Alicia Grimes
Ewing,KY
Summary
Knowledgeable medical office professional talented at correcting and resubmitting claims, preparing patient charts and reviewing health records to identify proper diagnosis codes for billing. Offers background in reviewing, analyzing and managing medical record information to obtain prior authorizations from insurance companies and ensure payment.
Overview
3
3
years of professional experience
Work History
Medical Biller and Coder
Primary Plus
09.2023 - Current
- Correctly coded and billed medical claims
- Reduced claim denials through meticulous verification of patient eligibility and coverage benefits prior to claim submission.
- Worked closely with physicians to accurately assign ICD-10 diagnostic codes for optimal reimbursement rates from insurance companies.
- Reviewed patient charts to better understand health histories, diagnoses, and treatments.
- Resourcefully used various coding books, procedure manuals, and on-line encoders.
Medical Records Clerk
Lexington Pain Clinic
03.2023 - 09.2023
- Ensured HIPAA compliance by adhering to strict confidentiality guidelines when handling sensitive patient information.
- Maintained confidentiality of all medical records and sensitive information to comply with HIPAA regulations.
- Processed medical records requests from outside providers according to facility, state, and federal law.
- Scanned medical records in digital format for easy retrieval and accessibility.
Compliance Advocate
Nesco Resource
03.2021 - 03.2023
- Spearheaded efforts to achieve full compliance with all applicable laws and regulations, resulting in successful audits and minimal fines or penalties.
- Managed regular internal audits to assess overall compliance health within the organization, addressing any deficiencies promptly and effectively.
- Enhanced regulatory compliance by implementing targeted training programs and monitoring adherence to policies.
- Kept up-to-date on case progress by frequently reviewing records and reporting findings to clients.
Education
Certificate - Medical Billing And Coding
Quality Medical Solutions
Wallingford, KY08.2023
Associate of Arts - Medical Administration
University of Phoenix
Tempe, AZ04.2013
Skills
- HIPAA Compliance
- Payment posting
- Insurance Verification
- ICD-10 Proficiency
Timeline
Medical Biller and Coder
Primary Plus
09.2023 - Current
Medical Records Clerk
Lexington Pain Clinic
03.2023 - 09.2023
Compliance Advocate
Nesco Resource
03.2021 - 03.2023
Certificate - Medical Billing And Coding
Quality Medical Solutions
Associate of Arts - Medical Administration
University of Phoenix
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