
Respond to Accounts Receivable department inquiries for claims determination and refund request and educate for efficient return on monies.
.

06/2011 to 01/2016Lehigh Valley Physican GroupAllentown

Coding -Physician coding for E/M and Specialty coding for cardiology.
Adjudicated schedules with charges entered.

Senior Billing Representative/ Accounts Receivalbe01/1999 to 03/2011Lehigh Valley Cardiology AssociatesBethlehem

Increase accounts receivable from various insurance companies.Reduced loss ratios through fair and prompt processing of claims.Audit medical records for review of medicare rescinded payment claims.Train new billing representative and front desk intake personnel to ensure correct collection and application of paymentsand adjustments from insurance companies.Identified and collected information and determined its value to a specific claim.Research of Accounts prior to issuing payments for overagesResponsible for Accounts receivables for all insurances.
In absence of Billing Manager assumed responsibilities for billing department until manager able to resume.
Stay updated on Hippa requirements as well as current procedural coding guidelines for Medicare and commercial carriers.
Adjudicated schedules with charges and payments received or outstanding.
Reviewed E/M services and Implemented training tools for Physician's to insure highest level of return.
Advised Clinical Staff on current billing guidelines for procedures in and out of office and implemented training tools.
Chart Audits for accuracy and charge capture.
Reviewed current billing procedures to insure charge capture and implemented plan to adjudicate those services.

Assist Group Leader Customer Service Representative01/1994 to 01/1999Capital Blue CrossAllentown

Team Lead for customer service representatives for dedicated accountsResponded to customer and provider inquires concerning benefits, payment of claims and acccount status.Handled incoming non assigned correspondence from speciality groups to resolve any customer or group complaints.
Worked directly with large group leaders to resolve various business issues such as claims,enrollment,cobra quidelinesand more.
Reviewed Policies as to effectiveness on claims.
Mentored new members of the claim staff.Explained premiums owed to policyholders and agents.Completed required investigations on referred files in a timely manner.

Education and Training

Associate of Science

Licenses American Academy of Professional Coders License

Associates Degree Medical Office Business

Medical Office Business1984Allentown Business SchoolAllentown, PA, 18012 Certified Professional Coder: Coding2010American Academy of Professional Coders

Licenses

Certified Professional Coder

Resume Overview

Companies Worked For:

Lehigh Valley Physican GroupAllentown
Lehigh Valley Cardiology AssociatesBethlehem
Capital Blue CrossAllentown

Job Titles Held:

Coding Analyst
Senior Billing Representative/ Accounts Receivalbe
Assist Group Leader Customer Service Representative

Degrees

Associate of Science
Medical Office Business1984Allentown Business SchoolAllentown, PA, 18012 Certified Professional Coder: Coding2010American Academy of Professional Coders

Coding Analyst Resume Example

Resume Score: 90%

DISCLAIMER

Resume Overview

Create a job alert for [job role title] at [location].

Similar Resumes