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Click here or scroll down to respond to this candidateCandidate's Name , CPC, CPMABrownsboro, Alabama EMAIL AVAILABLE PHONE NUMBER AVAILABLEPROFESSIONAL AFFILIATIONS and CERTIFICATIONSAmerican Academy of Professional Coders (AAPC), Member in good standing Certified Professional Coder, CPC Certified Professional Medical Auditor, CPMARELEVANT SKILLS and TRAININGCPT ICD-10-CM HCPCSMedical Terminology Anatomy PhysiologyCoding Guidelines HIPAA Policies ModifiersCoding Payment Policies NCD and LCD Edits NCCI Edits Compliance Fraud/Waste/Abuse Resolution Place of Service Medicare Parts A, B, C, D Advance Beneficiary Notice Microsoft Office Suite Availity/Navinet/Epic Cerner/Powerchart 3M/MMISPROFESSIONAL EXPERIENCECertified Professional Coder/Medical Billing/Account Specialist Present UPMC/Plastics, 2024- PresentSportsMed Complete Orthopedic Care, 2022- 2023Northside Hospital/NS Heart, 2020- 2022 Code medical records for the complete and correct assignment of CPT, ICD and HCPCS codes, following strict coding guidelines and maintaining quality accuracy coding rate while meeting and exceeding production goals Query providers to obtain information, documentation, and patient data to ensure compliant and complete patient documentation and medical records and obtain insurance verification/pre-certification for office procedures Analyze chart reviews and reports to create provider education regarding improvement opportunities Review coding data to find patterns in coding errors and denials, that can be used to improve accuracy of medical coding practices through staff feedback and training Lead or assist with coding audits, identifying trends and creating training focused on quality improvement Complete medical billing processes, verifying accuracy, submitting claims, appealing incorrect payments for maximum reimbursement Post charges and payments for visit encounters, verifying data for accuracy and completeness, identifying improper payments, contract amounts and reviewing adjustments Analyze patients insurance coverage, deductibles, possible insurance carrier payments and remaining balances not covered under policies, correcting any identified errors Work denials efficiently, making recommendations to improve efficiency, increase revenue, and reduce denials Lead Scheduler II/Front Office AssistantNorthside Hospital/Rehab Services, 2017- 2020Northside Hospital/NS Heart, 2008-2017 Coordinate telephone coverage and rotations for scheduling and front desk staff, providing direction, reviewing work processes, determining needs, proactively delegating tasks, and overseeing team productivity Complete financial chart review, creating financial estimates and initiating the financial assistance process as needed Serve as an initial point of contact for the office, greet patients, visitors, medical and drug representatives, keeping them informed of activities and delays to help them feel valued and important Deliver quality customer service through effectively registering patients for medical services, verifying insurance coverage and plans, obtaining authorizations, processing patient payments, assisting patients in completing medical forms, and collecting all information to provide accurate verification of benefits, streamlining workflows for patients Adhere to coding education while posting charges from visits according to providers record of treatment, following Federal, State and payor specific guidelines Perform all clerical duties including scheduling and confirming patient appointments, accurately processing incoming documents in a timely manner, managing a multi-line phone system, directing people to the appropriate area, answering questions, and resolving concerns, ensuring office efficiency |
