Livecareer-Resume
Jessica Claire
  • Montgomery Street, San Francisco, CA 94105
  • Home: (555) 432-1000
  • Cell:
  • resumesample@example.com
Summary

Medical Coder with a career spent both assigning and assessing provider documentation to ensure that appropriate codes have been assigned. Motivated individual with a strong work ethic and a can-do demeanor. Well-versed in all outpatient ancillary coding. Ready to tackle new challenges in a telecommute environment.

Skills
  • Skills Used
  • Problem solving, time management, coding knowledge, and critical thinking skills.
  • Microsoft Office (10+ years)
  • 3M encoder (4 years)
  • Medical Coding
  • CPT Coding
  • ICD-10
  • Medical Billing
  • ICD-9
  • EMR Systems
  • Medical Records
  • Process Improvement
  • ICD Coding
  • HIPAA
  • Hospital Experience
  • Auditing
  • Anatomy Knowledge
  • Medical Terminology
  • Auditing
  • Billing
  • CPT Coding
  • Critical thinking
  • ICD-9
  • Medical Billing
  • Medical Terminology
  • Problem solving
  • Process Improvement
  • Coding
  • Time management
  • Knowledgeable in Epic
  • Medical record security
Experience
SIU Team Lead, 03/2020 to Current
Sedgwick Claims Management Services, Inc.Irving, TX,
  • Reviewed claims for potential fraud, waste, abuse, and error.
  • Checked for coding accuracy by billing providers to ensure proper payment is being made.
  • Promoted coding accuracy and quality by closely inspecting claims and working closely with team members to correct deficiencies.
  • Maintained strict confidentiality with adherence to HIPAA guidelines and regulations.
  • Actively maintained current working knowledge of CPT and ICD-9 coding principles, government regulation, protocols and third party requirements regarding billing.
  • Quickly responded to staff and client inquiries regarding CPT codes.
  • Read through patient health data, including histories, physician diagnoses and treatments to gain understanding for coding purposes.
  • Applied coding rules established by American Medical Association and Centers for Medicare and Medicaid Services for assignment of procedural codes.
  • Maintained updated knowledge of coding requirements, which included continuing education and certification renewal.
  • Interpreted medical reports to apply appropriate ICD-9, CPT-4 and HCPCS codes.
Coding Consultant/SME Team Leader, 03/2015 to 03/2020
Maximus, Inc.Pittsburgh, PA,
  • Maintained strict confidentiality with adherence to HIPAA guidelines and regulations.
  • Quickly responded to staff and client inquiries regarding CPT codes.
  • Maintained 100% accuracy rate on daily production of 4 claims per hour.
  • Verified proper coding and accuracy of outpatient and inpatient procedures.
  • Interpreted medical reports to apply appropriate ICD-9, CPT-4 and HCPCS codes.
  • Maintained updated knowledge of coding requirements, which included continuing education and certification renewal.
  • Read through patient health data, including histories, physician diagnoses and treatments to gain understanding for coding purposes.
  • Applied coding rules established by American Medical Association and Centers for Medicare and Medicaid Services for assignment of procedural codes.
  • Coached team on company policies, procedures, and best practices to enhance operational efficiency and employee productivity.
  • Trained all new hires and acted as a mentor during their ramp period.
Outpatient Medical Coder, 10/2012 to 11/2016
Rice Memorial HospitalCity, STATE,
  • Assigned procedure and diagnosis codes for insurance billing using 3M Encoder.
  • Coded outpatient encounters at rate of 15 per day and 7 complex specialty coding, maintaining 98% accuracy.
  • Interpreted medical reports to apply appropriate ICD-9, CPT-4 and HCPCS codes.
  • Maintained updated knowledge of coding requirements, which included continuing education and certification renewal.
  • Read through patient health data, including histories, physician diagnoses and treatments to gain understanding for coding purposes.
  • Carefully coded disease and injury diagnoses, acuity of care and procedures in inpatient setting.
  • Quickly responded to staff and client inquiries regarding CPT codes.
  • Added modifiers as appropriate, coded narrative diagnoses and verified diagnoses.
  • Acted as liaison between business department, billers and third party payers in resolving billing and reimbursement accuracy.
  • Interpreted medical terminology and pharmacological information to translate information into coding system.
  • Applied coding rules established by American Medical Association and Centers for Medicare and Medicaid Services for assignment of procedural codes.
  • Communicated with healthcare personnel, including practitioners to promote accuracy.
  • Assisted coding supervisor and HIM Manager with employee development.
  • Trained newly hired top talent to fill key positions and maximize productivity.
Education and Training
AAS: Health Information Management, Expected in 2012
- Saint Cloud, MN
GPA:
AA: Liberal Arts, Expected in 2007
MSCTC - Moorhead, MN
GPA:
Accomplishments
  • Successfully promoted to the only fulltime outpatient coder for our department within my first year
  • Trained new coders and helped implement improved work flow processes
  • Helped develop remote coding productivity standards since I was the first coder to work from home
  • I now have 7 years of successful remote coding experience
  • Assisted with an automation project to help automate as much as the coding process as possible
  • Acted as a mentor and subject matter expert for newly hired coding analysts
Certifications
  • Registered Health Information (RHIT) License - 2013 to Present

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Resume Overview

School Attended

  • MSCTC

Job Titles Held:

  • SIU Team Lead
  • Coding Consultant/SME Team Leader
  • Outpatient Medical Coder

Degrees

  • AAS
  • AA

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