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SUMMARY OF QUALIFICATIONS

Over ten years' experience in medical coding and billing for physician group with over 50 providers in 9 specialties
Ensure the use of current technology in coding and billing for the review of physician documentation in both outpatient clinic and inpatient/outpatient hospital settings.
Assist in denial management, correcting billing/coding errors for resubmission when applicable
Advise and educate clinical staff, inclusive of physicians, physician assistants, and nurse practitioners on correct billing/coding procedures regarding differences between managed care products and Medicare policies
Maintain total privacy at all times regarding patient charts/billing/coding in compliance with HIPAA.
On-board and train new employees entering the coding/charge entry department on correct billing and coding procedures and their application into billing system

TECHNICAL PROFICIENCY

Broad knowledge base in current CPT, HCPCS, ICD-9 and ICD-10 terminology
Microsoft Office
Proficient in GE Centricity Business IDX , TES, McKesson STAR, MedAssets CodeCorrect, EMR Cerner Powerchart
Experience in the following physician specialties:
Internal Medicine, Cardiology, Dermatology, Endocrinology, Sports Medicine, Gastroenterology, Pulmonary, Allergy, Oncology, Infusion therapy

PROFESSIONAL EXPERIENCE

Confidential

Head of Coding/Charge Entry for large multi-specialty clinic
Coordinate and review hospital inpatient/outpatient visits by Charlotte Medical Clinic physicians and physician assistants for claim submission
Review GI and Pulmonary physician outpatient hospital procedures, including provation reports and physician progress notes, ensuring correct coding and compliance before submission into billing system
Assist and educate patient account representatives in denial management and resubmission of corrected claims

Confidential

Research patient account detail summaries to find correct charges, dates of service, or specific invoice numbers for reimbursement agents
Confirm account numbers and payments for specialty clinics within Presbyterian Healthcare
Research missed/misallocated payments by insurance and patients

OVERALL GOALS

Have completed additional online training on E/M coding from AAPC and am currently in process of training for CHONC Certification.
Strive to maintain efficiency and high standards pertaining to billing and coding, taking advantage of Continued Education opportunities in order to maintain current procedures and policies in an ever-changing coding environment.
Comply with all insurance regulatory agencies including Medicare.
Maintain communication with administrators, practice managers, physicians, physician assistants and nurse practitioners regarding current policies and procedures, and educate staff in both outpatient and inpatient settings for improved billing and coding.
Work in an area that provides growth and opportunities related to my expertise.