Certified Professional Coder Resume Samples

Description :

1. Certified Professional Coder Codes diagnoses and procedures for outpatient and inpatient.
2. Reviewed all ICD-10, CPT, and HCPCS charges for entry into the respective systems for providers in clinics, hospitals and out of office procedures.
3. Provided coding/documentation education to Physicians and Advance Practice Clinicians Demonstrates high attention to detail and uses resources.
4. Managed denials and work with the billing team to correct claims for resubmission Experience in a provider-based billing method.
5. Reviewed medical records for Humana's Medicare Risk Adjustment (MRA) department in order to capture missed Hierarchical Condition Categories/Chronic.
6. Reversed a six-month backlog within 90 days in coding and billing audits, while also improving processes, educating physicians, and resolving long-standing patient complaints.
7. Able to maintain current knowledge of medical coding rules and regulations pertaining especially.

Experience

10+ Years

Level

Senior

Education

Applied Science

Description :

1. Monitored and evaluated current reimbursement/payment rules and ensure that legislative and regulatory changes impacting medical billing are anticipated and communicated to the staff and department billing personal.
2. Maintained current knowledge and keep staff up to date on ICD-10, CPT and HCPCS codes.
3. Provided monthly workload reports and statistics for use in reports/surveys and made appropriate entries to the Composite Health Care System (CHCS).
4. Educated physicians on proper chart documentation Served as point of contact for new employees Maintained communication with ER Physicians regarding.
5. Certified Professional Coder Remote coder for the United States Coast Guard Leidos, Roger Tran TEKsystems, Rebecca McMahon.
6. Provided coding feedback and education to departmental leadership regarding completeness and accurateness of documentation and physician coding practices.
7. Analyzed and reviewed confidential and highly sensitive investigative material/documents concerning employees, subscribers, providers, and groups.

Experience

10+ Years

Level

Senior

Education

Business

Description :

1. Assigned codes for Interventional Radiology Services such as thrombectomy, angioplasty and stenting, AVF and many others.
2. Assigned ICD-9-CM and/or CPT-4 code(s) and sequence diagnosis and procedures per patient medical record.
3. Conducted training of new coders for compliance with ICD-9 classification systems, coding guidelines, and regulatory guidelines.
4. Audited the work of others in the unit for accuracy.
5. Reconciled clinical notes for compliance with HIPPA rules.
6. Provided coding and documentation advice to the coding unit and clinical/professional staff.
7. Analyzed billing to improve coding data accuracy for Medicare compliance reimbursement.

Experience

2-5 Years

Level

Senior

Education

BS

Description :

1. Served on several committees including Immunization Improvement Team, Process Improvement Team, Collection Policy Process Improvement Team, Intergy (Vitera) Implementation Team, as well as Office Activity Committee.
2. Lead coordinator of obtaining and maintaining credentialing of physicians.
3. Ensured coded data accurately reflects service provided, based on documentation, guarding against fraud and abuse.
4. Provided monthly workload reports and statistics for use in reports/surveys and made appropriate entries to the Composite Health Care System (CHCS).
5. Responsible for accurately assigning ICD-9/ICD-10 and CPT codes to out-patient anesthesia records for reimbursement -Codes a wide variety of out-.
6. Provided retrospective coding review on medical and hospital claims relating to medical necessity and coding discrepancies Reviews first level.
7. Obtained documentation, claims forms, checks, medical records, utilization records, specialized printouts and other data needed to determine if fraud or misrepresentation of fact is present in claims submissions.

Experience

5-7 Years

Level

Executive

Education

Associates

Description :

1. Included coding operative reports for general surgeons, pain management, cardiology procedures such as echocardiography, infusions, ophthalmology.
2. Responsible for entering and submitting charges for billing, performing billing functions for all charges each day, correcting edits/denials.
3. Employed and billing for various medical facilities/physicians around the State of Michigan to include: Brighton Sleep Diagnostics.
4. Certified Professional Coder with expertise in medical record review to assign accurate medical codes for diagnoses, procedures and services .
5. Assisted the Coding Manager to resolve coding edits received from Revenue Integrity as needed.
6. Obtained clarification of conflicting, ambiguous, or non-specific documentation.
7. Ensured compliance with HIPAA Privacy and Security Policies and Procedures.

