Alicia Guss
Andover
Summary
Dedicated healthcare professional with extensive experience in medical coding and patient management. Effectively utilized Epic and Encoder Pro to streamline coding processes and enhance accuracy across various specialties, including outpatient and same-day surgery. Committed to resolving patient inquiries and improving billing procedures to support operational excellence.
Overview
19
19
years of professional experience
1
1
Certification
Work History
Medical Receptionist
Park Nicollet
Rogers
10.2024 - Current
- Managed patient appointment bookings and cancellations to optimize scheduling.
- Answered phones and relayed messages from patients to providers and nurses regarding care needs.
- Contacted insurance companies to verify patient coverage, medications, and initiate prior authorization requests.
- Initiated prior authorization requests for necessary treatments
- Coordinated prescription refills to ensure patients received necessary medications.
- Organized and updated patient registries for mammograms and hypertension to enhance health monitoring.
- Checking in pts for appt and lab
- Faxing papers such as forms, referrals...
Coding Specialist
Optum United Health Group
06.2023 - 02.2024
- Accurately coded ENT, GI, and podiatry using proper ICD-10 codes and CPT codes.
- Utilized Encoder Pro to ensure coding precision
- Streamlined coding processes using Epic system
- Sought clarifications from physicians for missing documentation and code adjustments
- Facilitated team communication through Teams discussions
- Completing nonproductive coding time
- Completing and filling out training log
- Filling out timecards with accurate punches
- Following HIPAA policies
Coding Specialist
Revo Health/TCO
10.2021 - 06.2023
- Allscripts
- Encoder Pro
- Ensured accurate orthopedic E/M coding by assigning appropriate ICD 10 and CPT codes based on provider documentation in patient charts.
- Obtained and verified documentation from providers to ensure precise coding.
- Completed coding tasks promptly upon receipt of documentation, facilitating timely processing.
Coding Specialist
Allina Health
09.2013 - 10.2021
- Ensure accurate coding for professional services by assigning Proper ICD-10 dx coding and CPT, HCPCS coding for family practice/OBGYN and Derm while working with 3M encoder based on documentation.
- Reviewed denial cases to identify rejection reasons, facilitating resolution and improving future coding accuracy.
- Offered feedback to providers on documentation changes and additions, ensuring compliance and accuracy in coding.
- Ensures coding wq volumes are within the department goal
- Addressed patient billing inquiries, clarifying charges to enhance understanding and satisfaction.
- Engaged in regular team meetings to share insights and align on departmental goals.
- Utilizes all the resources and tools that are provided within the department to be a successful coder
- Proficient with Microsoft Excel and computers
Certified Nursing Assistant
Mercy Hospital
08.2007 - 09.2013
- Administered direct patient care in a clinical setting
- Provide safe assistance to patients in the activities of daily living
- Responded to patients' needs with respect and kindness to enhance patient experience
- Respond quickly to patients, residents, nurses, and family members
- Utilized Epic Hyperspace for accurate and timely patient charting
- Served as a preceptor to mentor and guide new staff
- Assisted at front desk by answering phones and checking in patients efficiently
Internship
Fairview Southdale Hospital
11.2012 - 12.2012
- Applied CPT coding standards, enhancing reporting accuracy.
- Managed coding for same day surgeries, streamlining billing procedures.
- Ensured emergency coding accuracy, enabling timely billing processes.
- Inpatient/outpatient coding
- Evaluation Management coding (subcategories/categories)
- Review the importance of the revenue cycle
Dietary Aide/Catering Associate
Mercy Hospital
11.2006 - 12.2007
- Monitored patient dietary restrictions to prevent allergic reactions
- Assisted patients in meal selection, ensuring dietary needs were met
- Delivered and arranged patient meal trays for accessibility, facilitating independent dining or appropriate assistance
- Putting together patient meal trays and making sure they have everything on their tray they asked for
- Clean up the kitchen as a team at the end of the day
Education
RHIT/AAS Degree -
Anoka Technical College
Anoka, MN12-2022
ICD 10 training -
Allina Health
Minneapolis, MN03-2014
Medical Billing and Coding Specialist Degree -
Anoka Technical College
Anoka, MN12-2012
Nursing Assistant License/Certificate -
Anoka Technical College
Anoka, MN06-2006
Skills
- Working knowledge of Epic Hyperspace
- Working knowledge of Allscripts
- EPIC charting
- Medical billing and coding
- Medical insurance knowledge
- Insurance verification
- Prior authorization
- Insurance claims
- CPT coding
- Coding accuracy
- Documentation of providers' notes
- Reading patient charts
- Patient registration
- Appointment scheduling
- Patient scheduling
- Medical records management
- Lab documentation
- Scan documentation
- Patient issue resolution
- Provider issue resolution
- Co-payment collection
- Patient callbacks
- Insurance authorizations
- Referral verification
- Medical office procedures
- HIPAA guidelines
- healthcare compliance
- Records management
- Record processing
- Medical charting
- Experienced with 3M Encoder
- Experienced with Encoder Pro
- EMR / EHR
- Proficient in Excel
- Proficient in Microsoft Office
- Multitasking
- Prioritization
- Organizational skills
- Adaptability
- Flexibility
- Team collaboration
- Problem solving
- Account management
- Appointment management
- Confidentiality
- Insurance authorizations
- Consent verification
- Team collaboration
- Appointment management
Certification
- RHIT Ahima 2026
Timeline
Medical Receptionist
Park Nicollet
10.2024 - Current
Coding Specialist
Optum United Health Group
06.2023 - 02.2024
Coding Specialist
Revo Health/TCO
10.2021 - 06.2023
Coding Specialist
Allina Health
09.2013 - 10.2021
Internship
Fairview Southdale Hospital
11.2012 - 12.2012
Certified Nursing Assistant
Mercy Hospital
08.2007 - 09.2013
Dietary Aide/Catering Associate
Mercy Hospital
11.2006 - 12.2007
RHIT/AAS Degree -
Anoka Technical College
ICD 10 training -
Allina Health
Medical Billing and Coding Specialist Degree -
Anoka Technical College
Nursing Assistant License/Certificate -
Anoka Technical College