Certified Medical Coder with 8 years providing administrative and patient support in hospital and medical office settings. Advanced knowledge of private insurance processes and codes.
Overview
9
9
years of professional experience
Work History
Coder
Optum
02.2023 - Current
Maintained high coding standards by adhering to industry best practices and staying current with emerging technologies.
Delivered consistent results under pressure by prioritizing tasks effectively during periods of high workload or tight deadlines.
Code selection and auditing for plastic surgery office, all office visits, procedures, ambulatory surgery, and in patient surgeries.
Charge Entry Technician II
Penobscot Community Health Care
03.2021 - 05.2022
Remote position entering charges for a large Federally Qualified Health Center for covid vaccines, office visits and walk in care visits for Penobscot Community Health Center
Applying appropriate modifiers, outreach to providers for missing ICD-10 and CPT codes when needed
Flexibility is crucial for this role due to changing guidelines for covid vaccines/testing and learning the differences between all insurance carriers.
UMAC II
Humana
01.2018 - 05.2020
Remote position working closely with UM nurses responsible for clinical review and determination of hospital and SNF authorizations
This included requesting clinical via phone/fax, attaching clinical faxes and assigning to appropriate nurse for review, creating and sending denial letters, working census reports, notification of approvals/denials, and scheduling peer to peer appointments.
Billing Tech
Northern Light EMMC
04.2016 - 12.2017
Charge entry and reconciliation of charges posted for multiple primary care offices
Attaching modifiers as needed, strong knowledge of coding guidelines required.
Referral Specialist
Health Access Network
10.2014 - 04.2016
Collaborated with healthcare providers to ensure accurate and complete referral information, improving patient care coordination.
Supported healthcare team members by providing detailed patient information for seamless transitions between providers.
Developed strong relationships with external healthcare facilities, fostering a collaborative approach to patient care coordination.
Education
CPC Training Program - Medical Insurance Coding
AAPC
Online
11.2020
Medical Administrative Specialist
Northern Penobscot Tech Region III
Lincoln, ME
06.2007
Skills
Speed Typing
EMR Systems
ICD-10 (International Classification of Disease Systems)