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coding quality coordinator resume example with 14+ years of experience

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

Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Specialties include strong analytical skills, attention to detail, ability to meet tight deadlines, experience in team leadership and management, remote working experience, strong written and verbal communication skills and willingness to take on added responsibilities to meet team goals.

Skills
  • Initiative and Discipline in Time Management and Assignment Completion
  • Public Speaking
  • Staff Training and Development
  • Teamwork and Collaboration
  • Ability to Work Independently
  • Cultural Awareness
  • Motivational Leadership Style
  • MS Office
  • Excellent Interpersonal Skills
  • Flexible and Adaptable
Work History
12/2021 to Current
Coding Quality Coordinator UCHealth University Of Colorado Hospital City, STATE,
  • Conducts audits of outpatient facility coding to verify the integrity of ICD-10 diagnoses, CPT, HCPCS and/or modifiers assigned for multiple specialties.
  • Validates assigned codes for accuracy and compliance based on medical record documentation and relevant laws, regulations and established coding and billing guidelines.
  • Completes audits of offshore staff coders and auditors and additional ad hoc coding audits as requested.
  • Analyzes audit results to identify patterns and error trends. Provides feedback as appropriate depending on audit findings.
  • Researches and develops education, training and reference materials based on audit analysis and/or updates to coding regulatory guidelines.
  • Provides thorough rationale and explanation for proper diagnosis and procedure code assignments based on supporting documentation.
  • Assists with developing and guiding SMEs responsibilities.
  • Responds to coding questions submitted throughout Health System.
  • Examines coded claims data in response to denials and customer service requests.
  • Reviews physician queries for appropriateness, and related correspondence.
  • Maintains up-to-date knowledge of coding regulations through continuing education courses.
  • Proficient in MS Office, Optum and 3M Encoder, Epic EHR.
10/2018 to 12/2021
Outpt Coding Specialist-CVIR/Ambulatory Clinics UCHealth University Of Colorado Hospital City, STATE,
  • Reviewed, analyzed, and managed coding of diagnostic and treatment procedures contained in outpatient medical records.
  • Maintained accuracy, completeness, and security for medical records and health information.
  • Achieved coding accuracy at 98% or above and exceeded productivity standards.
  • Resourcefully used various coding books, procedure manuals, and on-line encoders.
  • Reviewed patient charts to better understand health histories, diagnoses, and treatments.
  • Followed up with medical staff regarding missing information in patient records.
03/2013 to 10/2018
Medical Coding and Billing/Precert Specialist The Women’s Clinic Of Northern Colorado City, STATE,
  • Processed insurance company denials by auditing patient files, researching procedures, and diagnostic codes to determine proper reimbursement.
  • Applied official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services to assign diagnostic codes.
  • Verified signatures and checked medical charts for accuracy and completion.
  • Utilized active listening, interpersonal, and telephone etiquette skills when communicating with others.
  • Interacted with physicians and other healthcare staff to ask questions regarding patient services.
  • Communicated with insurance companies to research and resolve coding discrepancies.
  • Utilized electronic medical record systems to store, retrieve and process patient data.
  • Communicated effectively with staff, patients, and insurance companies by email and telephone.
  • Obtained pre-verification for scheduled surgeries.
  • Monitored claim payments to ensure adherence to corresponding fee schedule and contract compliance.
04/2009 to 03/2013
Head Receptionist/Accounts Receivable Specialist Fort Collins Dodge Chrysler Jeep City, STATE,
  • Submitted cash and check deposits and generated cash receipts to record money received.
  • Reconciled accounts receivable ledger to verify payments and resolve variances.
  • Safeguarded documents of accounts receivable and payments to enable tracking history and maintain accurate records.
  • Entered figures using 10-key calculator to compute data quickly.
  • Provided training and coordinated schedules for all receptionists.
  • Established organization of entire phone system network.
Education
Expected in 05/2013 to to
Diploma: Medical Billing And Coding
Institute For Business And Medical Careers - Fort Collins,
GPA:
Expected in 05/2011 to to
Associate of Arts: Business Administration And Management
Front Range Community College - Fort Collins, CO,
GPA:
Certifications
  • CPMA - Certified Professional Medical Auditor American Academy of Professional Coders


  • CPC - Certified Professional Coder American Academy of Professional Coders

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Resume Overview

School Attended

  • Institute For Business And Medical Careers
  • Front Range Community College

Job Titles Held:

  • Coding Quality Coordinator
  • Outpt Coding Specialist-CVIR/Ambulatory Clinics
  • Medical Coding and Billing/Precert Specialist
  • Head Receptionist/Accounts Receivable Specialist

Degrees

  • Diploma
  • Associate of Arts

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