Anita Warner CPC, CPB
Manassas,VA
Summary
Results-focused professional specializing in medical coding and revenue cycle management. Demonstrated track record in minimizing claim denials, maximizing collections, and maintaining strict adherence to healthcare adept at processing payments, reviewing claims, and maintaining billing reports. Expertise in the fields of pharmaceutical (specialty),gynecologic oncology, pediatrics, sleep, and pelvic surgeries, leveraging in-depth knowledge to drive efficiency and accuracy in medical documentation and billing processes. ICD 10 CM, CPT, HCPCS Medical Billing Surgery Coding Payer Policies & Procedures Medical Terminology Coding Error Resolution Project Management Insurance Claims Processing HIPAA/CMS Communication Collaboration Account Receivables
Overview
9
9
years of professional experience
1
1
Language
1
1
Certificate
Work History
Insurance Analyst II
Spectraforce Technologies (AbbVie)
04.2024 - Current
- Consistently achieved first-call resolution rates exceeding 97 %, leading to improved patient satisfaction
- Reduced patient out-of-pocket costs through successful negotiation with insurance companies and utilization of copay assistance programs
- Streamlined the prior authorization process, reducing approval times and enhancing patient access to critical medications
- Developed and delivered training materials for new hires, improving onboarding efficiency and knowledge retention
- Pharmacovigilance: Identify and report potential adverse events to ensure compliance with FDA regulations
- Cross-Functional Collaboration: Liaise with internal and external stakeholders to optimize patient support services and identify process improvements.
Certified Professional Coder – Apprentice
AAPC - Practicode 2.0 Practicum
12.2022 - 12.2023
- Maintained accurate coding practices by performing in-dept analysis on 600 diverse medical records covering fields like E/M, E/D, radiology, orthopedic, and general surgery
- Strengthened the comprehensiveness and precision of records information
- Adhered to established coding rules provided by American Medical Association and Centers for Medicare and Medicaid Services when assigning procedural codes.
Oncology Patient Specialist III
Inova Health Systems (ISCI)
Falls Church, VA
06.2019 - 06.2023
- Provided patient access and administrative support across two hematology oncology and multidisciplinary clinics, supporting 20+ physicians and surgeons
- Delivered exemplary customer service by managing 100-150 daily calls, effectively directing inquiries, and escalating urgent matters to ensure swift resolutions and patient satisfaction
- Coordinated complex Oncology scheduling and insurance verifications, enhancing service delivery within the Cancer Center, and ensuring accurate patient pre-registration
- Supported multiple patient and payer types to ensure billing procedures are followed
- Provided financial counseling to patients, using available tools to maximize reimbursement and support patient services
- Tracked all new patient requests provide monthly statistics and referring patterns.
Medical Billing Specialist
MidAtlantic Gynecologic Oncology DBA Northern Virginia Pelvic Surgery Associates
Fairfax, VA
11.2023 - 03.2023
- Demonstrated expertise in all aspects of medical billing, including abstracting information coding surgical reports, filing claims, resolving refund requests, refiling rejected claims, completing appeals, and rectifying underpayments
- Ensured timely submission of claim forms, adhering to established deadlines, and electronically submitting $15,000 worth of claims to insurance companies daily
- Maintained a 95% accuracy rate in daily production reviews, conducting detailed investigations and corrections of rejected and denied claims to uphold coding standards
- Posted EFTs daily and investigated all zero data RAs
- Collaborated in creating Accounts Receivable policies and procedures related to collections
- Regularly tracked aging report trends to inform strategic decisions by the Practice Administrator.
Scheduling Coordinator / Authorization Specialist
Diamond Home Health Care
Herndon, VA
10.2018 - 05.2019
- Directed eligibility verify standards and authorizations, and billing for home health services, ensuring compliance with HIPAA and regulatory standards, and coordinating over 200 visitor hours weekly
- Optimized staff efficiency by coordinating multidisciplinary schedule for 50+ nurses, strengthening regional office operations
- Worked remotely and independently on assigned tasks from home office
- Accelerated the insurance verification process, effectively doubling the number of verified claims per day
- Achieved 25% reduction in claim denials and recovered over $50,000 in denied claims through detailed claims review and auditing processes.
Medical Receptionist / Insurance Specialist
McLean Pediatrics, Inc.
McLean, VA
07.2017 - 05.2018
- Managed patient scheduling and office procedures in a busy pediatric practice, ensuring on-time registration and resolving billing issues to maintain positive patient relations
- Served as key liaison between patients and insurance companies, verifying accuracy and completeness of documentation to meet insurance requirements
- Reversed denied claims successfully, securing full reimbursement and demonstrating expertise in claims support and resolution.
Office Manager
Dynamic Rehab & Spine, LLC
Chantilly, VA
01.2016 - 10.2016
- Spearheaded staff leadership initiatives to boost operational efficiency and patient care quality, enhancing overall productivity
- Oversaw daily client services for over 50 patients, including check-ins, scheduling, and insurance verifications, ensuring smooth office operations
- Orchestrated the seamless integration of up-to-date CPT coding, leading to a 10% increase in billing accuracy
- Improved collections significantly from insurance and personal injury cases, achieving record highs within first four weeks of tenure.
Education
Bachelor of Science Health Information Management -
Western Governor University
01.2027
Medical Billing and Coding Diploma -
Everest College
01.2013
Skills
- Data privacy initiatives
- Eligibility Determination
- Documentation skills
- Claims history analysis
- Skilled in EPIC, Athena, Salesforce, Centricity
- Proficient in 3M Encoder
- Payer Policies & Procedures
- Insurance plan verification
- Coding Error Resolution
- Project Management
- Background in insurance
- Collaboration
Certification
- Certified Healthcare Access Associate (CHAA), NAHAM
- Certified Professional Coder (CPC), AAPC
- Certified Professional Biller (CPB), AAPC
- Medical Terminology & Anatomy, AAPC
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Timeline
Insurance Analyst II
Spectraforce Technologies (AbbVie)
04.2024 - Current
Medical Billing Specialist
MidAtlantic Gynecologic Oncology DBA Northern Virginia Pelvic Surgery Associates
11.2023 - 03.2023
Certified Professional Coder – Apprentice
AAPC - Practicode 2.0 Practicum
12.2022 - 12.2023
Oncology Patient Specialist III
Inova Health Systems (ISCI)
06.2019 - 06.2023
Scheduling Coordinator / Authorization Specialist
Diamond Home Health Care
10.2018 - 05.2019
Medical Receptionist / Insurance Specialist
McLean Pediatrics, Inc.
07.2017 - 05.2018
Office Manager
Dynamic Rehab & Spine, LLC
01.2016 - 10.2016
Bachelor of Science Health Information Management -
Western Governor University
Medical Billing and Coding Diploma -
Everest College
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