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 Hospital – City, 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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