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hedis coordinator taskmedical coding and billing resume example with 20+ years of experience

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Jessica Claire
, , 100 Montgomery St. 10th Floor (555) 432-1000, resumesample@example.com
Summary

As a Medical HEDIS Coordinator with five years of experience I have consolidated my knowledge and i believe i would be a great addition to your company

Skills
  • Certified Medical Coder
  • Appointment Scheduling
  • Epic Systems
  • Medical History Recording
  • Medical Terminology
  • Knowledgeable in [Software]
  • Doctor Communication
  • Microsoft Excel
  • Patient Information Verification
  • Patient Rights
  • Records Review
  • Medical Histories and Vital Statistics
  • ICD-9 Coding
  • Medical Information Computerization
  • Protected Health Information
  • EMR Systems
  • ICD-10 Coding
  • Medical Translation
  • Maintaining hight accuracy rate on daily charts reviews
  • Verify that all diagnosis and submitted.
  • code for each chronic or major condition have been captured,monitored assessed,
  • Responsible to read patient health data.,histories,physician diagnoses,
  • Responsible for closing all measures and sending them to bill,
  • Responsible ,the goals of HEDIS and Stars are objectives,,:comprehensive diabetes care,Eyes ex, colonoscopy,Mammog,Retinopathy,COA,CBP etc,to close Gaps in care
  • Charting and Clinical Documentation
Experience
11/2018 to 06/2023 HEDIS Coordinator TaskMedical Coding and Billing Providence Health & Services | Marysville, WA,
  • Read through patient health data, histories, physician diagnoses and treatments to gain understanding for coding purposes.
  • Maintained updated knowledge of coding requirements, which included continuing education and certification renewal.
  • Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements.
  • Added modifiers as appropriate, coded narrative diagnoses and verified diagnoses.
  • Maintained high accuracy rate on daily production of completed reviews.
  • Assigned additional diagnosis codes based on specific clinical findings (laboratory, radiology and, pathology reports as well as clinical studies) in support of existing diagnoses.
  • Interpreted medical reports to apply appropriate ICD-9, CPT-4 and HCPCS codes.
  • Actively maintained current working knowledge of CPT and ICD-9 coding principles, government regulation, protocols and third party requirements regarding billing.
  • Interpreted medical terminology and pharmacological information to translate information into coding system.
  • Applied coding rules established by American Medical Association and Centers for Medicare and Medicaid Services for assignment of procedural codes.
  • Quickly responded to staff and client inquiries regarding CPT codes.
  • Reconciled clinical notes, patient forms and health information for compliance with HIPAA rules.
  • Acted as liaison between business department, billers and third party payers in resolving billing and reimbursement accuracy.
  • Proofread documents carefully to check accuracy and completeness of all paperwork.
  • Safeguarded medical records to maintain patient confidentiality.
  • Compiled and coded patient data using standard classification systems.
  • Entered patient insurance, demographic and health information into software and confirmed records.
  • Assigned patients to diagnosis-related groups using appropriate computer software.
  • Processed patient admission and discharge documents.
  • Set up patient charts and documented information in various company software.
  • Streamlined day-to-day office processes to meet long-term goals.
  • Mentored junior team members and managed employee relationships.
  • Transmitted information or documents to customers through email, mailings or facsimile machine.
  • Ordered and restocked supplies in line with budget limits and office needs.
  • Pulled patient records and transferred information to appropriate parties.
  • Knowledge and understanding of CMS regulations,clinical care guidelines and HEDIS/STARS measures

