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Skills

  • Billing procedures
  • Customer service
  • Claim denial resolution
  • Database management
  • CMS guidelines compliance
  • Project organization
  • Electronic Health Records (EHR) management
  • Inventory management
  • Planning and coordination
  • Accurate diagnosis code assignment

Work Experiences

  • Achieved results in 2019.
  • Advised the billing department on coding best practices, improving revenue flow by $18 annually.
  • Devised and implemented techniques to improve the retrieval of medical records.
  • Conducted daily assessment of ICD-10 codes.
  • Implementing system process improvements increased team efficiency.
  • Gathered documentation and contacted providers to clarify ambiguous patient care statements.
  • Achieved an President's Club-winning performance in compliance.
  • Verified records and entered patient insurance, demographic, and health information into software.
  • Accurately assigned codes using software and an official print copy of the code book.
  • Assigned ICD, CPT, and HCPCS codes after reviewing clinical data from medical records.

Summaries

  • Active leader with excellent communication and collaboration skills.
  • Knowledge of Salesforce in depth, as well as performance reporting and risk assessment abilities.
  • When communicating with patients, insurance companies, and healthcare personnel, demonstrated professionalism.
  • Certified Coder who has previous experience entering data by reviewing accounts and applying appropriate codes.
  • Certified Coder with risk assessment and stakeholder engagement abilities.
  • Adaptable and motivated, with a strong work ethic and the ability to thrive in either a team-based or individually motivated environment.
  • Strategic thinker with expertise in data analysis.
  • Certified Coder with 11 years of experience accurately entering data for insurance and billing purposes.
  • Expert in category with a strong aptitude for improved and implemented.
  • Achieved Excellence Award-winning performance.

Accomplishments

  • Implemented continuous improvement methodologies resulting in a 16% reduction in coding errors, improving overall compliance and revenue cycle efficiency.
  • Utilized Asana to streamline claim workflows, reducing processing time by 80% and improving overall revenue cycle management by $169,000.
  • Utilized multi-specialty coding knowledge to bill accurately across various departments, resulting in a 67% reduction in rejected claims.
  • Handled sensitive medical records with adherence to HIPAA while reviewing and coding over 13 cases per week accurately to avoid any compliance issues.
  • Awarded Employee of the Month for excellence in improving claim acceptance rates by 53% through detailed medical record review and accurate code assignment.
  • Collaborated with physicians to ensure accurate code assignment on over 9 patient medical records, leading to a reduced claim rejection rate of 70%.
  • Reduced claim rejection rates by 33% in partnership with insurance providers by implementing coding best practices and quality improvement initiatives.
  • Collaborated with insurance providers to correct data discrepancies and resubmit denied claims, recovering $87,000 in lost revenue.
  • Collaborated with appeals teams, leading to a 36% increase in successfully contested denied claims and recovering $5,000 in previously uncategorized revenue.
  • Developed a coding error reduction strategy by closely analyzing rejection patterns and implemented corrective actions, reducing errors by 85% in product.

Affiliations

  • Professional Association of Medical Coding Instructors (PAMCI) - Facilitated educational sessions for students pursuing initial certification.
  • Federation of Coding Integrity Professionals (FCIP) - Regularly attended sessions on maintaining coding integrity in large healthcare enterprises.
  • Certified Professional Coder Discussion Forum - Actively participated in discussions on denial resolution and procedural coding updates.
  • Revenue Cycle Coders Alliance (RCCA) - Monthly engagements with other members on improving the denial rate and increasing practice revenue.
  • Revenue Integrity Coding Association (RICA) - Participated in group efforts to establish benchmarks and KPIs in coding accuracy.
  • Certified Coding Specialists Network (CCSN) - Participated in monthly discussions revolving around denial resolution strategies and coding innovations.
  • Healthcare Financial Management Association (HFMA) - Collaborated with members to discuss challenges and solutions in reducing claim denial rates in 2024.
  • Certified Inpatient Coder Network (CIC) - Engaged in peer-to-peer learning on improving coding workflows for inpatient services.
  • Healthcare Coding Compliance Group - Reviewed and shared insights on updates to HIPAA policy as it affects coding and billing practices.
  • Association of Medical Auditors (AMA) - Collaborated with colleagues to streamline medical coding audit routines.

Certifications

  • Certified in Healthcare Research Compliance (CHRC) – HCCA
  • RxCoder Certification - initiative
  • Microsoft Office Specialist (MOS)
  • Certified Professional Compliance Officer (CPCO) - AAPC
  • SHRM Senior Certified Professional (SHRM-SCP)
  • American Academy of Financial Management (AAFM)
  • Revenue Cycle Representative Certification (RCR) - program
  • Certified Inpatient Coder (CIC) – program
  • Certified Documentation Improvement Practitioner (CDIP) - procedure
  • Certified Revenue Integrity Professional (CRIP) - method

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