Risk Adjustment Coder Billing Specialist Resume Example Company Name

RISK ADJUSTMENT CODER-BILLING SPECIALIST

Professional Summary

Licensed RN with 1 year of clinical experience. Seeking to become a top nurse by following protocols and promoting efficiency. As student nurse at Manati Medical Center (Puerto Rico), achieved higher-than-average patient satisfaction and 97% favorable preceptor evaluations.

Skills

Patient education
Phlebotomy
EMR / EHR
Record Keeping
Medicine Administration

Triaging Patients
Care and Discharge Planning
Assessment
Teamwork

Work History

Risk Adjustment Coder-Billing Specialist | Company Name - City, State02/2021 - Current

Accurately and thoroughly review medical visits and procedures as performed by physician, including but not limited to: patient medical history, procedures, and treatments performed by healthcare professionals, including nurses and physician assistants, patient education and explanations of risks and benefits, Physician-dictated diagnoses, prescriptions and instructions for patient or family members for self-care and follow-up.
Spot mistakes or inconsistencies in medical documentation.
Apply current ICD- 10 codes as supported by provider's documentation.
Apply CPT codes as performed by providers and clinical staff.
Apply HEDIS (CPT category 2) as documented by providers and clinical staff.
Complete appropriate paperwork/documentation/system entry regarding claim/encounter information.
Monitor coding changes to ensure that most current information is available.

Coding and Billing Specialist | Company Name - City, State09/2019 - 02/2021

Review medical record information to identify all appropriate coding based on ICD- 10 coding guidelines and current CPT codes.
Review referral request as directed by Physician, via provider documented medical record.
Send task via EHR to provider to correct information in order to reduce errors.
Ensure that all clinical data, lab or other test results, interpretation of results by Physician are recorded accurately in medical record.
Provide coding support, education and training related to, quality of documentation, level of service and diagnosis coding consistent with established coding guidelines and standards.
Provide real-time support and coordination with Primary Care Providers and Care Coordinators for Medicare Risk Adjustment (MRA) coding, HEDIS and STARS.
Accurately review and code encounters on timely basis.
Researching and address coding questions for multiple providers as directed.

Medical Coordinator | Company Name - City, State04/2017 - 04/2019

Responsible for assessing, facilitating and monitoring all components of client medical services.
Obtain, compile, and maintain medical files on each admission.
Ensure proper daily documentation in Southwest Key Program's database ETO, and ORR-UAC Portal and maintain hard copy of required documents and medical record.
Schedule and comply with required medical and dental appointments and timelines.
Respond and comply to individual emergency medical needs immediately.
Maintain and review for accurate and complete list of medical supplies, prescribe medications, and over-the-counter OTC medications according to standing orders.
Prepare youth for examinations and record medical intake, take vital signs, height and weight.
Initiate routine lab tests.
Participate and advocate during medical procedures performed by medical providers and other health services.
Assist medical providers' staff with examination procedures when needed, such as patient screening and triage.
Dispense medication according to self-administration of medication - SOMA schedule, policies and procedures.
Collect, maintain, and submit weekly, monthly, quarterly, and annual reports to supervisor.
Facilitate and conduct SOMA, universal precautions, TB 101, allergies and other related training to employees.
Provide fail-safe plan with medication count, label accuracy, and SOMA, including over-the-counter drugs.
Educate and counsel youth concerning their disease, treatment, and prevention of disease.
Schedule and provide transportation to clients on medical appointments with assistance from floor staff as needed.

Education

AAPC - City12/2020Certified Professional Coder: Medical Insurance Coding

EDP University Of PR Inc - City04/2019Associate Degree in Nursing: Nursing

Medical Sciences University Of Granma - City07/2013M.D.: Medicine

Certifications

Registered Nurse. License RN9557486
ACLS / BLS
CRC - AAPC Certified Risk Adjustment Coder

Languages

English
Spanish

Resume Overview

School Attended

AAPC
EDP University Of PR Inc
Medical Sciences University Of Granma

Job Titles Held:

Risk Adjustment Coder-Billing Specialist
Coding and Billing Specialist
Medical Coordinator

Degrees

Certified Professional Coder : Medical Insurance Coding
Associate Degree in Nursing : Nursing
M.D. : Medicine

Risk Adjustment Coder-Billing Specialist Resume Example

Resume Score: 80%

DISCLAIMER

Resume Overview

Create a job alert for [job role title] at [location].

Similar Resumes