We provide IT Staff Augmentation Services!

Medical Biller And Coder Resume

Thousand Oaks, CA

SUMMARY:

Seeking a medical billing, collecting, or coding specialist position within the company. Experience in reconciling insurance and resolving patient accounts. Versatile quality assurance expert, enhancing productivity while minimizing quality risks. Able to visualize defects and recommend best practice solutions.

CORE COMPETENCIES:

Medical Billing Software MEDISOFT

Aging Report and Follow - up

CMS 1500/HCFA, UB04/UB92, ADA Forms

Entering Demographics

EHR systems MEDCIN

HIPAA/ CMS Compliant

HMO/ PPO/ IPA/ POS plans

Medical/Dental Terminology

Insurance verification

TAR forms/ Authorizations/ Referrals

Quality Mangement Systems

Supplier Quality Systems

FDA/ External & Internal audits

Appeal Letters/Correspondence

Posting Charges and Payments on Accout

ICD-9, ICD-10 CPT, HCPCS, and CDT Coding

Scheduling Appointments/ Printing Superbills

Typing 50 wpm/ 10 Key by touch

Medical Records

Contract Interpretation

Medicare/ Med-Cal guidelines

EOB/ EOMD Proficient/ Accounts Receivable

Regulatory Compliance

Six Sigma/ DMAIC

Cross-Functional Team Building

Continuous Improvement

PROFESSIONAL EXPERIENCE:

Confidential, Thousand Oaks, CA

Medical Biller and Coder

Responsibilities:

  • Participated in 200-hour unpaid externship.
  • Using Prime Clinical EHR software, posted charges and payments on accounts for time and accuracy.
  • Submitted charge statements to Medicare, Medicaid, patients, and private health insurance providers.
  • Under supervision, applied ICD-10 and CPT coding to health records under supervision.
  • Performed follow-up on past due bills.

Confidential, El Segundo, CA

Facilities Technical Specialist

Responsibilities:

  • Performed and tracked department root cause investigations targeting non-conformance resolution within 30 days.
  • Coordinated efforts across multiple departments to gather supporting justification data to determine appropriate corrective and preventative actions.
  • Created/revised Standard Operating Procedures (SOPs).
  • Managed department personnel training.

Confidential, Thousand Oaks, CA

Senior Quality Operations Analyst

Responsibilities:

  • Spearheaded Corrective Action Preventive Action (CAPA) management across entire facility including manufacturing and quality control (QC).
  • Organized comprehensive root cause investigations targeting non-conformance resolution within 30 days.
  • Advanced continuous improvement initiatives to prevent recurrences.
  • Provided compliance to good manufacturing practices (GMP) regulations and assisted in documentation for area operations and support processes.

Quality Operations Analyst

Confidential

Responsibilities:

  • Performed statistical trending on temperature-controlled equipment monitored by Confidential system.
  • Participated in quality audits. Defended investigation outcomes during reviews by regulatory agency auditors.
  • Sharpened manufacturing processes by uncovering compliance deficiencies after being recruited to audit Confidential vaccine operations.

QA Product Release Associate

Confidential

Responsibilities:

  • Reviewed bulk manufacturing and final product batch records for GMP and compliance with FDA, product license, and SOP requirements.
  • Exercised approval authority.
  • Completed 100% of product release activities within established timelines.
  • Broadened expertise by assisting with product complaint investigations.