Hardworking professional applies official coding conventions and rules established by American Medical Association and Centers for Medicare and Medicaid Services. Confident Medical Coder adheres to data confidentiality and privacy rules in all workflows and promotes dynamic interpersonal skills.
Competent medical coder with 22 years of experience in handling wide variety of medical coding and billing tasks. Sophisticated and hardworking individual with excellent analytical and multitasking abilities. Coordinates with insurance companies and expedites claims processes. Expertise in accurately inputting procedure and diagnosis codes into billing software to generate invoices.
Reliable Medical Coder with a background in document oversight, data security procedures and resolving coding errors. Detail-oriented performer with medical terminology knowledge. Considered a team player with exemplary multitasking skills.
Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.
Enthusiastic senior coder eager to contribute to team success through hard work, attention to detail and excellent organizational skills. Clear understanding of Anesthesia Pain Managment, Child Cardiology, Adult Cardiology , Physical Medicine and Rehabilitation, emergency room coding and training in anything team needs. Motivated to learn, grow and excel in Industry.
Skills
Patient Data Abstracts
Standard Classification Systems
Drgs Patient Assignments
Information Classification
Medical History Recording
Reading Comprehension
Client Inquiries
Office Health Records Preparation
Health Record Index Maintenance
Information Sourcing
Word Processing Software
Treatment Documentation
3M Encoder
Insurance Billing
Operational Requirements
Patient Medical Records Maintenance
Emergency Room Services
Reviewing Patient Information
Patient Data Coding
Medical Billing Processing
CPT Code Modifiers
Diagnostic Codes
Certified Professional Coder
Government Forms
Financial Assistance
Medical Histories and Vital Statistics
Protected Health Information
Document Quality
Medical Information Computerization
Patient Health Information Access
Electronic Health Record Applications
Coverage Determination
Medical Translation
ICD-10 (International Classification of Disease Systems)
Demographics Information
Customer Experience
Charting and Clinical Documentation
Hospital Inpatient and Outpatient Records
Patient Rights
Complex Problem-Solving
Paperwork Processing
Electronic Filing System Organization
Records Accuracy
Past Due Account Management
Doctor Communication
Medical Release of Information ROI
Records Review
Patient Admission Documents Processing
Discharge Documentation
Coding Error Resolution
Confidential Records Management
Compliance Verification
Work History
07/2014 to Current
Medical CoderChange Healthcare – Mohrsville, PA,
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.
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.
06/2013 to 06/2014
Senior Claims RepresentativeCountry Financial – Tucson, AZ,
Collaborated with legal department on important claims.
Conducted investigations into complicated mid- and high-exposure claims.
Selected and managed expert witnesses and litigation managers for investigations.
Updated field operations staff on status of open claims and current actions.
Recommended and set reserves based on expected payouts.
Checked documentation for accuracy and validity on updated systems.
Carried out administrative tasks by communicating with clients, distributing mail and scanning documents.
Verified client information by analyzing existing evidence on file.
Generated, posted and attached information to claim files.
Maintained strong knowledge of basic medical terminology to better understand services and procedures.
Made contact with insurance carriers to discuss policies and individual patient benefits.
Assured timely verification of insurance benefits prior to patient procedures or appointments.
Processed and recorded new policies and claims.
Posted payments to accounts and maintained records.
Maintained confidentiality of patient finances, records and health statuses.
Prepared insurance claim forms or related documents and reviewed for completeness.
Resubmitted claims after editing or denial to achieve financial targets and reduce outstanding debt.
Modified, updated and processed existing policies.
Communicated effectively with staff members of operations, finance and clinical departments.
Calculated adjustments, premiums, and refunds.
Communicated verification and authorization status updates with Type department to facilitate decision-making for patient admissions and insurance coverage.
Reviewed outstanding requests and redirected workloads to complete projects on time.
Coordinated with contracting department to resolve payer issues.
Determined appropriateness of payers to protect organization and minimize risk.
Acted as Type subject matter expert, answering internal and external questions and inquiries.
Reviewed Number patient cases per week and verified insurance coverage information.
Notified insurance agents and accounting departments of policy cancellations and changes.
Collected premiums and issued accurate receipts.
Presented insurance options to customers in order to close sales on new policies.
Processed Number invoices each Timeframe and mailed documentation to clients.
01/2003 to 06/2014
Senior Medical CoderWakeMed Raleigh Campus – 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.
Reviewed patient charts to better understand health histories, diagnoses and treatments.
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 nursing 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 Software 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.
Used Software and Software to input information into computerized patient record system.
Entered orders into EMR system efficiently and without errors.
Applied charges and updated patient records by using Software and Software.
Coded Observations and Inpatient Professional Services at average rate of Number per hour.
Scanned and filed medical records in alphabetical order to maintain organized and up-to-date filing system.
Initiated, performed and documented quarterly coding audits for physicians.
Coded inpatient charts at rate of Number per hour or Number per day.
Reviewed Number medical records per Timeframe to select appropriate coding sequences.
Implemented new coding procedures that reduced mistakes by Number% and simplified processes.
Tutored Number new coders for compliance with Type and Type classification systems and coding guidelines.
Education
Expected in 06/2002 to to
Associate Of Applied Science: Medical Claims Examination City College Fort Lauderdale Fl - Fort Lauderdale, FL, GPA:
Expected in 11/1999 to to
Bachelor Of Administrative Studies: Medical Insurance Billing Vytautas Didysis University - Kaunas , GPA:
Expected in 06/1996 to to
Diploma : High School Administration St.Paul High School - Sestokai Lithuania , GPA:
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