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Medical Coder Specialist Resume Example

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MEDICAL CODER SPECIALIST
Summary

Meticulous Coding Specialist with sound knowledge of billing systems for collecting, posting and managing account payments. In-depth expertise of analytical reviews submitting claims and following up with insurance companies. Partners and communicates with internal and external teams to align billing objectives.

Skills
  • ICD-10, HCPCS and PCS Coding Systems
  • CPT efficient
  • Anatomy and Physiology of Disease, Pharmacology
  • 3-M Grouper,
  • Medical Terminology, ICD-10 Programs and Knowledge of Medical Insurance Programs
  • Health Information Management Technology
  • Internships; AHIMA VLab Coding Cases, 3M Coding and Reimbursement, Cengage Medical Coder Trainer
  • Strong work ethic and management skills, team sport
  • Billing
  • C
  • Charts
  • CPT
  • Bilingual - English
  • Front office
  • Insurance
  • Laser
  • Management skills
  • Marketing
  • Medical Terminology
  • Meditech
  • Personnel
  • Coding
  • Quality
  • Sales
  • Spanish
  • Trainer
Experience
Claim Specialists LLCCity , STATEMedical Coder Specialist10/2020 to Current
  • Translated patient information into alphanumeric and numeric medical codes
  • Investigated rejected and denied claims, correcting applicable coding.
  • Submitted clean claims to insurance companies electronically to secure payments.
  • Utilized Level 1 HCPCS and Level 2 HCPCS systems to complete coding tasks.
  • Maintained strict confidentiality with adherence to HIPAA guidelines and regulations.
  • Developed new, efficient and well-tested code for 3 different projects.
  • Carefully coded disease and injury diagnoses, acuity of care and procedures in inpatient setting.
  • Sought clarification from physicians and other hospital personnel for answers to any needed coding interpretations prior to abstracting records.
  • Verified final claim submissions by comparing account charges with documentation.
  • Applied coding rules established by American Medical Association and Centers for Medicare and Medicaid Services for assignment of procedural codes.
  • Coded medical observations and professional services delivered for each patient.
  • Reviewed account information to confirm patient and insurance information is accurate and complete.
  • Quickly responded to staff and client inquiries regarding CPT codes.
  • Reviewed and abstracted relevant clinical data from electronic medical records to select appropriate code for procedures.
  • Maintained updated knowledge of coding requirements, which included continuing education and certification renewal.
  • Categorized health services and assigned a specific CPT/ICD10/PCF code to each one.
  • Interpreted medical terminology and pharmacological information to translate information into coding system.
  • Coded outpatient encounters at rate of 40 per day and 20 complex specialty coding, maintaining 100% accuracy.
  • Read through patient health data, including histories, physician diagnoses and treatments to gain understanding for coding purposes.
  • Reviewed medical record information to identify all appropriate coding based on diagous and procedures categories.
  • Actively maintained current working knowledge of CPT and ICD-9 coding principles, government regulation, protocols and third party requirements regarding billing.
  • Assigned procedure and diagnosis codes for insurance billing using MediTech and ECW.
  • Added modifiers as appropriate, coded narrative diagnoses and verified diagnoses.
  • Communicated with healthcare personnel, including practitioners to promote accuracy.
  • Submitted and processed over 40 insurance claims per 8 hours to conduct medical code verifications and assessments.
  • Assigned additional diagnosis codes based on specific clinical findings (laboratory, radiology and, pathology reports as well as clinical studies) in support of existing diagnoses.
  • Reconciled clinical notes, patient forms and health information for compliance with HIPAA rules.
  • Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements.
  • Received, organized and maintained all coding and reimbursement periodicals and updates.
  • Coded outpatient encounters at rate of [Number] per day and [Number] complex specialty coding, maintaining [Number]% accuracy.
  • Used [Software] and [Software] to record weekly statements, including expenditures and balances.
Ft Lauderdale Behavioral Health HospitalCity , STATEMedical Coding Intern10/2019 to 01/2020
  • Reviewed account information to confirm patient and insurance information is accurate and complete.
  • Carefully coded disease and injury diagnoses, acuity of care and procedures in inpatient setting.
  • Actively maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third party requirements regarding billing.
  • Used [Software] and [Software] to record weekly statements, including expenditures and balances.
  • Reviewed medical record information to identify all appropriate coding based on [Type] and [Type] categories.
  • Categorized health services and assigned a specific [Type] code to each one.
  • Assigned procedure and diagnosis codes for insurance billing using [Software].
  • Sought clarification from physicians and other hospital personnel for answers to any needed coding interpretations prior to abstracting records.
Elase Medical SpasCity , STATEMedical Facial Specialist03/2005 to 11/2008
  • Created and maintained accurate and confidential patient files according to regulatory mandates.
  • Conducted patient intake interviews to collect medical information and insurance details.
  • Employed online tracking systems to manage medical supply inventory, insurance records, patient charts and company files.
  • Answered phone calls to provide assistance, information and medical personnel access to maximize office efficiency.
  • Supported administrative and healthcare staff, providing order fulfillment and inventory management services to ease operations.
  • Addressed, documented and responded to incoming correspondences to address client queries.
  • Updated patient financial information to promote accurate record keeping.
  • Managed front office customer service, appointment management, billing and administration tasks to streamline workflow.
  • Compiled physical and digital documents, charts and reports to meet business and patient need.
Education and Training
Certificate in Coding:Information Health Management10/2019Sheridan Technical College, City
Associate of Science:Paramedical Skin Care06/2004Florida College Of Natural Health, City, State
CCA Certificate01/2020AHIMA
Languages
Bilingual - English/Spanish
Certifications
  • CCS, AHIMA - anticiapated date March 2021
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Resume Overview

School Attended

  • Sheridan Technical College
  • Florida College Of Natural Health
  • AHIMA

Job Titles Held:

  • Medical Coder Specialist
  • Medical Coding Intern
  • Medical Facial Specialist

Degrees

  • Certificate in Coding : Information Health Management 10/2019
    Associate of Science : Paramedical Skin Care 06/2004
    CCA Certificate 01/2020

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