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Click here or scroll down to respond to this candidateCandidate's Name
Street Address W 75th Street PHONE NUMBER AVAILABLEIndianapolis, Indiana, Street Address EMAIL AVAILABLE PHONE NUMBER AVAILABLEProfessional SummaryTeam oriented healthcare professional with excellent organizational and time management skills. Experienced with front end Coding/Reimbursement and back end Coding Denials including Medical Necessity, LCD/NDC, and Inclusive Appeals. Keen understanding of business priorities and committed to my role in helping to improve processes to ensure organizational success.Core QualificationsStrong verbal communicationMedical TerminologyCurrent Procedural Terminology (CPT)ICD-9 and ICD-10LCD/NCD GuidelinesNCCI EditsPQRS Codes for CMSComplex Problem SolvingCoding Denials and Medical Necessity AppealsSurgery CodingRadiology CodingE/M CodingExperienceUrology of Indiana (Thats Good HR)Coder/Charge EntryApril 2023 November 2023Responsible for ensuring the accurate insurance demographic entry of patient information to enable timely reimbursement. Responsible for the notification and accumulation of correct data from Physicians, hospital personnel and/or office personnel, in the event incomplete data is submitted.*Responsible for current knowledge of all CPT-4 codes and modifiers, ICD-9 coding as well as any regulatory compliance issues as it pertains to billing of Physicians services.*Responsible for notification to the Physician/Administration of any errors and/or compliance issues noted on submitted encounter forms for charge entry into the computer system.*Responsible for the timely, accurate posting of all submitted encounter forms, hospital charges and any ancillary charges submitted by the Physicians supported by the Central Billing Operations.*Responsible for the follow up of all missing encounter forms, and claims on hold for further information as noted on the Daily Batch Form.*Act as a liaison for the Central Billing Operations for all site locations.*Responsible for the retrieval of chart notes used in the processing of appeals and/or refiling as requested by the Central Billing Operations employees.*Ability to accurately code operative/patient notes as presented.*Responsible for adhering to the Corporate Confidentiality Policy.*Responsible for cross training with other positions within the Corporation as designated by Management.Responsible for meeting the production and quality standards as set for this position.Other duties as assigned.Northwest RadiologyMedical CoderAugust 2016 March 2023Working and following through on task management queues.Assigning the appropriate CPT and ICD-10/CPT/HCPCS codes to dictated indications, impressions and procedures in radiology dictated reports.Follow through on account issues to resolve Coding Denials and Medical Necessity Claims.Assigns appropriate PQRS code.Keeping abreast of coding guidelines and reimbursement reporting requirements.Investigating nonpayment of claims denied due to coding reasons; following through with resubmitting corrected claims or appeals.Radiology of Indiana (Indianapolis, IN)Coding and Reimbursement SpecialistJanuary 2014 to August 2016Working and following through on task management queues.Assigning and sequencing ICD-9 or ICD-10/CPT/HCPCS codes to dictated indications, impressions and procedures in radiology dictated reports.Follow through on account issues to resolve Coding Denials and Medical Necessity Claims.Assigns appropriate PQRS code.Keeping abreast of coding guidelines and reimbursement reporting requirements.Investigating nonpayment of claims denied due to coding reasons; following through with resubmitting corrected claims or appeals.Radiology of Indiana (Formerly Irvington Radiologist PC) (Indianapolis, IN)Account Receivable RepresentativeFebruary 2013 to January 2014Follow through on Insurance denials to include reviews and appeals.Process Insurance and Patient refunds.Process patient credit card payments.Prepared and attached all required claims documentation including referrals, treatment plans or other required correspondence to reduce incidence of denials.Performed full-cycle medical billing in a fast-paced medical billing company.Investigate non-payment of claims.Receive incoming billing calls and follow through with any corrective action.Review and follow through on daily Insurance/Patient correspondence.Added modifiers as appropriate, coded narrative diagnoses and verified diagnoses.Appropriately and correctly identified errors and re-filed denied/rejected claimsIU Health Revenue Cycle (Indianapolis, IN)Denials, Collections and A/R SpecialistOctober 2010 to January 2013Responsible for collection and follow-up activities related to outstanding patient account balances for both unpaid and denied claims.Manage aged accounts effectively and efficiently.Responsible for the timely adjudication of insurance and third party claims with minimal outstanding receivables and maximum reimbursement while providing a proactive, high level, value-added customer service.Analyze and process routine customer service calls and inquiries.Assessing customer needs regarding both physician and hospital billing, offering solutions and providing preeminent service.Handle all patient correspondence.EducationUS Careers Institute 2019Medical Coding CertificatePenn Foster (Scranton, PA) 2014Administrative Assistant CertificateIvy Tech State College (Indianapolis, IN) 1995 to 2000Certificate of Collection Techniques for PhlebotomistsEmmerich Manual High School (Indianapolis, IN) 1991 |
