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/CEDCNorthside Hospital – Stockbridge, 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/CEDCCarilion 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 CounselorCarilion 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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