LiveCareer-Resume

revenue integrity analyst resume example with 9+ 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:
  • :
Website, Portfolio, Profiles
  • www.linkedin.com/in/Jessica-c-Claire-cpc-crcr
Professional Summary

Competent Revenue Cycle Analyst and Medical Coder with over 10 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. Adaptable and driven with strong work ethic and ability to thrive in a team-based or individually motivated settings. Portrays excellent analytical and multitasking abilities. Frequently praised as hard-working by peers, and can be relied upon to help the Revenue Integrity department achieve its goals.

Skills
  • Audit
  • Discrepancy Resolution
  • Data Analysis and Organization
  • Process Monitoring
  • Medical Billing Processing
  • Certified Professional Coder
  • Epic Systems
  • ICD-9/ICD-10 Coding
  • Coding Error Resolution
Work History
Revenue Integrity Analyst, 12/2020 - Current
Unitypoint Health Hiawatha, IA,
  • Daily review of charge items and Revenue Integrity work queues
  • Analyzes billed charges and medical records to look for missing, incorrect or late charges
  • Evaluates charge capture practices to ensure accuracy and completeness of charge capture
  • Maintains working knowledge of CPT and HCPCs coding as well as billing, CCI, MUEs, and other relevant coding and billing guidelines
  • Performs database editing and auditing functions to maintain and/or improve data quality
  • Performs account reconciliations and resolves variances
  • Reports trends, findings, and opportunities for improvement to management
  • Provides recommendations based on findings to improve charge capture workflows and to standardize charge capture processes
  • Assists in training of work processes to fellow employees
  • Promoted consistent accuracy of billing information by reconciling 1,000 accounts monthly.
  • Trained and mentored team members and managers on new work processes and policies to build cohesive groups and promote operational performance.
Claims Coder II, 11/2012 - 12/2020
VCU Health Systems City, STATE,
  • Conducted and oversaw review of hospital claims to ensure compliance with all applicable federal, state, local and payor specific requirements
  • Reconciled billing sheets with patient procedure record to ensure proper procedure billing and timely filing of claims
  • Utilized GE/IDX and Cerner to manage and confirm patient data, such as insurance, demographic and medical history information
  • Drove LCD Denial Report and Claims Submission operational improvements that resulted in significant savings and improved profit margins
  • Initiated audit process to evaluate thoroughness of documentation and maintenance of facility standards
  • Performed account reconciliations and resolved variances
  • Guarded against fraud and abuse by verifying coded data accurately reflected services provided.
  • Reviewed outpatient diagnostic Radiology records and interpreted documentation to identify diagnoses and procedures.
  • Interacted with physicians and other healthcare staff to ask questions regarding patient services.
  • Accurately selected proper descriptive code when more than one anatomical location was indicated.
  • Reviewed, analyzed and managed coding of diagnostic and treatment procedures contained in outpatient medical records.
  • Performed billing and coding procedures for diagnostic radiology and cardiology services.
  • Processed insurance company denials by auditing patient files, researching procedures and diagnostic codes to determine proper reimbursement.
  • Verified signatures and checked medical charts for accuracy and completion.
  • Reviewed patient charts to better understand health histories, diagnoses and treatments.
  • Applied charges and updated patient records by using Cerner and GE/IDX.
  • Resourcefully used various coding books, procedure manuals and on-line encoders.

HCC Remote Coding Specialist, 09/2012 - 02/2013
Verisk Analytics Inc City, STATE,
  • Code hospital and multi-specialty outpatient charts for HCC risk adjustment and HEDIS
  • Consistently met productivity standards of coding 10 charts per hour with 95% accuracy.
  • Guarded against fraud and abuse by verifying coded data accurately reflected services provided.
  • Reviewed outpatient records and interpreted documentation to identify HCC diagnoses.
  • Verified signatures and checked medical charts for accuracy and completion.
  • Accurately selected proper descriptive code when more than one anatomical location was indicated.
  • 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.
  • Reviewed patient charts to better understand health histories, diagnoses and treatments.
Education
Bachelor of Science: Healthcare Administration , Expected in 12/2022
-
Liberty University - Lynchburg, VA
GPA:
Status -

GPA: 3.77

  • Dean's List Fall 2019
  • Dean's List Spring and Fall 2020
  • Dean's List Spring and Fall 2021
  • Member of Sigma Beta Delta Honor Society
Health Records Coding Technician Health Records Coding: , Expected in 05/2009
-
J Sargeant Reynolds Community College - Richmond, VA
GPA:
Status -

GPA: 4.0

Certifications
Certified Professional Coder (CPC) Certified Revenue Cycle Representative (CRCR) 01211090,
Affiliations
  • American Academy of Professional Coders
  • Healthcare Financial Management Association

By clicking Customize This Resume, you agree to our Terms of Use and Privacy Policy

Your data is safe with us

Any information uploaded, such as a resume, or input by the user is owned solely by the user, not LiveCareer. For further information, please visit our Terms of Use.

Resume Overview

School Attended

  • Liberty University
  • J Sargeant Reynolds Community College

Job Titles Held:

  • Revenue Integrity Analyst
  • Claims Coder II
  • HCC Remote Coding Specialist

Degrees

  • Bachelor of Science
  • Health Records Coding Technician Health Records Coding

By clicking Customize This Resume, you agree to our Terms of Use and Privacy Policy

*As seen in:As seen in: