Arlene Garza
Palmetto
Summary
Seasoned Senior Medical Coder with comprehensive background in healthcare coding and billing systems. Skilled at reviewing and analyzing patient records, ensuring accuracy of diagnostic codes, and maintaining compliance with federal regulations. Demonstrated strengths include problem-solving capabilities, advanced knowledge of medical terminology, and ability to streamline process for improved efficiency. Proven track record of improving workflow processes leading to increased productivity within previous roles.
Overview
26
26
years of professional experience
1995
1995
years of post-secondary education
1
1
Certification
Work History
Senior Medical Coder
Optum
Palmetto
01.2017 - Current
- Reviewed medical records for accurate coding compliance and reimbursement standards.
- Collaborated with healthcare providers to clarify documentation requirements and coding guidelines.
- Trained junior coders on coding practices and regulatory updates within the organization.
- Analyzed coding discrepancies to identify trends and recommend process improvements.
- Maintained up-to-date knowledge of ICD-10, CPT, and HCPCS coding systems and rules.
- Conducted audits of coded claims to ensure accuracy and compliance with regulations.
- Reviewed medical records to identify diagnoses, procedures and services rendered for accurate coding.
- Analyzed physician documentation to ensure accuracy of codes assigned in accordance with accepted coding guidelines.
- Provided coding guidance and assistance to physicians, nurses and other staff members.
- Maintained positive working relationship with fellow staff and management.
Billing Specialists/Medical Coding Specialist
MCR Health Services
Bradenton
11.1999 - 01.2017
- Processed customer invoices and billing statements accurately and timely.
- Reviewed and reconciled billing discrepancies with clients and internal teams.
- Managed accounts receivable and followed up on outstanding payments regularly.
- Collaborated with finance teams to ensure compliance with billing policies.
- Provided support to clients regarding billing inquiries and payment options.
- Trained new staff on billing procedures and software usage effectively.
- Answered customer inquiries regarding billings, payments, account status.
- Worked with team members to identify and develop process improvements.
- Investigated incorrect billings and processed refunds as necessary.
- Reviewed medical records to ensure accuracy of billing information and patient data.
- Verified insurance coverage and identified third-party payers for billing purposes.
- Accurately input procedure codes, diagnosis codes and patient information into billing software to generate up-to-date invoices.
- Submitted claims to insurance companies.
Education
Southeast High
Bradenton, FLSkills
- ICD-10 coding
- CPT coding
- HCPCS coding
- Auditing claims
- Risk analysis
- Inpatient coding expertise
- Outpatient coding
Certification
- Certified Professional Coder (CPC), October 2013
- Certified Risk Adjustment Coder(CRC), December 2015
Timeline
Senior Medical Coder
Optum
01.2017 - Current
Billing Specialists/Medical Coding Specialist
MCR Health Services
11.1999 - 01.2017
Southeast High