LiveCareer-Resume

Coding Coordinator resume example with 18+ years of experience

Jessica Claire
  • , , 609 Johnson Ave., 49204, Tulsa, OK 100 Montgomery St. 10th Floor
  • Home: (555) 432-1000
  • Cell:
  • resumesample@example.com
Summary

I am a well-organized medical biller, coder and collections specialist with over 10 years of experience. Working with various insurance companies, billing clean claims, and performing inpatient and outpatient coding with ICD-10. I am seeking to secure a position as a Medical Coding Coordinator with potential growth.

Education and Training
Certified Professional Coder: Medical Insurance Coding, Expected in 10/2019
AAPC - ,
GPA:
: General study in Business Management, Expected in 2002
Community College of Rhode Island - Warwick, RI
GPA:

GPA 3.0

High School Diploma: , Expected in 2001
Mount Pleasant High School - Providence, RI
GPA:
Experience
Coding Coordinator, 07/2022 to Current
Baycare Health System, IncPalm Harbor, FL,

Reporting to the Director Revenue Cycle and Billing & Coding Manager, I provide coding and revenue cycle support to the Department of Emergency Medicine.

I am responsible for the review and resolution of all coding related pre-billing edits and/or rejections to ensure prompt and accurate reimbursement.

I initiate medical record reviews and recommend proper action. I communicate with providers and billing staff regarding missing or unclear documentation. I analyze and report trends to Billing & Coding Manager.

  • Review and resolve all assigned tasks and encounters associated with potential coding discrepancies as it relates to prebilling system edits and/or claims with outstanding balances.
  • Review and resolve any pre & post billing coding edits (TES) and resubmits claim for adjudication.
  • Ensure all services documented in patient charts are coded with appropriate diagnoses, CPT & HCPCS procedure codes
  • Aim to reduce accounts receivable by reviewing claims rejected for coding; investigate assigned accounts to determine what additional steps must be taken for claims to be resolved.
  • Conduct one-on-one or small group education to physicians regarding the results of their periodic audits while maintaining an exceptionally high level of professionalism
  • Assist providers in developing affective Letters of Medical Necessity (LMN) and/or templates for appealing denials associated to complex procedures based on payer requirements and medical documentation.
  • Maintain a thorough working knowledge of all aspects of billing and collections including billing rules and regulations, collection practices, electronic billing processes, CMS 1500 Form requirements, diagnosis and CPT/HCPCS coding, and applicable county, state, and federal requirements.
  • Research and respond to insurance coding requests; assist with claim issues, including preparing coding appeals.
  • Proactively elevate coding problems to the providers and maintain tracking reports when issues and trends have been identified.
  • Answer and triage patient correspondence received via telephone, emails and fax. Respond to inquiries and directs callers.
  • Cross cover other duties as needed.
Coding and Charge Edits Specialist III, 12/2018 to 07/2022
Basis.EdPhoenix, AZ,

As a Coding and Charge Edits Specialist III, I am responsible for reviewing and resolving all coding related prebilling edits and/or rejections to ensure prompt and accurate reimbursement. I also review and analyze all charge correction requests and then process any needed adjustments/edits. I follow organizational policies and procedures to ensure consistency of charge capture processes and reimbursements.

  • Reduces accounts receivable by reviewing claims with outstanding balances.
  • Research and respond to insurance coding requests.
  • Proactively elevate coding problems to leadership.
  • Performs other job duties as required and assigned.
  • Execute charge corrections in order to ensure to achieve account resolution.
  • Assist in developing policies and procedures related to Charge Corrections.
  • Generate reports to monitor the types of errors and their frequency.
  • Responsible for performing edits on high dollar accounts.
Accounts Receivable Specialist, 05/2016 to 12/2018
ThedacareDarboy, WI,

As an Account Receivable Specialist, I am responsible for all facets of medical billing and accounts receivable charge entry, payment posting, customer service and follow-up in accordance with practice protocol with an emphasis on maximizing patient satisfaction and profitability. Investigate assigned accounts to determine what additional steps must be taken for claims to be paid.

  • Maintain a thorough working knowledge of all aspects of billing and collections rules and regulations, electronic billing processes, CMS 1500 requirements, diagnosis and procedure coding, and applicable county, state, and federal requirements.
  • Assist in eligibility and work with insurance company, patients and/or families in resolving charges and billing problems.
  • Review account history for third party sponsorship.
  • Proactively elevates billing and collection problems to CRO Revenue Cycle Supervisor as needed.
  • Check status of claims using on-line functionality and automated systems, as necessary.
  • Establishes payment arrangements according to pre-set guidelines; documents terms in ETM.
Medical Assistant, 03/2004 to 03/2016
Wayland Medical AssociatesCity, STATE,

As a Certified Medical Assistant, I had administrative responsibilities for three physicians and clinical aspects of patient care.

  • Take and monitor vital signs for upwards of 50 patients a day.
  • Record, manage, and update patient information and medical histories in accordance with HIPAA regulations.
  • Perform venipunctures and injections more than 15 times a day.
  • Prep patients for exams and medical procedures.
  • Clean and sanitize tools and equipment daily.
  • Handling and providing of monetary receipts.
  • Billing and coding for vaccine administrations.
Skills
  • Microsoft Office (Word, Excel, PowerPoint, Outlook), Lotus Notes.
  • EPIC
  • IDX, Eagle, Experian, Passport, Crown, Eclinical works.
  • Medical Coding-ICD10, CPT Code.
  • Medical terminology.
  • Fluent in Spanish, oral, reading, and written.

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Resume Overview

School Attended

  • AAPC
  • Community College of Rhode Island
  • Mount Pleasant High School

Job Titles Held:

  • Coding Coordinator
  • Coding and Charge Edits Specialist III
  • Accounts Receivable Specialist
  • Medical Assistant

Degrees

  • Certified Professional Coder
  • High School Diploma

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