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Click here or scroll down to respond to this candidateCandidate's Name , CPCEMAIL AVAILABLEPHONE NUMBER AVAILABLEStreet Address Bell Rd Apt 1305Antioch, TnStreet Address
To pursue a challenging and rewarding career that will utilize my skills and education of the betterment of a company.WORK EXPERIENCEHCC CoderSt. Thomas Medical Partners Nashville, TN November 2016 to PresentAssisted in the development of the HCC Coding Department. Developed HCC training manual. Set Chart production. Recruited potential candidates. Review medical record information for abstracting appropriate diagnosis based on CMS Risk Adjustment, and Health Quality Physician Assessment Guidelines. Apply appropriate diagnosis codes per documentation for the assignment of an accurate HCC/RxHCC category. Utilize standard coding guidelines, principles and coding clinics to verify that the appropriate ICD-10-CM codes are assigned. 2017 MSSP Quality Reporting Audit Overreads.HCC CoderUnitedHealth Group Franklin, TN December 2013 to November 2016Review medical record information for abstracting appropriate diagnosis based on CMS Risk Adjustment, and Health Quality Physician Assessment Guidelines. Apply appropriate diagnosis codes per documentation for the assignment of an accurate HCC/RxHCC category. Utilize standard coding guidelines, principles and coding clinics to verify that the appropriate ICD-9-CM codes are assigned. Worked on Hedis projects.Medical Coder and BillerThe West Clinic (Oncology Clinic) - Memphis, TN - July 2012 to December 2013Codes appropriately the daily fee tickets from clinic as assigned, Codes appropriately the hospital visit charges, hospital surgeries and ASC procedures, including interventional radiology as assigned, Link diagnosis codes appropriately to procedures/ drugs, Analyzes/Corrects Medicare denials for medical necessity ( diagnosis) and forward to A/R representative for final process, Researches/Resolves any other coding issue/discrepancy,Writes up hospital charges from the hospital, Sorts the daily fee tickets byPhysician for all the coders, on a rotating basisInsurance SpecialistStone River Pharmacy - Memphis, TN - September 2011 to June 2012Obtain medical authorizations from insurance carriers for workers' compensation patients. Communicate various surgery, testing, therapy, and appointment approvals to medical facilities. Ensured order requests would be compensable to medical providers. Verify the validity and compensability of work comp claims. Research un-provided patient and employer demographics. Insert data in different systems and programs. Contact employers, clinics/hospitals, insurance companies, and patients through the duration of the day. Notate conversations on a consistent basis. Send secure faxes and emails to different third-party administrators. Initiate and facilitate the processes necessary to be certain number of days-to-pay is minimized once invoices are billed. Utilize education of different work-comp laws across different states. Accrued monthly bonuses based on paid accounts settled within a specified time frame beginning date of billed invoices.Insurance SpecialistUnified Health Services - Cordova, TN - February 2011 to August 2011Adhere to HIPAA federal law and provide excellent customer service during communication with insurance carrier and healthcare providers in reference to workers compensation claims.Submit workers' compensation claims for review and processing to insurance carrier and bill review companies to secure full reimbursement.Manage workers' compensation claims after processing to ensure full reimbursement on claims according to state fees and regulations.Utilize education of different work-comp laws across different states. Make sure the correct CPT codes and ICD-9 codes are on the bills before sending out to vary insurance companies.Credit RepresentativePortfolio Recovery Associates - Jackson, TN - September 2009 to July 2010Make at least 100 calls per day to clients/debtors. Confer with clients/debtors by telephone to determine reasons for overdue payments. Generate payments from clients/debtors. Locate and notify clients/debtors of delinquent accounts by mail or telephone, order to solicit payment. Perform various administrative functions for assigned accounts, such as recording address changes and purging the records of deceased clients/debtor. Receive payments and post amounts paid to clients/debtors accounts. Record information about financial status of clients/debtors and status of collection efforts. Trace delinquent clients/debtors to new addresses by inquiring at post offices, telephone companies, credit bureaus, or through the questioning of neighbors. Advise clients/debtors of necessary actions and strategies for debt repayment.Credit RepresentativeMidSouth Credit Bureau - Paris, TN - November 2006 to April 2007Verified information of the overdue liabilities of the clients. Organized daily outbound/inbound phone calls to clients in order to collect debts before the due dates. Advised clients on their outstanding accounts that needed to be settled.Approved negotiation details of the clients. Bring customers' accounts up to date and respond to customer inquiries. Organized records and documentations of the clients for future reference. Negotiate payment arrangements with customers. Use communication and analytical skills to provide mutually beneficial problem resolutions.INTERNSHIP/VOLUNTEERJACKSON OBYGN DR. CLARENCE T. GOOCH - March 2009 to May 2009Responsible for managing medical records, filing claims, preparing insurance form and handling billing.-Provide clerical support for the front office.Medical Coder and Biller ( Internship )MEMPHIS CENTER OF REPRODUCTIVE HEALTH - Memphis, TN - July 2011 to September 2011Created the super bill in order for the clinic to transfer over to taking personal insurance for medical services.-Responsible for managing medical records, filing claims, preparing insurance form and handling billing.-Provide clerical support for the front office.EDUCATIONAssociates of Science BiologyNashville State Nashville, TN2016 to PresentDiploma in Professional Medical Billing and CodingWest Tennessee Business College - Jackson, TNJune 2009 |