01/2006 to 09/2017 Pharmacy Assistant Long Island Fqhc | Hempstead, NY,
  • Read through patient health data, histories, physician diagnoses and treatments to gain understanding for coding purposes.
  • Maintained updated knowledge of coding requirements, which included continuing education and certification renewal.
  • Interpreted medical terminology and pharmacological information to translate information into coding system.
  • Quickly responded to staff and client inquiries regarding CPT codes.
  • Safeguarded medical records to maintain patient confidentiality.
  • Maintained positive working relationship with fellow staff and management.
  • Set up patient charts and documented information in various company software.
  • Streamlined day-to-day office processes to meet long-term goals.
  • Transmitted information or documents to customers through email, mailings or facsimile machine.
  • Released information to persons or agencies according to regulations.
06/2006 to 01/2007 Medical Assistant Imagenes | City, STATE,
  • Scheduled appointments for patients via phone and in person.
  • Prepared treatment rooms for patients by cleaning surfaces and restocking supplies.
  • Measured vital signs and took medical histories to prepare patients for examination.
  • Interviewed and engaged patients to obtain medical history, chief complaints and vital signs.
  • Organized charts, documents and supplies to maintain team productivity.
  • Cleaned and maintained medical equipment following procedures and standards.
  • Documented notes during patient visits.
  • Responded to patient callbacks and phone-in prescription refill requests.
  • Educated patients about medications, procedures and physician's instructions.
  • Secured patient information and maintained patient confidence by completing and safeguarding medical records.
  • Contacted pharmacies to submit and refill patients' prescriptions.
  • Assessed, documented and monitored vital signs for patients within outpatient setting.
  • Assisted with diagnostic testing by collecting and packaging biological specimens for internal and laboratory analysis.
  • Participated in team meetings to improve workflows and contribute to improving patient population outcomes.
  • Collaborated with local pharmacies to resolve and clarify issues with patient medication.
  • Labeled and completed lab requisitions using ICD and CPT coding.
  • Administered rapid tests for COVID and strep to help clinical staff assess conditions.
08/1985 to 02/2002 Doctor of Medicine Clinico Quirurgico 10 0ctober | City, STATE,
  • Examined patients and recorded medical histories to use in health assessments and help determine conditions.
  • Provided health education to patients, families and colleagues.
  • Monitored patients with acute conditions for changes, improvements or need for intervention.
  • Recorded patients' medical history, vital statistics and test results in electronic medical records.
  • Interviewed patients about symptoms and conducted thorough physical examinations.
  • Prescribed medications and advised patients about dosage, schedule and possible side effects.
  • Provided patient diagnosis, test evaluation and treatment under strict time constraints.
  • Advised patients about diet, hygiene and other lifestyle behaviors to promote health and prevent disease.
  • Established and maintained relationships with specialists to support patient referrals.
  • Monitored treatment regimens to determine efficacy and adjusted according to results achieved.
  • Ordered laboratory tests and imaging scans to complete further investigations.
  • Implemented treatment plans for disorders, heart disease, hypertension and diabetes.
  • Referred patients with serious medical conditions and emergencies to hospital for immediate care.
  • Evaluated health history and genetic information to recommend preventive healthcare.
  • Collaborated closely with fellow medical team members to share knowledge and discuss best courses for treatment.
  • Maintained accurate and thorough patient charts in accordance with legal and clinical standards.
  • Consulted with specialists and referred patients for more advanced support based on individual needs.
  • Completed continuing education programs to maintain certifications.
  • Evaluated nursing notes to confirm accuracy of care provided and patient responses.
  • Recommended dietary changes and fitness activities to improve overall health and boost longevity.
  • Maintained strict patient privacy and confidential patient information, taking care to meet HIPAA guidelines and statutes for data security.
  • Recommended diagnostic and laboratory tests to determine underlying causes for [Type] and [Type] symptoms.
  • Treated patients with strokes, head traumas, comas and intracranial hematomas.
Education and Training
Expected in 10/2018 to to Associate of Science | Certified Professional Coder Florida National University, Hialeah, FL GPA:
Expected in 03/2018 to to CPC | Excelsior Technical Institute INC., Miami, FL, GPA:
Expected in 02/2017 to to Associate of Science | International Institute For Health CareProfessiona, Boca Raton, FL, GPA:
Expected in 08/1985 to to Master of Science | Medicine Doctor Victoria De Giron, C Habana,Cuba, GPA:

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Resume Overview

School Attended

  • Florida National University
  • Excelsior Technical Institute INC.
  • International Institute For Health CareProfessiona
  • Victoria De Giron

Job Titles Held:

  • HEDIS Coordinator TaskMedical Coding and Billing
  • Pharmacy Assistant
  • Medical Assistant
  • Doctor of Medicine

Degrees

  • Associate of Science
  • CPC
  • Associate of Science
  • Master of Science

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