Coding Specialist Resume
Objective : To obtain a position that challenges my leadership, communication, and creative skills while contributing to the success and growth of a business.
Skills : Account Management, Billing, Customer Service, Data Entry, Excel, Filing, Fax, Medical Terminology, Quickbooks, Receptionist, Typing, Word.
- Reviewed and coded Neurology, ENT, Plastic Surgery, Family practice, Internal Medicine, and Vascular of Medicine.
- Reviewed reports and performed internal E&M audits hospitalist groups.
- Made sure Documentation standards for medical record E&M guidelines.
- Reviewed reimbursement of payers and complete recoupment when there is reimbursement deficiency.
- Provided coding reviews and recommendation for correction to the Manager of Reimbursement and Education.
- Analyzed A/R and claim denials for trends directly related to reimbursement issues to assist with improving department results.
- Addressed RAC and other recoupment efforts of government and PPO payers for accuracy.
- Worked denied and appeal queues as well as makes recommendation in relation to Account Representative processes when appropriate.
Billing Coding Specialist Resume
Summary : Seeking a position in the Healthcare Business Office. I have been a Medical Outpatient Coder for 6 years and I really enjoy what I do. I would love to continue working in the Healthcare Office field because I feel this is where I belong. Working in a field that my degree is in as well as what I have been doing for the past 6 years would be wonderful.
Skills : Data Entry, Microsoft Office, 10-Key, Typing, Excel, Billing, Medical Coding.
- Responsible for all coding including outpatient and inpatient surgical procedures, in-office surgeries, in-patient consults, emergency room visits and a large volume of E/M coding for 14 physicians.
- Ensure a thorough understanding of each surgery performed by reading Operative Notes, Pathology Reports and if necessary consulting with the physician that performed the procedure.
- Responsible for invoices associated with each surgery and applying them to each patient.
- Schedule inpatient and outpatient surgeries.
- Conduct in house audits for 14 physicians in our practice.
- Answer numerous questions via email and telephone throughout each day regarding procedures from physicians and more than 40 ENT Associates employees.
- Advise coders via Internet in other Birmingham area hospitals on coding procedures.
Medical Coding Specialist Resume
Objective : A well-presented, highly personable individual with a 21-year track record of providing Medical Record, Executive Administrative Support and First Level IT Support for various office environments. Talent for quickly mastering technology. Diplomatic and tactful with professionals and non-professionals at all levels. Accustomed to handling sensitive, confidential records. Flexible and versatile - able to maintain a sense of humor under pressure.
Skills : RHIT, CCS-P, CDIP.
- Responsible for performing coding/auditing of medical records retrospectively to ensure ICD-9 codes that are submitted to the Centers of Medicare and Medicaid Service (CMS) for Risk Adjustment Payment System (RAPS) are accurate and are supported by written clinical documentation/criteria in accordance with ICD-9 official guidelines, state and federal regulations, and UPMC Health Plan internal policies and procedures.
- Ability to code using ICD-9-CM and appropriately assigning diagnosis codes after reviewing all clinical documentation available.
- Performs audits to determine accuracy of code selection and assists with risk adjustment validation (RADV) audits.
- Responsible for validating diagnoses submitted via claims to the Health Plan by reviewing inpatient, outpatient and provider office documentation, reviewing clinical criteria.
- Assists with inter-rater reliability audits and conducts review of coded materials to ensure compliance with coding guidelines and principles and CMS Risk Adjustment Participant Guidelines.
- Identifies topics for training and education and assists with training of new hires.
- Helps support daily operational functions of the Medicare HCC Risk Adjustment Department.
- Provides technical support to medical abstractors, as needed, for software and hardware issues they may encounter out in the field when performing chart reviews.
Senior Biller/Coding Specialist Resume
Objective : Medical billing, coding and collection experience for 15+ years providing administrative and patient support. Advanced knowledge of private insurance, Medicaid and Medicare processes.
Skills : Microsoft Office, Outlook, Google Drive.
- Preview all insurance claims to ensure accuracy, compliance and conformity with AMA, CMS, AAPC and payer specific guidelines for more than 250 providers (Women's Health CT and Women's Health NY).
- Review patient medical records to ensure that coding change(s) are supported by medical record documentation.
- Appeal denied or inappropriately bundled claims when necessary.
- Respond daily to all internal and external divisional staff questions associated with coding.
- Train divisional and internal staff in OB-GYN specific coding.
- Attend and participate in payer meetings on a monthly or as needed basis.
- Update, maintain and communicate payer specific guideline information, AMA and CMS updates to internal and external staff.
- Perform chart audits as needed to ensure that patient medical record documentation supports the code(s) billed to patients and health plans.
Senior Medical Coding Specialist Resume
Objective : Certified Coding Specialist (CCS) and review analyst with extensive experience in coding, and auditing for major healthcare companies including Blue Cross Blue Shield of Michigan Reviewed medical records and followed up with insurance carriers to resolve open insurance claims / denials and balances proficiency with CPT, ICD-9, and HCPCS coding, including X-Ray and Operation Room Reporting. Explained patient medical benefits for in-home physical therapy and health services.
