Alexis Martin, CPC
Rocky Face,GA
Summary
Certified Professional Coder with a solid background in healthcare and health insurance. Experienced in accurately coding healthcare claims for multiple specialties, conducting complex claim audits, and ensuring quality. Proficient in ICD 10-CM conventions, CPT/HCPCS coding, and Medicare/Medicaid guidelines. Strong ability to work both independently and collaboratively within a team.
Overview
14
14
years of professional experience
1
1
Certification
Work History
Clinical Denials Coding Specialist
HCA Parallon
11.2023 - Current
- Reviewed outpatient records and interpret documentation to ensure accuracy of claim coding for multiple specialties.
- Identify coding discrepancies and areas for improvement.
- Communicated with insurance companies to research and resolved coding discrepancies.
- Utilize Multiple EMR systems to store, retrieve, and process patient data.
- Exceed department production and quality standards.
Medicare Accounts Receivable Specialist
Cigna
01.2023 - Current
- Drive root cause analysis for open AR and billing related errors.
- Analyzing billing data to identify trends and potential claim issues.
- Provide current and appropriate education to providers as it relates to Medicare and internal policy updates.
- Exceed Service Level Agreements.
- Develop actions plan and/or project plan to resolve trends identified and impacting at a segment level.
Medical Coding Specialist
Advanced Billing Consultants
03.2023 - 10.2023
- Review outpatient records and interpret documentation to identify diagnoses and procedures.
- Responsible for correctly coding healthcare claims in order to obtain reimbursement from insurance companies.
- Accurately and efficiently code visits for multiple specialty practices such as; Orthopedic Surgery, Physical Therapy, Wound Care and DME.
- Consistently exceed 95% coding accuracy goal.
Quality Review & Audit Lead
Cigna Healthcare
10.2020 - 01.2023
- Lead quality reviews and audits, ensuring accurate and timely claim submissions.
- Audit multiple complex claim types such as; Outpatient and Inpatient hospital claims.
- Offer guidance and coaching to junior team members to increase productivity.
- Identify and recommend process improvements for enhanced efficiency.
Claim Senior Representative
Cigna Healthcare
03.2017 - 10.2020
- Manage dedicated account claims for NFL and HCA accounts.
- Determine proper claim adjudication steps according to department procedures.
- Settle claims in line with policy provisions.
- Participate in special claims projects.
- Process a wide range of claim types, including but not limited to; Office Visits, Outpatient Hospital, Inpatient Hospital, Behavioral Health, Dental, Oncology, and Home Health.
Clerical and Imaging Representative
Chattanooga Imaging
06.2016 - 11.2016
- Effectively verify insurance and billing information for patients during check-in process.
- Assist patients in understanding their insurance coverage and details while providing exceptional customer service.
- Schedule patient procedures and collaborate with medical team to organize and maintain accurate patient records.
- Proficiently prepare patient images and medical records to facilitate radiologist presentations at Tumor Board conferences, ensuring timely and accurate dissemination of crucial information.
Customer Service Specialist
Blue Cross Blue Shield of TN
08.2010 - 06.2016
- Deliver comprehensive education to customers and providers, explaining current plan specifics and available options.
- Consistently excel in delivering exceptional customer service to members, brokers, and providers.
- Effectively communicate claim and reimbursement information to both members and health care providers.
Education
Certificatication - Medical Billing And Coding
Chattanooga State Community College
Chattanooga, TNAssociate of Business Administration - Business
Chattanooga State Community College
Chattanooga, TNHigh School Diploma -
Hixson High School
HixsonSkills
- Multiple specialty coding
- Profee Coding
- ICD-10-CM conventions and guidelines, CPT/HCPCS
- Medicare and Medicaid guidelines
- Abstracting from medical records
- Complex claim auditing
- Quality Assurance
- Proficient in multiple EMR systems
- Document Management
- Process improvement
- Data Analyst
Certification
- Certified Professional Coder (CPC)-AAPC
Timeline
Clinical Denials Coding Specialist
HCA Parallon
11.2023 - Current
Medical Coding Specialist
Advanced Billing Consultants
03.2023 - 10.2023
Medicare Accounts Receivable Specialist
Cigna
01.2023 - Current
Quality Review & Audit Lead
Cigna Healthcare
10.2020 - 01.2023
Claim Senior Representative
Cigna Healthcare
03.2017 - 10.2020
Clerical and Imaging Representative
Chattanooga Imaging
06.2016 - 11.2016
Customer Service Specialist
Blue Cross Blue Shield of TN
08.2010 - 06.2016
- Certified Professional Coder (CPC)-AAPC
Certificatication - Medical Billing And Coding
Chattanooga State Community College
Associate of Business Administration - Business
Chattanooga State Community College
High School Diploma -
Hixson High School
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