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Remote Qa Analyst Educator Resume Example

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Jessica Claire
  • Montgomery Street, San Francisco, CA 94105
  • H: (555) 432-1000
  • C:
  • resumesample@example.com
  • Date of Birth:
  • India:
  • :
  • single:
Career Focus
Certified Outpatient Coder with 15 years of experience.  Previous QA Team Leader with excellent written and verbal communication skills and auditing experience.
Certifications and Credentials

  • 2015- ICD-10 Proficiency Assessment Certificate
  • 2015- ICD-10 PCS Training completed, Altegra Health
  • 2007- COC
  • 2007- CPC-H
  • 2002 - Certificate of Medical Billing/Coding

Skill Highlights
  • Three years  experience outpatient  multi-specialty  SDS coding of ICD-9,ICD-10CM & PCS, CPT & HCPC code sets.
  • Four years experience in ER/ Observation/ Infusion & Injection Clinic.
  • Three years experience in Physician Office/ Office procedure coding.
  • Eleven years experience in outpatient diagnostic & therapeutic  Ancillary services.
  • A total of Fifteen years of coding experience in all facets of outpatient services.
  • QA Lead of 3-5 QA teammates for Altegra's #1 client while maintaining Client Profiles of two clients and performing regular monthly audits.
Professional Experience
Remote QA Analyst/Educator, 10/2015 to 2017
Altegra Healthcare City, STATE,
  • QA Lead for #1 client of Altegra, led  3-5 QA members on two clients.
  • Audited OP medical records to provide a second level review of codes assigned to diagnoses and procedures ensuring  billing conformed with compliance of federal coding regulations and guidelines.
Remote OP Claims Editor, 02/2015 to 10/2015
Altegra Healthcare City, STATE,
  • Analyzed NCCI edits
  • Coded Ambulatory Surgical accounts and Physician office claims.
  • Experience with ICD-10 CM & PCS, CPT & HCPCS code sets.
  • Promotion  offer to QA Analyst.
Cardiovascular Charge Lead/Analyst, 07/2013 to 02/2015
Metropolitan Hospital City, STATE,
  • Built Cardiovascular charges for the CDM  
  • Coded CPT codes to IP/OP OBS/IR accounts
  • Analyst - work queues
  • Recommended documentation changes for maximum reimbursement and corporate compliance.
AncillaryCoder/ER Charge Analyst/OBS Carveout, 02/2002 to 07/2013
South Haven Health System City, STATE,
  • HIM coder 
  • ER charge Analyst and Observation carve out Analyst.
  • NCCI edit Analyst
  • Reduced unbilled accounts by daily monitoring to ensure timely billing.
  • Recommended documentation/coding improvement opportunities to appropriate personnel for follow up resolution.
  • Coded  4,000 accounts per month.
Specialized Training
: Allied Health, Expected in 2015
to
AAPC - Salt Lake City, UT
GPA:
ICD-10 CM Proficiency Assessment Certificate
: Allied Health, Expected in 2002
to
Davenport University - Kalamazoo, MI
GPA:
Certificate of Medical Billing/Coding
: Allied Health, Expected in 2007
to
AAPC - Salt Lake City, UT
GPA:
CPC-H
Professional Affiliations
  • Kalamazoo Coders Local AAPC Chapter
Skills
  • Analyst
  • Billing
  • ICD-10 CM & PCS, CPT & HCPCS code set coding, ICD-9
  • Documentation, Teaching, Leadership
  • Excel, Office, Outlook,WebEx
  • EPIC, Cerner, Allscripts, 3M Encoder, CAC
  • Trucode, Mediregs
  • Personnel, promotion to QA,
  • Radiology,IR, Surgery,  Urology,Cardiovascular, Peripheral Vascular, GI, GYN, Ortho, Pulmonary, OTO, Plastic Surgery, Neurology, ER, OBS, Infusion & Injection, Ancillary, Rehab- Cardiac, Pulmonary, PT, ST, OT.

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Resume Overview

School Attended
  • AAPC
  • Davenport University
  • AAPC
Job Titles Held:
  • Remote QA Analyst/Educator
  • Remote OP Claims Editor
  • Cardiovascular Charge Lead/Analyst
  • AncillaryCoder/ER Charge Analyst/OBS Carveout
Degrees

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