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medical outpatinet multi specialty coder resume example with 20+ years of experience

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

Medical Billing and Coding Specialist with 14 years providing administrative and patient support in hospital and medical office settings. Advanced knowledge of private insurance processes and codes.

Skills
  • Thorough knowledge and understanding of patient billing, billing transmission and electronic billing systems, including reimbursement knowledge of Medicare, Blue Cross, United Health Care, Medicaid, commercial insurance and HMO carriers.
  • Knowledge of medical terminology and ICD-10/CPT coding. Demonstrate competency in coding CPT and ICD10 related to reimbursement
  • Ability to maintain a high level of integrity and confidentiality of medical information
  • Knowledge of electronic billing systems and EMR’s.
  • Ability to work and resolve problems independently and demonstrate task completion.
  • Strong written and oral communication skills including the ability to work with other departments. Demonstrate positive interpersonal relations in dealing with fellow employees, Supervisors, Physicians, Management so that productivity and positive employee relations are maximized.
  • Ability to interpret third parry coverage, patient responsibility and evaluate a patient’s financial condition.
  • Organizational skills
  • Administrative writing skills
Education
Everett Institute Duluth, GA 30026, Expected in 08/2010 Certified Billing Specialist: Healthcare : Medical Coding And Insuracne Billing - GPA :
Jackson County Comprehensive Highschool Jefferson, GA 30549, Expected in 05/1995 High School Diploma : - GPA :
Work History
Tigergraph - Medical Outpatinet Multi-Specialty Coder
Atlanta, GA, 09/2020 - Current
  • Accounts for coding and abstracting of patient encounters, including diagnostic and procedural information, significant reportable elements, and complications.
  • Analyzes medical records and identifies documentation deficiencies
  • Audits clinical documentation and coded data to validate documentation supports services rendered for reimbursement and reporting purposes.
  • Assigns codes for reimbursements, research and compliance with regulatory requirements utilizing guidelines.
  • Reviewed patient charts to better understand health histories, diagnoses and treatments.
  • Verified signatures and checked medical charts for accuracy and completion.
  • Follows coding conventions. Serves as coding consultant to care providers
  • Researches, analyzes, recommends, and facilitates plan of action to correct discrepancies and prevent future coding errors
Danaher - Accounts Receivable and Billing Specialist
Redwood City, CA, 09/2009 - 09/2020
  • Maintains current knowledge of third party, federal and state regulations, insurance coverage, rejection codes and billing requirements related to physician billing and follow-up. This it to be accomplished by attending related seminars, research, meeting with insurance reps and reading all memos/payer updates.
  • Ensures secondary billing on accounts with secondary liability; follow-up on any unpaid balances.
  • Provides corrected data and resubmit claims as necessary.
  • Ensures that denied visits/services are appealed or processed to be written off if applicable.
  • Works closely with other billing personnel and Practice/Billing Manager in following up on accounts.
  • Ensures the integrity and timeliness of workflow by making sure work is turned in as assigned as well as follow-up on the progress and documentation of account load.
  • Collects and review all patient insurance information needed to complete the billing process.
  • Completes all necessary insurance forms (i.e. HCFA 1500) to process the proper billing information in a timely manner as required by all third-party payers.
  • Submits all paper claims and supporting documentation as required by payers.
  • Maintains updated resource manuals and related materials.
  • Ensures integrity, confidentiality and security of patient records.
  • Researches all credit balance accounts and identifies source(s) of overpayment.
  • Works CBO reports in a timely manner and turn in to Supervisor/Manager on designated dates. Reports must be completed along with putting notes in the system, follow-up as needed and awareness to reducing the over 90 (+) days aging buckets
Chi Health - Customer Service Rep
Tacoma, WA, 08/2005 - 09/2009


  • Provided primary customer support to internal and external customers.
  • Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.
  • Provided information regarding charge accounts and loyalty programs.
  • Answered constant flow of customer calls with minimal wait times.
  • Responded to customer requests for products, services and company information.
  • Answered customer telephone calls promptly to avoid on-hold wait times.
  • Managed timely and effective replacement of damaged or missing products.
Chateau Elan Spa - Massage Therapist
City, STATE, 08/1996 - 09/2005
  • Provided safe, effective and appropriate massage therapy techniques during customer appointments.
  • Spoke with clients regarding health history, expectations, services and procedures for safety and customer satisfaction.
  • Maintained client treatment records and designed long-term care programs for return customers.
  • Maintained care products inventory and inspected equipment and selling areas for stock checks and organization.
  • Stimulated energy flow along medians to channel body healing responses.
  • Booked appointments, answered phones, greeted clients, handled payments and created client service tickets.
  • Coached and supervised staff by monitoring techniques and daily activities to suggest improvements.

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Resume Overview

School Attended

  • Everett Institute
  • Jackson County Comprehensive Highschool

Job Titles Held:

  • Medical Outpatinet Multi-Specialty Coder
  • Accounts Receivable and Billing Specialist
  • Customer Service Rep
  • Massage Therapist

Degrees

  • Certified Billing Specialist: Healthcare
  • High School Diploma

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