Almira Saric
Des Plaines,IL
Summary
Certified Professional Coder (CPC) with over two years of experience in medical coding and more than 16 years in the healthcare field. Proficient in coding patient services, auditing clinical documentation, and ensuring compliance with reimbursement and regulatory standards. Skilled in insurance verification, prior authorizations, and resolving billing issues.Experienced in adjusting claims based on coding discrepancies, such as mutually exclusive codes, medical necessity issues, or timely filing, and ensuring that corrections or appeals are submitted accurately to optimize reimbursement outcomes.
Overview
18
18
years of professional experience
1
1
Certification
Work History
Medical Coding Denial Specialist
Nationwide Credit & Collection, Inc. (NCC)
Oak Brook, IL
09.2022 - Current
- Review and analyze denied claims, ensuring accurate assignment of ICD-10, CPT, and HCPCS codes for physician services.
- Investigate and resolve claim denials using LCDs/NCDs and payer-specific policies.
- Adjust claims based on mutually exclusive codes, medical necessity issues, or timely filing and submit corrections or appeals as needed..
- Train and mentor new staff on coding standards and denial resolution best practices.
- Collaborate with teams to optimize denial resolution processes and improve claim accuracy and appeals.
- Improve reimbursement by correcting coding errors and ensuring compliance with payer requirements.
- Conduct research on payer policies and analyze trends and updates to ensure compliance with industry standards.
- Identify and resolve coding issues, working on special projects with management.
Patient Access Representative
AdvocateAurora Lutheran General
Park Ridge, IL
10.2006 - Current
- Verify insurance eligibility and ensure proper documentation for patient services.
- Assist with billing inquiries and resolve payment-related issues with patients and insurance providers.
- Assign accurate medical codes for proper claim submission and reimbursement.
- Audit and analyze documentation to support accurate diagnosis and procedure coding.
- Collect co-pays and other payments from patients at the time of service.
- Schedule outpatient appointments and manage patient accounts in the EMR system.
- Scan documents into the electronic medical records system and promptly answer phone calls professionally.
Education
Health Information Technology
Oakton Community College
Des Plaines, IL12-2024
Medical Coder And Biller Certification (MCBC) - Health Information Technology
Oakton Community College
Des Plaines, IL12-2021
Skills
- Medical Billing
- Medical Coding
- HIPAA Compliance
- Documentation Review
- Insurance Verification
- Data Entry
- Teamwork and Collaboration
- Problem-Solving
- Time Management
- Analytical Skills
- Software Proficiency: Epic, Cerner, Allegra, Active Fax, CareConnection, Microsoft Office Suite
Certification
- Certified Professional Coder (CPC)
- Medical Coder and Biller Certification (MCBC)
Languages
Croatian
Professional
Affiliations
- Member of AHIMA (American Health Information Management Association), AAPC (American Academy of Professional Coders), and the Honor Roll Society.
.
Accomplishments
- Spirit Awards for outstanding patient service and commitment to excellence.
- Volunteer Team Captain, Patient Access Department, AdvocateAurora Lutheran General Hospital.
Timeline
Medical Coding Denial Specialist
Nationwide Credit & Collection, Inc. (NCC)
09.2022 - Current
Patient Access Representative
AdvocateAurora Lutheran General
10.2006 - Current
- Certified Professional Coder (CPC)
- Medical Coder and Biller Certification (MCBC)
Health Information Technology
Oakton Community College
Medical Coder And Biller Certification (MCBC) - Health Information Technology
Oakton Community College
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