Skills : Microsoft Office, Microsoft Word, Microsoft Outlook.
- Reviewed and verified proper coding of, ICD- 9, and CPT code sets.
- Maintained up to date CPT, ICD - 9, and HCPCS code sets.
- Reviewed, monitored, audited, and reconciled patient accounts for accurate billing.
- Responsible for uncollectable accounts; reviewed the accounts in regards to dates of service, authorization, and codes.
- Processed insurance and patient claims timely and accurately.
- Performed monthly reviews and quality audits for compliance for the federal government.
- Followed up with insurance carriers to resolve open insurance claims / denials and balances proficiency with CPT, ICD-9, and HCPCS coding.
- Verified of Client's Insurance (benefits, Deductible and Co-Insurance) and assigned Private Pay Agreements for Private Pay Policies.
Associate's In Healthcare Administration
Remote Clinical Auditor/Coding Specialist Resume
Objective : Associates Degree Medical Coding Orthopedic Specialist AAPC Certified Medical Coder Certified Surgery Coder Ambulatory Surgery Center (ASC) Coder Anesthesia Coder Pain Management Coder Orthopedic Proficiency Certified Remote Abstract/Outsource Coder Charge Entry Specialist Instructor at Indiana Business College Instructor at Med-Tech College.
Skills : EHR, 3M ENCODER, MICROSOFT OFFICE.
- Provide coding and auditing services for a variety of medical specialties.
- This includes the analysis and translation of medical and clinical diagnoses, procedures, injuries, or illnesses into designated ICD-9 and CPT codes.
- Perform documentation assessment and review for accurate abstracting of clinical data to meet regulatory and compliance requirements, ensuring coded data accurately reflects services provided, guarding against fraud and abuse.
- Provide ongoing feedback and education to coding staff and providers.
- Accomplishments: Coder for six provider specialties, to include Internal Medicine, Infectious Disease, Orthopedic Surgery and OBGYN.
- Inpatient, Outpatient, clinical and office coding knowledge/experience.
- Analyze provider documentation to assure and/or assign the appropriate Evaluation and Management (E&M) levels.
CPT In Insurance Verification
Medical Billing/Coding Specialist Resume
Headline : Highly qualified Coding Specialist with experience in the industry. Enjoy creative problem solving and getting exposure on multiple projects, and I would excel in the collaborative environment on which your company prides itself.
Skills : Microsoft Office Answering Multi Line Phones ICD-10.
- Reviews and codes designated office/hospital notes for one or multiple practices.
- Abstracts CPT-4, HCPC II, and ICD-9 CM from medical records.
- Receives and reviews charge documentations from clinic and/or hospital.
- Charge entry into billing system in timely manner.
- Resolves complex coding scenarios and resolve coding related denials.
- Provides feedback and documentation advice to the physician; non-physician practitioner, and practice management.
- Assists and direct the practice or other appropriate staff regarding documentation, billing, coding, and reimbursement issues.
- Works in conjunction with A/R team on follow up and resolution of coding related denials rejections.
Bachelors In Business Administration
Senior Claims Analyst/Coding Specialist Resume
Summary : Medical Billing Specialist with number years experience in multiple specialty coding. Researched and denied claims and submitted appeals. Familiar with health billing and collections. Worked with EMR/ Centricity business programs.
Skills : Fluent In Speaking, Reading And Writing In Spanish.
- Precisely completed appropriate claims paperwork, documentation and system entry.
- Correctly coded and billed medical claims for various specialties.
- Thoroughly researched newly identified diagnoses and/or medical procedures to expand skills and knowledge.
- Meticulously identified and rectified inconsistencies, deficiencies and discrepancies in medical documentation.
- Maintained updated knowledge of coding requirements, through continuing education and certification renewal.
- Entered orders into the EMR system efficiently and without errors.
- Assigned appropriate medical codes with a number percent accuracy rate.
Certificate Of Achievement
Coding Specialist(Medical Records Technician) Resume
Headline : To obtain a position in the healthcare field that will allow me to maximize my career and educational experiences in an environment that is stimulated by healthcare's changing challenges.
Skills : MICROSOFT OFFICE.
- Responsibilities: Assists physicians, patients, insurance representatives, procedure schedulers and managers by identifying problem billing patterns and correcting insurance denials.
- Audit/Research problems pertaining to coding by reviewing submitted claims, denials and reimbursements to ensure maximum reimbursements from payors.
- Maintain regulatory/compliance environment by following organizational policies and procedures to ensure compliance to state, local and federal standards and regulations.
- Receive insurance denials and requests and reviews patients' medical records to resubmit claims using Accurate codes and following professional coding standards to ensure maximum reimbursement from payors.
- Review and assist with hospital charge processing using current and accurate coding practices.
