Amanda Miano
Newington
Summary
Experienced with revenue cycle processes, including billing, coding and claims management. Analytical skills to identify and resolve discrepancies efficiently. Track record of effective communication and collaboration to enhance financial performance.
Overview
23
23
years of professional experience
1
1
Certification
Work History
Coding Denials Specialist
Guidehouse
09.2024 - Current
- Responsible for the management of health information systems consistent with the medical, administrative, ethical and legal requirements of the health care delivery system.
- Oversees the maintenance of medical records and the coding of data from medical records.
- Participates in the preparation of reports, provides information and prepares correspondence regarding patient admissions, treatment, discharges and deaths in accordance with departmental policies and legal requirements governing the release of medical information.
- Works collaboratively with providers, other health care professionals and coding team to ensure that clinical information in the medical record is present and accurate so that the appropriate utilization, clinical severity, outcomes and quality is captured for the level of service rendered to each patient, as well as ensuring compliant reimbursement of patient care services.
- Follows detailed instructions for new activities or special assignments
Trinity Health Mount Carmel
02.2021 - 09.2024
Pro-fee Medical coding Auditor
HCCS
06.2018 - 07.2020
- Provide auditing services on for assigned clients and internal coders
- Report findings with detailed comments and corrective measures
- Adhere to deadlines set by HCCS to ensure clients have their results in a timely manner
- Report results of audit findings with corrective measures, guidance and education if needed
Remote-Quality Assurance Auditing Coding Specialist
Meridian Medical Management
08.2015 - 01.2018
- Provide auditing services on internal coding staff and vendor staff including ICD-10 Coding and CPT coding
- Perform daily quality assurance assessments on coding transactions to ensure the proper assignment of codes and modifiers
- Perform monthly quality assurance error reports to report findings and negative trending to operational management and vendors
- Review corrective actions in response to reported errors to determine appropriateness and provide guidance and education to minimize future errors
- Aggregate trends and ensure that operational coding policies, work instructions and directives are being followed
Abstractor at Connecticut Children’s Medical Center
K-force
10.2012 - 08.2015
- Identify records for abstraction by using appointment lists
- Locate data elements within the medical record
- Extract data from the medical record to be entered into the EMR
- Review problem lists, allergies, immunizations, past medical history, past surgical history, past social history for abstraction
HIM Level 2 Outpatient Coding Specialist
St. Francis Hospital
07.2012 - 10.2012
- Pull charts from previous days
- Responsible for the assignment of ICD-9-CM diagnosis/procedure codes, CPT-4 and HCPCS codes for outpatient services rendered
- Knowledge and adherence to coding guidelines, CPT coding conventions and regulatory requirements
- Contribute to the general efficiency of the section and the department
- Diagnosis coding for all Laboratory claims
- Enter charges as they are coded.
- Use 3M encoder to help determine the correct codes.
Surgery and Urology Procedure Room Site Supervisor/Coder
Grove Hill Medical Center
06.2007 - 07.2012
- Supervise a Surgery staff of 5 and a Urology staff of 15
- Prepare time cards
- Approve vacation time
- The staff will come to me with any issues that they have then I will report to the manager of the departments
- Keep track and pay all invoices
- Keep track and make necessary changes to the Dr’s schedules for the office
- Scan charges through our electronic charge posting system
- Keep the electronic encounter forms for each office up to date
- Code all of the hospital op reports for both departments
- Work denials from A/R that have issues they can’t fix
- Assist staff with registration and authorization problems
- Retrieve op notes from various hospitals
- Code op notes using ICD-9 and CPT codes
- Enter global dates into the computer system
- Preauthorize Inpatient, Outpatient and Office surgical procedures
- Scan office/hospital notes into SRS (EMR)
- Work with denials from several insurance carriers
- Work with pre-collection of accounts with high balances
- Assist the office manager with any outstanding balances that are over 90 days old
- Check over, correct and add modifiers to the encounter forms
- Assist office manager with supervision of the Surgery department staff
- Help patients with billing issues
Accounts Receivable Representative/ Coding Assistant
Grove Hill Medical Center
06.2006 - 06.2007
- Follow up and collection of third party monies for Anthem Blue Cross Blue Shield, Cigna, ConnectiCare and Medicaid
- Research, determine and implement appropriate corrective action as required to resolve claim problems in a timely matter
- Provide resolution to patient inquiries regarding their account
- Correct coding errors and write appeals
- Assistant to the manager including, but not limited to excel spreadsheets, training new staff, covering for other members of the staff when there was a staffing shortage.
- Assist with special projects involving specific insurance carriers
- Coordinate meetings with Provider Representatives
Clerical Assistant
Reed & Stefanow Machine Tool Inc.
06.2002 - 06.2006
- Process customers’ orders
- Place material orders
- Filing business documents
- Shipping/Receiving/Invoicing
- Responsible for finished parts inventory control
- Accounts Receivable/Payable
Receptionist
Saporito Chiropractic Office
11.2005 - 04.2006
- Sign Patients in and book appointments
- Enter patients’ billing into the computer
- Enter charges
- File patient documents
- Submit bills to insurance companies
- Verify patients’ insurance
Education
Health Claims Specialist Program
Branford Hall Career Institute
Southington, CT01.2006
Skills
- EPIC
- Medical Manager
- Medical Coding
- Terminology/Anatomy
- Medical Transcription
- Doc Manager
- Health Insurance
- SRS Chart Manager
- Cerner Power Chart
- Epic
- QA database
- White Plume
- Microsoft Office
- Centricity Care link
- Quick Books
- Easy Start
- Outlook Express
- 3M Encoder
- Chart filing
- AAPC coder
- EMR
- SFS
- IDX Groupcast
- Independent Worker
- Multitasking
- Organized
- Dependable
- Fast Paced Worker
- Novell Groupwise
- Vertex Dr
Certification
Certified Professional Coder
Timeline
Coding Denials Specialist
Guidehouse
09.2024 - Current
Trinity Health Mount Carmel
02.2021 - 09.2024
Pro-fee Medical coding Auditor
HCCS
06.2018 - 07.2020
Remote-Quality Assurance Auditing Coding Specialist
Meridian Medical Management
08.2015 - 01.2018
Abstractor at Connecticut Children’s Medical Center
K-force
10.2012 - 08.2015
HIM Level 2 Outpatient Coding Specialist
St. Francis Hospital
07.2012 - 10.2012
Surgery and Urology Procedure Room Site Supervisor/Coder
Grove Hill Medical Center
06.2007 - 07.2012
Accounts Receivable Representative/ Coding Assistant
Grove Hill Medical Center
06.2006 - 06.2007
Receptionist
Saporito Chiropractic Office
11.2005 - 04.2006
Clerical Assistant
Reed & Stefanow Machine Tool Inc.
06.2002 - 06.2006
Health Claims Specialist Program
Branford Hall Career Institute
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