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cpc cedc resume example with 16+ 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

Knowledgeable medical office professional talented at correcting and resubmitting claims, preparing patient charts and reviewing health records to identify proper diagnosis codes for billing. Offers background in reviewing, analyzing and managing medical record information to obtain prior authorizations from insurance companies and ensure payment.

Skills
  • CPT Code Modifiers
  • Medical History Recording
  • Emergency Room Services
  • Client Inquiries
  • Medical Billing Processing
  • Patient Data Abstracts
  • Professional Development
  • Information Sourcing
  • Insurance Billing
  • Office Health Records Preparation
  • Diagnostic Codes
  • Word Processing Software
  • 3M Encoder
  • Standard Classification Systems
  • Patient Medical Records Maintenance
  • Patient Data Coding
  • Tracking Spreadsheets
  • Treatment Documentation
  • Procedural Codes
  • Certified Medical Coder
  • Reading Comprehension
  • Sequence Selection
  • Document Quality
  • Patient Rights
  • Hospital Inpatient and Outpatient Records
  • Medical Information Computerization
  • Reviewing Patient Information
  • Protected Health Information
  • Telephone Etiquette
  • Demographics Information
  • Coverage Determination
  • Administrative Support
  • EMR Systems
  • Operational Requirements
  • Accounts Payable and Accounts Receivable
  • Patient Health Information Access
  • Customer Experience
  • Complex Problem-Solving
  • Electronic Filing System Organization
  • ICD-10 (International Classification of Disease Systems)
  • Medical Records and Documentation
  • Discharge Documentation
  • Records Review
  • Clerical Support
  • Workers' Compensation Forms
  • Paperwork Processing
  • Medical Release of Information ROI
  • Confidential Records Management
  • Invoice Statements
  • Call Transfers
  • Records Scanning
  • Compliance Verification
  • Software Applications
  • Active Learning
  • Records Accuracy
  • Knowledge of Treatments
  • Charting and Clinical Documentation
  • Coding Error Resolution
  • Health Codes Understanding
  • Health Information Management Applications
  • Doctor Communication
  • Account Information Review
Work History
05/2021 to Current
CPC/CEDC Northside Hospital Suwanee, GA,
  • Interacted with physicians and other healthcare staff to ask questions regarding patient services.
  • Reviewed outpatient records and interpreted documentation to identify diagnoses and procedures.
  • Reviewed, analyzed and managed coding of diagnostic and treatment procedures contained in outpatient medical records.
  • Resourcefully used various coding books, procedure manuals and on-line encoders.
  • Utilized active listening, interpersonal and telephone etiquette skills when communicating with others.
  • Applied official coding conventions and rules from AMA, VHA, and Centers for Medicare and Medicaid Services to assign diagnostic codes.
  • Correctly coded and billed medical claims for various hospital and outpatient facilities/specialties.
  • Accurately selected proper descriptive code when more than one anatomical location was indicated.
  • Verified signatures and checked medical charts for accuracy and completion.
  • Guarded against fraud and abuse by verifying coded data accurately reflected services provided.
  • Used 3M to assign procedure and diagnostic codes to patient records for billing purposes.
  • Performed billing and coding procedures for ambulance, emergency room, impatient and outpatient services.
01/2009 to 05/2021
CPC/CEDC Carilion Clinic City, STATE,
  • Interacted with physicians and other healthcare staff to ask questions regarding patient services.
  • Reviewed outpatient records and interpreted documentation to identify diagnoses and procedures.
  • Reviewed, analyzed and managed coding of diagnostic and treatment procedures contained in outpatient medical records.
  • Resourcefully used various coding books, procedure manuals and on-line encoders.
  • Utilized active listening, interpersonal and telephone etiquette skills when communicating with others.
  • Applied official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services to assign diagnostic codes.
  • Correctly coded and billed medical claims for various hospital and specialty facilities.
  • Accurately selected proper descriptive code when more than one anatomical location was indicated.
  • Verified signatures and checked medical charts for accuracy and completion.
  • Guarded against fraud and abuse by verifying coded data accurately reflected services provided.
  • Used 3M and EncoderPro to assign procedure and diagnostic codes to patient records for billing purposes.
  • Performed billing and coding procedures for ambulance, emergency room, impatient and outpatient services.
  • Processed insurance company denials by auditing patient files, researching procedures and diagnostic codes to determine proper reimbursement.
  • Applied charges and updated patient records by using EPIC.
  • Coded Observations and Inpatient Professional Services.
08/2006 to 01/2009
Financial Counselor Carilion Clinic City, STATE,
  • Contacted insurance providers to obtain key information regarding patient benefits and to submit documentation for accounts.
  • Identified healthcare resources and programs for patients unable to meet financial obligations.
  • Worked directly with clients to provide financial counseling and education using individualized counseling model and personal finance course.
  • Established network of related specialists for debt consolidation, real estate, mortgage and banking.
  • Liaised between patient, doctor and insurance provider to smooth claims processes.
  • Conducted interviews with patients and family members and answered questions regarding insurance benefits.
Education
Expected in 12/2021
Bachelor of Science: Human Services
Bluefield College - Bluefield, VA,
GPA:
Additional Information

Worked as a Certified Nursing Assistant (CNA) for 7 years in a skilled and memory care facility. Provided part-time care for a patient that had a traumatic brain injury (TBI). Provided 24 hour care for an elderly couple, one with COPD and the other had Alzheimer's. Care consisted of basic ADLs (feeding, bathing, etc,) and making daily decisions for healthcare and financial decisions. Completed two internships in college for the Human Services degree obtained, one in geriatrics and the other in pediatrics.

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Resume Overview

School Attended

  • Bluefield College

Job Titles Held:

  • CPC/CEDC
  • CPC/CEDC
  • Financial Counselor

Degrees

  • Bachelor of Science

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