Amanda Bindrum
Broken Arrow,USA
Summary
Detail-oriented and highly skilled Medical Coder with 5 years of experience transforming complex clinical documentation into precise, actionable codes. My expertise in ICD-10-CM, CPT, and HCPCS Level II coding, combined with a deep understanding of medical terminology and anatomy, allows me to ensure optimal accuracy and compliance in every coding task. Adept at navigating EHR systems and utilizing advanced coding software, I excel in enhancing revenue cycle efficiency and reducing claim denials. With a proven track record of conducting thorough audits and staying current with industry regulations, I am committed to delivering high-quality coding solutions that support effective healthcare management and billing processes. My proactive approach to problem-solving and clear communication skills further ensure that all coding challenges are addressed with precision and professionalism.
Overview
1
1
Certification
Work History
Medical Coder and Claims Analyst
E5 Workflow
05.2024 - Current
- Navigated complex disputes with proficiency, achieving a 95% success rate in case resolution and reducing dispute resolution time by 30% through the strategic utilization of analytical tools such as Excel.
- Evaluated and determined Medical Necessity for healthcare services in dispute resolution cases.
- Validated accuracy of diagnosis codes as well as modifiers used on claims before final submission to payer and insurance companies.
- Verified accuracy of procedure codes to ensure proper reimbursement levels.
- Coded diagnoses and procedures from patient medical records using ICD-10-CM and CPT codes.
- Provided support for coding queries raised by coders or staff members regarding specific cases or coding issues.
- Interpreted medical reports to apply appropriate ICD-9, CPT-4 and HCPCS codes.
- Maintained high accuracy rate on daily production of completed reviews.
Medical Coder and Biller
Olympia Neurological Institute
- Successfully orchestrated end to end coding and billing processes, resulting in revenue generation surpassing $500k and ensuring seamless processing of an average of 1500 claims per month based on individual productivity metrics.
- Implemented ICD-10/CM/PCS and CPT codes in physician's documentation for accurate medical record keeping
- Generated approximately 1.5 Million in additional revenue through the successful processing of 152 new patient referrals.
- Conducted in-depth Management Review of audit findings, providing valuable insights for enhancing the organization's dispute resolution process. Increased efficiency by 30% through the utilization of Root Cause Analysis and SWOT Analysis methodologies.
- Preserved $525,000.00 by thoroughly investigating and implementing corrective actions for 150 delayed claims, preventing provider write-offs
- Coded diagnoses and procedures from patient medical records using ICD-10-CM and CPT-4 codes.
- Assigned additional diagnosis codes based on specific clinical findings (laboratory, radiology and, pathology reports as well as clinical studies) in support of existing diagnoses.
- Communicated with healthcare personnel, including practitioners to promote accuracy.
- Managed coding for multiple specialties, ensuring specific codes are accurately applied.
- Resolved coding discrepancies and denials to maximize reimbursement.
Senior Claims Analyst/Medical Biller and Coder
Cigna
- Increased efficiency in coding accuracy and billing procedures by utilizing coding software to assign ICD-10/CM/PCS, CPT, and HCPCS codes based on physician-provided documentation.
- Ensured coded data accuracy and compliance through periodic audits.
- Achieved precise code assignment by meticulously analyzing physician documentation, adhering to accepted coding guidelines.
- Verified and abstracted medical data from records to assign appropriate codes for records.
- Added modifiers as appropriate, coded narrative diagnoses and verified diagnoses.
- Enhanced diagnostic accuracy by applying specific clinical findings to assign additional diagnosis codes supporting existing diagnoses.
- Managed coding for multiple specialties, ensuring specific codes are accurately applied.
Medical Biller and Coder
CVS
- Executed a major cleanup project of Covid-19 tests that denied 150,000 tests being by multiple payers
- Managed the coding and billing of medical claims for multiple hospital and nursing facilities, encompassing emergency and critical care services, and inpatient hospital services, utilizing CPT, ICD-10 CM, and ICD-10 PCS codes with EHR systems to achieve a 40% increase in claims accuracy.
Case Manager/Medical Biller and Coder
Green Country Behavioral
- Collaborated with patients to enhance health and independence, resulting in a 35% increase in patient outcomes. Utilized case management software to create service plans and track progress towards closure.
- Collaborated with medical professionals to coordinate treatment plans for clients.
- Monitored accounts receivable activity to ensure timely payment of invoices.
- Reviewed medical records to ensure accuracy of billing information and patient data.
- Reconciled codes against services rendered.
- Assessed billing statements for correct diagnostic codes and identified problems with coding.
Lead Direct Care Specialist
Laura Dester Children's Shelter | Tulsa
- Billed for all services rendered utilizing ICD-10 CM, CPT, ICD-10 PCS, and HCPCS where Applicable
- Processed case assignments, drafted service plans, reviewed case progress and determined case closure, worked with patients to achieve wellness and autonomy.
Lead Mental Health Technician
Parkside Psychiatric Hospital and Clinic | Tulsa
- Stayed current with cutting-edge industry advancements, honed new skills, and expanded network outreach by actively participating in industry-leading events, global conferences, and specialized seminars
- Enhanced data accuracy by 30% through the implementation of data validation tools and stringent measures across all records and reports
- Oversaw the supervision of all Mental health techs and floor processes throughout the shift using healthcare software to elevate the quality of care and standards.
Education
Oncology Data Specialist Certification
Andrew College
08.2024
Associate of Applied Science Health Information Technician -
Rasmussen University
03.2024
Diploma Medical Billing and Coding -
Penn Foster
02.2021
Skills
- Proficient in multiple EHR systems
- Outpatient Coding
- Data Mining and warehousing
- Quantitative Analysis
- Medical Terminology
- Anatomy & Physiology
- Data Forecasting
- Networking
- Auditing
- Data Analysis
- Clinical Documentation Improvement
- Coding Guidelines
- 5 Years Production Coding Experience
- 12 Years Experience in Healthcare
- UB-04
- CMS 1500
- Ability to work independently
- E/M outpatient and ER
- Teaching Facility
- Reporting
- ICD 10-CM & PCS
- US Health Insurance Portability and Accountability Act
- Coding Practices
- HCC Coding
- Utilization Review
- Regulatory and Compliance Requirements
- Modifier Usage
- HCPCS
- RVU's
Certification
- Certified Coding Associate (CCA), AHIMA, 12/31/23
- Registered Health Information Technician (RHIT), AHIMA, 04/01/24
Timeline
Medical Coder and Claims Analyst
E5 Workflow
05.2024 - Current
Medical Coder and Biller
Olympia Neurological Institute
Senior Claims Analyst/Medical Biller and Coder
Cigna
Medical Biller and Coder
CVS
Case Manager/Medical Biller and Coder
Green Country Behavioral
Lead Direct Care Specialist
Laura Dester Children's Shelter | Tulsa
Lead Mental Health Technician
Parkside Psychiatric Hospital and Clinic | Tulsa
Oncology Data Specialist Certification
Andrew College
Associate of Applied Science Health Information Technician -
Rasmussen University
Diploma Medical Billing and Coding -
Penn Foster
- Certified Coding Associate (CCA), AHIMA, 12/31/23
- Registered Health Information Technician (RHIT), AHIMA, 04/01/24
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