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Click here or scroll down to respond to this candidateTAMARA VASHAKMADZE, MEcol EMAIL AVAILABLE PHONE NUMBER AVAILABLEMEDICAL BILLING & CODING SPECIALISTMultilingual, analytical Professional with over 20 years of experience in medical billing and coding. Exceptional at people management, patient support, and insurance processes. Proficient in translating medical services into codes, ensuring compliance, and prompt data entry/documentation. Adept at reviewing medical records and assigning appropriate diagnosis and procedure codes. Passionate about helping patients and insurance companies with inquiries while providing claim resolutions to ensure patient satisfaction and business growth. Areas of Expertise Medical Code Translation Operational Improvement Revenue Cycle Management Coding Audits Teamwork HIPAA Compliance Data Entry & Documentation ICD-9, ICD-10, & HCPCS Coding Insurance RequirementsEHR Software ExperienceCriterions eClinicalWorks (ECW) Nextech CareCloud Gazelle EDUCATIONTHE AMERICAN ACADEMY OF PROFESSIONAL CODERS (AAPC) CERTIFIED PROFESSIONAL CODER (CPC) 2024 CONCORD RUSAM PRIVATE CAREER SCHOOL MEDICAL BILLING & CODING CERTIFICATION (MBC1) 2020 National Healthcareer Association Accredited Program CONCORD RUSAM PRIVATE CAREER SCHOOL BILLING & CODING SPECIALIST CERTIFICATION 2014 UNIVERSITY OF ECOLOGY AND PROTECTION OF THE ENVIRONMENT MASTER OF SCIENCE DEGREE IN ECOLOGY 1997 Degree Achieved in Tbilisi, GeorgiaPROFESSIONAL EXPERIENCEMEDICAL BILLING & CODING SPECIALIST 2020 - PRESENT THE OFFICE OF DR. SHIFRIN OBGYN P.C., 2021 - PRESENT BROOKLYN, NY DERMACARE MEDICAL, 2020 - 2021 BROOKLYN, NYOversee daily billing department functions; team management, medical coding, charge entry, claims, payment posting, and reimbursement management. Direct tracking and collection of insurance company and patient payments, handle all claim denials and appeals and examine patient encounter forms to verify diagnosis codes and ensure matches. Review, analyze, and manage coding diagnostics and treatment procedures in outpatient medical records. Complete Clearhouse LLP reports daily; analyze denials and return correct claims promptly. Advise on operational improvements to enhance efficiency of charge capture processes resulting in reduced coding- related denials and optimized reimbursements for billed services. Maintain knowledge of coding requirements through continued education while consistently researching newly identified diagnoses and medical procedures.SUPERVISOR MEDICAL BILLING DEPARTMENT 2017 - 2020 VANGUARD DERMATOLOGY/PHYNET LLC BROOKLYN, NYManaged the billing operations and team of six employees; administered onboarding programs, tracked and collected payments via insurance companies and patients, and ensured claim submission compliance. Spearheaded new procedures to reduce denied claim percentages. Enhanced efficiency of charge capture processes which resulted in reduced coding-related denials and optimized reimbursements for billed services.OFFICE MANAGER MEDICAL BILLING 2010 - 2017INNA GORDIN MEDICAL P.C. BROOKLYN, NYManaged daily administration duties for the office. Coordinated routine documentation and coding audits; executed qualitative analysis of discharged charges. Reviewed and validated accuracy of charges, including dates of service, services provided, location, patient identification, and provider signatures. Interpreted medical reports and data to assign ICD-9 and ICD-10 codes. Proactively updated diagnosis lists and entered procedures, diagnosis codes, and requisite patient information into ECW. ADDITIONAL EXPERIENCE INCLUDES: MEDICAL BILLING & CODING SPECIALIST WITH STAR MEDICAL OFFICES P.C., 2003 - 2010 References Available Upon Request |
