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outpatient external auditor resume example with 19+ years of experience

Jessica Claire
  • Montgomery Street, San Francisco, CA 94105 609 Johnson Ave., 49204, Tulsa, OK
  • H: (555) 432-1000
  • C:
  • resumesample@example.com
  • Date of Birth:
  • India:
  • :
  • single:
  • :
Professional Summary

In-depth knowledge of ICD-10-CM/PCS, ICD-9-CM/PCS, and CPT coding. Motivated, energetic, self-starter with years of coding experience in nationwide venues encompassing full spectrum coding including, education, compliance, and auditing in the health information management industry. Proven ability as an independent problem solver, with emphasis on accuracy, high production rate resulting in follow-through to meet deadlines.

Ambitious Outpatient Auditor and Coder with years of hands-on experience. First-rate expert at customer communication, data entry, and organization. Diligent and meticulous professional commended for quickly and accurately learning new procedures.

Skills
  • General Computer Skills
  • Microsoft office
  • Microsoft Outlook
  • Epic
  • Mckesson
  • Power Chart
  • HDM
  • Optum 3M 360
  • Cardiology
  • CPT
  • Excellent customer service
  • English
  • ICD-10
  • ICD-9
  • Injections & Infusions
  • Excel spreadsheets
  • Policies & Procedures
  • Observation Coding
  • Interventional Radiology
  • Emergency Room Coding
  • Inpatient Swing Bed
  • Outpatient surgery coding
  • Quality auditor
  • Internal / External Liaison
  • Outpatient surgery coding
Work History
Outpatient External Auditor, 12/2008 - Current
Healthcare Resolution Services, Inc. (Hcrs) Peach Springs, AZ,
  • Performing quality audits and education to hospital coders for accuracy of ICD-10-CM, CPT, and APC per Coding Guidelines, CPT Assistant, Hospital Coding Policies and Procedures, and Compliance for past five-plus years.
  • Audit Retrospective accounts with a concise rationale.
  • Stay up to date on all coding updates quarterly and yearly.
  • Follow all client-specific guidelines and client-specific policies & procedures Consistently achieve production requirements and meet any deadline requirements.
  • Report to the Coding Supervisor trends and areas of education needs when required.
  • Answer coder questions and audit rebuttals per client process per Excel spreadsheets, Epic Abstracting, Review Mate, and or Skype meetings.
  • I recoded for Medical Necessity ICD-10-CM, CPT, and APC on Outpatient denial claims. Excellent customer service skills and a positive attitude, as demonstrated by receiving the employee of the quarter.
  • Work independently with minimal supervision.
  • Communicates timely and appropriately.
  • Maintain the 95% Accuracy Rate or higher.
  • ICD-9-CM, ICD-10-CM, CPT, and APC, Outpatient surgeries, Interventional Radiology, Cardiology, Oncology, Observation, Emergency Room records including Injections and infusions, and Medical Necessity for the facility.
  • Always maintain an excellent attendance record, consistently arriving to work on time.
  • I worked with multiple customers to understand needs and provide excellent service.
Outpatient Medical Coder, 03/2012 - 04/2017
Healthcare Resolution Services, Inc. (Hcrs) Pine Ridge, SD,
  • Accurately code Day Surgeries, Observations, Emergency Department, and Ancillary accounts for ICD-10-CM, CPT.
    Achieve a 95% or higher accuracy rate.
    Always Maintained 100% Attendance.ccurately code Day Surgeries, Observations, Emergency Department, and Ancillary accounts for ICD-10-CM, CPT.
    Achieve a 95% or higher accuracy rate.
    Maintained 100% Attendance.
Outpatient Medical Coder, 05/2003 - 12/2008
Healthcare Resolution Services, Inc. (Hcrs) Polacca, AZ,
  • Level II Trauma center.
  • Accurately coded facility Ambulatory Surgery, Interventional Radiology, Emergency Room records, Ancillary for ICD-9- CM/PCS and CPT for facility coding, Inpatient coding for swing bed.
  • Contact physicians and/or ancillary departments when additional information is needed to accurately code the record.
  • Successfully re-coded accounts for Medical Necessity on Outpatient denial claims.
  • Achieved a 95% or higher accuracy rate.
  • Maintained 100% Attendance.
  • Organized patient files and streamlined operations to improve efficiency.
  • Completed skilled administrative work to support all office staff and operational requirements.
  • Maintained current and accurate medical records for over multiple patients.
Outpatient Medical Coder, 08/2001 - 05/2003
Research Medical Center, Outpatient Coder City, STATE,
  • Level 1 Trauma Center.
  • Responsible for accurately coding and abstracting Emergency Room records applying E/M levels for the facility, Colonoscopy, and Esophagogastroduodenoscopy records, Wound care, Oncology diagnoses with coding injections and infusions, pain clinic.
  • I assisted an associated hospital (Belton Hospital) with their outpatient coding backlog.
  • Worked on the lost chart list and coded them.
  • Pulled deficient Medical Records for physicians to complete and updated the chart when they finished it.
  • I assisted Assembly and Analysis as needed.
  • Located, checked in, and pulled medical records for doctors' incomplete charts.
Education
GED: , Expected in
-
Lincoln High School - Lincoln, Il.,
GPA:
Status -
: Anatomy & Physiology, And Medical Terminology, Expected in
-
Ozarks Technical Community College - Springfield, MO
GPA:
Status -
Accomplishments
  • AHIMA Approved ICD-10-CM/PCS Trainer/Ambassador-HIM Continuing Education to further my knowledge of Outpatient Coding and Auditing through webinars, online Courses with Elsevier, AHIMA, and AAPC.
Certifications

Certified Coding Specialist

AHIMA Approved ICD-10/PCS Trainer/Ambassador-HIM

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Resume Overview

School Attended

  • Lincoln High School
  • Ozarks Technical Community College

Job Titles Held:

  • Outpatient External Auditor
  • Outpatient Medical Coder
  • Outpatient Medical Coder
  • Outpatient Medical Coder

Degrees

  • GED
  • Some College (No Degree)

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