Coding Specialist resume example

• Reviewed outpatient records and interpreted documentation to identify all diagnoses and procedures.
• Guarded against fraud and abuse by verifying all coded data accurately reflected services provided.
• Entered orders into EMR system efficiently and without errors.
• Correctly coded and billed medical claims for various hospital and nursing facilities.
• Resourcefully used various coding books, procedure manuals and on-line encoders.
• Accurately selected proper descriptive code when more than one anatomical location was indicated.
• Initiated, performed and documented quarterly coding audits for physicians.
• Interacted with physicians and other healthcare staff to ask questions regarding patient services.
• Performed billing and coding procedures for ambulance, emergency room, impatient and outpatient services.
• Utilized active listening, interpersonal and telephone etiquette skills when communicating with others.
• Reviewed patient charts to better understand health histories, diagnoses and treatments.
• Scanned and filed medical records in alphabetical order to maintain organized and up-to-date filing system.
• Processed insurance company denials by auditing patient files, researching procedures and diagnostic codes to determine proper reimbursement.
• Reviewed, analyzed and managed coding of diagnostic and treatment procedures contained in outpatient medical records.
• Verified signatures and checked medical charts for accuracy and completion.
• Applied official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services to assign diagnostic codes.

• Guarded against fraud and abuse by verifying all coded data accurately reflected services provided.
• Reviewed outpatient records and interpreted documentation to identify all diagnoses and procedures.
• Entered orders into EMR system efficiently and without errors.
• Processed insurance company denials by auditing patient files, researching procedures and diagnostic codes to determine proper reimbursement.
• Reviewed, analyzed and managed coding of diagnostic and treatment procedures contained in outpatient medical records.
• Used Epic software to input information into computerized patient record system.
• Accurately selected proper descriptive code when more than one anatomical location was indicated.
• Used optum 360 to assign procedure and diagnostic codes to patient records for billing purposes.
• Interacted with physicians and other healthcare staff to ask questions regarding patient services.
• Utilized active listening, interpersonal and telephone etiquette skills when communicating with others.
• Resourcefully used various coding books, procedure manuals and on-line encoders.
• 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.
• Tutored 5 new coders for compliance with classification systems and coding guidelines.
• Reviewed patient charts to better understand health histories, diagnoses and treatments.

Carefully reviewed medical records for accuracy and completion as required by insurance companies.Assigned additional diagnosis codes based on specific clinical findings (laboratory, radiology and, pathology reports as well as clinical studies) in support of existing diagnoses.Strictly followed all federal and state guidelines for release of information.Examined diagnosis codes for accuracy, completeness, specificity and appropriateness according to services rendered.Carefully coded disease and injury diagnoses, acuity of care and procedures in an inpatient setting.Accurately entered procedure codes, diagnosis codes and patient information into billing software.Reviewed diagnostic and procedural terminology for consistency with acceptable medical nomenclature.Consistently ensured proper coding, sequencing of diagnoses and procedures.Quickly responded to staff and client inquiries regarding CPT codes.Verified and abstracted all medical data to assign appropriate codes for hospital inpatient records.Demonstrated knowledge of HIPAA Privacy and Security Regulations by appropriately handling patient information.Received, organized and maintained all coding and reimbursement periodicals and updates.Appropriately and correctly identified errors and re-filed denied/rejected claims as they were received from the Patient Account Representative.Added modifiers as appropriate, coded narrative diagnoses and verified diagnoses.Interpreted medical reports to apply appropriate ICD-9, CPT-4 and HCPCS codes.Evaluated the accuracy of provider charges, including dates of service, procedures, level of care, locations, diagnoses, patient identification and provider signature.Communicated with medical transcriptionists regarding patient medical records.Posted charges, payments and adjustments.Ensured timely and accurate charge submission through electronic charge capture, including the billing and account receivables (BAR) system and clearing house.

Thoroughly investigated past due invoices and minimized number of unpaid accounts.Recorded and filed patient data and medical records.Demonstrated analytical and problem-solving ability by addressing barriers to receiving and validating accurate HCC information.Carefully reviewed medical records for accuracy and completion as required by insurance companies.Scheduled patient appointments.Completed registration quickly and cordially for all new patients.Monitored shared email in-boxes and ensured inquiries were addressed.Carefully coded disease and injury diagnoses, acuity of care and procedures in an inpatient setting.Accurately entered procedure codes, diagnosis codes and patient information into billing software.Reviewed diagnostic and procedural terminology for consistency with acceptable medical nomenclature.Consistently ensured proper coding, sequencing of diagnoses and procedures.Quickly responded to staff and client inquiries regarding CPT codes.Acted as a liaison between the business department, billers and third party payers in resolving billing and reimbursement accuracy.Verified and abstracted all medical data to assign appropriate codes for hospital inpatient records.Demonstrated knowledge of HIPAA Privacy and Security Regulations by appropriately handling patient information.Received, organized and maintained all coding and reimbursement periodicals and updates.Appropriately and correctly identified errors and re-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 HCPCS codes.Thoroughly reviewed remittance codes from EOBS/AR's.Confirmed patient information, collected copays and verified insurance.Evaluated the accuracy of provider charges, including dates of service, procedures, level of care, locations, diagnoses, patient identification and provider signature.Completed appeals and filed and submitted claims.Posted charges, payments and adjustments.Carefully prepared, reviewed and submitted patient statements.Ensured timely and accurate charge submission through electronic charge capture, including the billing and account receivables (BAR) system and clearing house.Meticulously tracked and resolved underpayments.Consistently informed patients of their financial responsibilities prior to services being rendered.Remained up-to-date with all insurance requirements, including the details of patient financial responsibilities, fee-for-service and managed care plans.Performed quality control of the data entry system to verify that claims and payments were posted correctly.Prepared and attached all required claims documentation including referrals, treatment plans or other required correspondence to reduce incidence of denials.Efficiently performed insurance verification and pre-certification and pre-authorization functions.

Carefully reviewed medical records for accuracy and completion as required by insurance companies.Assigned additional diagnosis codes based on specific clinical findings (laboratory, radiology and, pathology reports as well as clinical studies) in support of existing diagnoses.Strictly followed all federal and state guidelines for release of information.Examined diagnosis codes for accuracy, completeness, specificity and appropriateness according to services rendered.Coded outpatient encounters at a rate of 160 per day and 120 complex specialty coding.Carefully coded disease and injury diagnoses, acuity of care and procedures in an inpatient setting.Accurately entered procedure codes, diagnosis codes and patient information into billing software.Reviewed diagnostic and procedural terminology for consistency with acceptable medical nomenclature.Consistently ensured proper coding, sequencing of diagnoses and procedures.Demonstrated knowledge of HIPAA Privacy and Security Regulations by appropriately handling patient information.Received, organized and maintained all coding and reimbursement periodicals and updates.Appropriately and correctly identified errors and re-filed denied/rejected claims as they were received from the Patient Account Representative.Added modifiers as appropriate, coded narrative diagnoses and verified diagnoses.Interpreted medical reports to apply appropriate ICD-9, CPT-4 and HCPCS codes.Evaluated the accuracy of provider charges, including dates of service, procedures, level of care, locations, diagnoses, patient identification and provider signature.