- Initiates correspondence to and answer rejections from insurance companies regarding patients accounts and claim appeals by following established insurance protocols.
- Works with Cardiology Associates staff through the Practice Management system's tasking function to obtain the necessary documentation prior to following up and submitting claims that require referrals, records or additional information.
- Communicates and initiates correspondence with insurance companies to resolve coding discrepancies to ensure maximum reimbursement from payors.
Bachelor Of Arts
Decoding Specialist Resume
Summary : Highly organized, analytical Medical Coding professional with superior goal setting, decision-making, and problem solving skills. Solid reputation for having in-depth knowledge of coding techniques and guidelines of medical coding. Very sound knowledge of medical terminology, physiology and pharmacology. Strong ability to identify, develop and sustain a network of people and other resources for tasks.
Skills : Excel.
- Responsible for maintaining an assigned portfolio of clients.
- Determine the benefits and services the relocating employee will receive based on the client matrix provided and distribute to the appropriate departments within Cartus.
- Work closely with client services and account management to ensure the coding matrices are kept up to date.
- Assist manager with data integrity projects and clean up projects for business units.
- Facilitate team training, cross training development for IC Coordinators.
- Client Services Consultant Served as the major point of contact to the transferring employee, navigating the customer through his/her relocation.
- Maintained an assigned caseload while delivering impeccable customer service to external and internal customers.
- Communicated via phone the client's relocation program/policy to transferring customers.
Bachelor Of Arts In Communications
Coding Specialist Externship Resume
Summary : To acquire a position in the healthcare field that will require me to utilize my education and healthcare experience to help strengthen the company as they continue to produce positive, successful and quality outcomes.
Skills : HIT.
- Coded patient claims using ICD-9 and CPT codes, supporting office with five full- time physicians, one part-time physician, and 19 nurse anesthetists.
- Worked with Medicare, Medicaid, and private insurance claims.
- Developed skill in identifying errors that resulted in nonpayment and meticulously documenting justifications for payment.
- Used hospital's Meditech system; utilized Internet resources to double-check accurate procedure names and codes.
- Ran monthly business reports along with office administrator; these included aging reports, broken down by CPT code and volume of each unit.
- Followed up on aging reports; significantly reduced number of unpaid and underpaid claims and maintained excellent record of winning disputes with insurance companies by providing documentation to prove validity of claims.
- Provided documentation and codes for Medicare Physician Quality Reporting Initiative, tracking adherence to protocols.
- Ensured patient claims were coded within one week of date of procedure, reducing previous backlog of three- to four-week delay.
Jr. Coding Specialist Resume
Objective : I have a lot of Medical Office experience and would love to work with your company. I know I would be a great fit and would love the opportunity to provide you with my coding knowledge to help your company succeed. I look forward to speaking with you soon.
Skills : Soft Med, 3M Encoder/Grouper, Quantum, Meditech, IMAC, Medisoft, Allscripts, Cerner Sorian, Microsoft Office, Word-perfect, Xerox Copier. All Other Standard Office Equipment.
- Review medical record documentation to accurately assign medical codes to all diagnoses and/or services, for purposes of classification of morbidity and mortality data for statistics using ICD-9-CM, CPT, and HCPCS coding systems.
- Review medical documentation for accuracy and compliance with inpatient and outpatient coding and coverage rules.
- Determine Diagnosis-Related Groups (DRGs) and Hierarchical Condition Categories (HCCs) based on codes assigned.
- Evaluate and confirm final determinations on discrepant records.
- Mediate coding decisions between coders utilizing appropriate resources to support decisions.
- Recommend resolutions in keeping with the Centers for Medicare & Medicaid Services (CMS) and company policy.
- Facilitate, contribute to, and attend various administrative meetings.
- Maintain internal control processes for all activities in compliance with the Health Insurance Portability and Accountability Act (HIPAA).
M.A. In Health Care Administration
Coding Specialist Resume
Summary : Qualified and highly motivated certified professional coder with 15 years of experience. Dedicated to accurate and efficient coding for timely reimbursement for employer and patient. 11 year member of AAPC education with 48 CEU's due every 2 years to maintain AAPC credentials ICD -10-CM certified through AAPC.
Skills : Administration, Customer Service, Leadership, Training, Healthcare, Medical Terminology, Medical Coding, Operations, Management, Insurance Precertification.
- Managed and processed in/outpatient billing and procedural codes for Emergency Department and Outpatient Surgery.
- Communicated with physicians and clinical documentation specialists to ensure dictation accuracy, as well as with providers to appeal claim denials.
- Established and maintained positive relationships with physicians, clinical documentation specialists and floor personnel.
- Coordinated medical necessity of outpatient testing.
- Maintained top accuracy and productivity records for ICD-9, CPT and HCPCS coding exceeding 98%.
- Achieved daily production maintaining top production performance, while exceeding quality goals.
- Assisted in internal audits of in/outpatient procedural records; analyzed medical records to identify inaccuracies.