Experience

10+ Years

Level

Senior

Education

Applied Science

Description :

1. Certified Professional Coder -- CPT, ICD-9, and ICD-10 coding of all office, hospital, and surgical encounters for five providers, with focus on .
2. Assisted with diagnosis coding for outpatient services such as X-rays, labs, and injections.
3. Established departmental policies, procedures, and objectives.
4. Corrected several coding problems that have gone unrecognized before was doing the coding.
5. Maintained physician peer review. Work the billing error on a daily basis.
6. Responsible for the accurate assignment of diagnostic and procedure codes for the clinic outpatient visits and clinic inpatient visits in a timely manner.
7. Assisted with the monitoring of unbilled accounts and with activities related to reimbursement. 

Experience

5-7 Years

Level

Executive

Education

Certificate

Description :

1. Able to give ideas to upper management to help make the process of ensuring proper insurance and patient demographics were obtained in a timely manner to make the billing process easier.
2. Reviewed medical documentation Accurately assign diagnosis codes and procedure codes Determine the proper Evaluation and Management code Submit charges.
3. Performed all phases of CPT and ICD-9 coding through chart abstraction involving surgeries and office procedures for 9 Urology surgeons Applied.
4. Responsible for verifying complete documentation in medical records, assigning appropriate ICD-10-CM, HCPCS, and CPT-4 codes for office visits.
5. Used Multitasking Typing Organization Time Management Communication Maintaining a friendly environment.
6. Reviewed and corrected any rejected or denied claims and re-submitting to insurance.
7. Responsible for accurate coding of professional services.

Experience

7-10 Years

Level

Management

Education

Medical Billing

Description :

1. Worked with peers and management on a regular basis to make changes and or recommendations on coding issues that required giving feedback directly to the client.
2. Connections-Voice and Data Communications, Issaquah WA, Owner/Office Manager.
3. Able to research, Medicare guidelines, Local Coverage Determinations (LCD), NCCI edits, Coding Clinics, and professional medical society websites.
4. Certified Professional Coder o Review provider's documentation to match the correct level of service to appropriate coding guidelines and review of.
5. Identified, assigned and submitted HPSC and CPT billing codes in relation to patient encounters, medical treatment and procedures, and diagnoses.
6. Reviewed documentation and assign appropriate CPT and ICD-9 codes to reflect the services performed by the healthcare providers in Critical Access.
7. Responsible for the daily abstraction and coding of substance abuse medical records to include a review of clinical documentation for proper code.

Experience

5-7 Years

Level

Executive

Education

Interior Design

Description :

1. Responsible for reviewing procedure codes and diagnosis codes for accuracy,
2. Verifies that the assignment of International Classification of Diseases (ICD), Current Procedural Terminology (CPT and Health Common Procedural Coding (HCPC) codes are compatible and accurate by using reference materials to include coding manuals and correct coding initiatives.
3. Interpreted medical terminology in order to comprehend translation to accurate billing.
4. Able to utilize third-party payer knowledge in order to maximize reimbursement.
5. Demonstrated professional conduct by appropriate communications, respect, and courtesy to individuals reports to the supervisor.
6. Coordinated and monitored reimbursement activities of an MFA Department. 
7. Reviewed patient records and recommend appropriate coding/documentation for deficient records.

Experience

7-10 Years

Level

Management

Education

Interior Design

Description :

1. Evaluated the accuracy of provider daily charges.
2. Analyzed and interpreted surgical records to determine billable services.
3. Investigated past due claims and problem solve with patients.
4. Started as a Floater that would cover for different areas of the office.
5. Promoted to the billing department as an Account Receivable Rep.
6. Used Strict Confidentiality Knowledge of different Healthcare Insurances Self Motivated Deadline-driven.
7. Responsible for contacting insurance companies on denials and checking for medical necessity.

Experience

10+ Years

Level

Senior

Education

Medical Billing