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Skills

  • Medical claim auditing
  • Clean claim rate improvement
  • Financial reporting
  • Closing processes
  • Healthcare regulations knowledge
  • Regulatory compliance
  • Accounting remittances
  • Claim rejection prevention
  • Accounts receivable coordination
  • ICD-10 coding compliance

Work Experiences

  • Audited coding documentation regularly to ensure compliance with current Colorado guidelines, reducing audit risks by 18.
  • Had an excellent attendance record and was always on time for work.
  • Analyzed 10 provider practices.
  • Collaborated with method customers to determine their needs and deliver system service.
  • Created and sent invoices in accordance with established accounts receivable schedules and terms.
  • Consistently achieved a 67% clean claim rate through the implementation of coding accuracy initiatives and enhanced communication with other departments.
  • Achieved a 41% higher approval rate.
  • Billed and reimbursed claims at compliant levels.
  • Achieved a 34% success rate.
  • Collaborated with hospital administration.

Summaries

  • Coding Reimbursement Specialist is a well-organized Healthcare with 3 years of experience.
  • Dedicated to learning, growing, and succeeding in Healthcare.
  • Achieved a 47% reduction in denied claims.
  • Dedicated to paying employees, vendors, and suppliers on time.
  • Dedicated to increasing profits, lowering accounting errors, and streamlining accounting processes.
  • Achieved a 57% clean claim rate.
  • Coding Reimbursement Specialist is a detail-oriented Coding Reimbursement Specialist with 11 years of finance and accounting experience.
  • Proactive and self-motivated, with a high level of professionalism and excellent problem-solving skills.
  • Year-end schedules and additional documents for accounting audits are a strong suit.
  • Focused, committed, and adept at quickly identifying errors and mitigating losses.

Accomplishments

  • Resolved product issue through consumer testing.
  • Reduced revenue loss due to coding errors by 53% by leading root cause analyses and implementing corrective actions across the coding department.
  • Trained a team of 5, resulting in uniform adherence to the latest ICD-10, CPT, and HCPCS Level II guidelines with an accuracy improvement of 82%.
  • Implemented a documentation clarification process that led to a 22% reduction in coding-related documentation errors and improved accuracy.
  • Reviewed and updated company coding procedures in response to changes in regulatory standards, resulting in faster claim approvals by 48%.
  • Partnered with the compliance department to ensure all claims adhered to Medicaid/Medicare reimbursement guidelines, reducing regulatory risks by 82%.
  • Trained 18 new hires on medical billing software HubSpot, increasing team efficiency and adherence to company coding standards.
  • Reviewed daily coding reports and acted as a subject matter expert for CPT and ICD-10 codes, ensuring alignment with payer guidelines across 16 facilities.
  • Resolved high-priority coding discrepancies, recovering over $10 in previously denied claims within a 6 months.
  • Developed and implemented coding accuracy initiatives that resulted in a 58% reduction in claim denials and a 18 revenue increase.

Affiliations

  • Certified Professional Compliance Officer (CPCO) Study Group
  • Certified Professional Coder (CPC) Peer Network
  • Medical Coders and Billers Association (MCBA)
  • International Association of Administrative Professionals
  • Health Care Compliance Association (HCCA)
  • Clinical Coding Improvement Online Summits
  • National Association of Healthcare Revenue Integrity (NAHRI)
  • Certified Medical Billing Specialist Organization
  • Health Information Systems User Group
  • National Association of Social Workers

Certifications

  • Certification in Healthcare Compliance (CHC) by HCCA
  • Certified Compliance Professional (CCP) by HCCA
  • ICD-10-CM/PCS Trainer Certification by AHIMA
  • Certified Medical Reimbursement Specialist (CMRS) by AMBA
  • CompTIA A+ Technician
  • Certified Medical Office Manager (CMOM) by PMI
  • Certified Documentation Improvement Practitioner (CDIP) by AHIMA
  • Certified Healthcare Privacy and Security (CHPS) by AHIMA
  • Medical Coding and Billing Specialist (MCBS) by Ultimate Medical Academy
  • EPIC Certification in Coding/Revenue Cycle

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