Risk Adjustment Coder-Billing Specialist Resume Example
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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
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Work History
Risk Adjustment Coder-Billing Specialist | Lifepoint Hospitals - Russellville , KY02/2021 - 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 | Arc Of Seneca Cayuga - Penn Yan , NY09/2019 - 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 | Southwest Key Programs - Casa Mesa Shelter & Staff Secure - 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
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Resume Strength
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- Formatting
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- Length
- Measurable results
- Strong summary
- Target job
- Clear contact info
- Typos
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
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