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Objective

Bilingual Medical Coder seeking a position that will allow my broad knowledge of the ICD-9, CPT, and HCPCS in today's coding systems to be used. I am a focused, self-motivated, and detailed oriented individual. I possess highly developed skills in coding principles and guidelines. I am proficient in the Microsoft Office with 50 wpm. I am seeking a position in which I can utilize my advanced coding skills and look forward to long-term growth of opportunities.

Advanced Coding Skills

ICD-10 Certified
CPT Coding Guidelines
ICD-9 Guidelines at the Sections, Subsection, and Category Level
NCCI Edits / OIG
Reimbursement Strategies
OSHA Regulations
Medicare and ABN
HIPAA Regulations
Law Ethics
Advanced Anatomy Physiology
Medical Terminology
HCC Coding
Familiarity with Third Party Payer Commercial Insurance
Medicaid
NextGen Software
CPR Certified
Phone Etiquette

Experience

Confidential

Assist in all ICD-10 implementation processes.
Review final diagnoses and procedures coded by the provider to ensure it is valid, complete, and accurate.
Ensure the final diagnosis accurately reflect the care and treatment rendered.
Review records for compliance with third party reimbursement agencies.
Assist biller with any payer denials associated with coding to ensure claims are processed and paid correctly.
Review medical records on a concurrent and retrospective basis to improve overall quality and completeness of clinical documentation of patient records.
Document and verify information across systems and update records according to strict guidelines.
Work collaboratively with clinicians to ensure that clinical information in the medical record is present and accurate and provides training and education as needed.
Review and analyze records for accuracy and completeness.
Prioritize and reprioritize work based on business needs.
Escalate issues to management to ensure that customer needs are met and that company records are complete and prepared for review and/or verification.

Confidential

Verified and ensured the accuracy, completeness, specificity and appropriateness of diagnosis codes based on services rendered.
Reviewed medical record information to identify all appropriate coding based on CMS HCC categories.
Completed appropriate paperwork/documentation/system entry regarding claim/encounter information.
Supported and participated in process and quality improvement initiatives.
Entered codes into computer applications supporting different medical plans.
Researched codes and medical terminology.
Abstracted ICD9-CM codes from handwritten charts and electronic medical records.

Confidential

Accurately apply payments to patient accounts.
Ensure claims are entered and submitted with 48 hours of receipt
Post and reconcile insurance and patient payments. Research and resolve incorrect payments, EOB
rejections, and other issues with outstanding accounts
Audit accuracy of insurance claims. Verify correct ICD-9 and CPT codes for a variety of specialties
Set up new patient accounts
Assign ICD-9 to physicians diagnosis and insure correct level of service and various other CPT codes
Set-up practice management software for submission of electronic claims to clearinghouse. Work with
clearing house to resolve file compatibility issues
Retrieve Electronic Remittance Advice ERA's
Send secondary claims upon processing of primary insurance.
Daily processing of Patient statements. Answer and resolve patient billing inquiries
Follow up on Insurance and patient aging. Re-submit insurance claims as necessary. Knowledgeable
in timely filing restrictions
Ensure office practices are in compliance with HIPAA regulations
Answering phone calls, and helping patients with any questions.
Sorted mail and files neatly and accurately to help keep office organized.
Externship
200 Hours
Responsible for answering phone calls and helping patients with billing questions.
Sorted mail to keep the office well organized.
Reviewed medical records for the determination and accurate assignment of all documented diagnoses and procedures.
Assigned and sequenced codes based on medical record documentation.
Assigned appropriate discharge coding modifiers
Abstracted and entered coded data and designated quality management data for hospital statistical and reporting requirements.
Communicated documentation improvement opportunities and coding issues i.e., discrepancies, physician queries, etc. to the appropriate personnel for follow up and resolution.
Reviewed complex operative procedures for office surgeries.
Coordinated and reconciled multiple surgical schedules to ensure complete charge capture.
Worked in conjunction with A/R team on follow up and resolution of denials and rejections.
Responsible for maintaining current knowledge of coding guidelines and relevant federal regulations through the use of current CPT-4, HCPCS II, and ICD-9/ICDD-10 materials, Federal Register, and other pertinent materials.

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