CARRIE KLEIS
West Des Moines,IA
Summary
Medical Billing and Coding Specialist with 5 years providing administrative and patient support in hospital and medical office settings. Advanced knowledge of private insurance processes and codes.
Knowledgeable medical office professional talented at correcting and resubmitting claims, preparing patient charts and reviewing health records to identify proper diagnosis codes for billing.
Polished professional manages multiple tasks, utilizes electronic medical record systems, and provides excellent customer service to patients and staff.
Hardworking professional applies official coding conventions and rules established by American Medical Association and Centers for Medicare and Medicaid Services.
Confident Medical Coder adheres to data confidentiality and privacy rules in all workflows and procedures for HIPAA compliance.
Overview
18
18
years of professional experience
Work History
Medical Coder
Iowa Ortho
11.2020 - Current
- Has an 98 - 100 % coding accuracy.
- Increased coding accuracy by diligently reviewing medical documentation and applying appropriate codes.
- Resourcefully used various coding books, procedure manuals, and on-line encoders.
- Reviewed patient charts to better understand health histories, diagnoses, and treatments.
- Applied official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services to assign diagnostic codes.
- Reviewed, analyzed, and managed coding of diagnostic and treatment procedures contained in outpatient medical records.
- Correctly coded and billed medical claims for various hospital and nursing facilities.
- Ensured compliance with industry regulations and guidelines by staying up to date on latest coding changes.
- Collaborated with physicians to obtain necessary documentation, improving claim approval rates.
- Minimized errors by providing ongoing feedback to clinical staff regarding proper documentation practices.
- Reduced claim denials by maintaining thorough knowledge of payer-specific requirements and guidelines.
- Monitored changes in coding regulations to provide recommendations for compliance.
- Expedited claim resolution with insurance companies through clear communication and prompt follow-up actions.
- Verified signatures and checked medical charts for accuracy and completion.
- Prevented costly fines by ensuring adherence to HIPAA regulations when handling sensitive patient information.
- Interacted with physicians and other healthcare staff to ask questions regarding patient services.
Apprentice Coder
Unity Point Health Grinnell
11.2017 - 02.2020
- ked under guidance of experienced professionals to learn trade best practices and techniques.
- Demonstrated eagerness to learn by asking questions and seeking clarification when necessary.
- Enhanced practical skills by assisting experienced professionals in various tasks.
- Learned wide range of simple and complex techniques.
- Observed experienced professionals in action, gaining valuable insights into best practices within field.
- Received constructive feedback from mentors, leading to improved performance and increased knowledge.
- Utilized newly acquired skills by taking on increasingly complex assignments over time.
- Graduated from apprenticeship program with solid foundation in industry-specific knowledge.
Yield Management Supervisor
Health Management Systems
02.2007 - 03.2016
- Process claims recovery for Institutional and Professional claims for Iowa Medicaid Enterprise
- Coordinate Pay & Chase activities for Commercial and Medicare healthcare projects
- Process IRS, IA Workforce Development and Child Support Liens
- Share in leadership of Third-Party Liability and Claim Adjustment Specialists
- Manage and train staff to create, modify and release liens asserted against liable third parties in recovery of medical claims paid by State of Iowa
- Communicate with local and international law firms and insurance carriers regarding status of Mass Tort or personal injury cases.
Verification Specialist
The Palmer Group
08.2006 - 02.2007
- Verify other insurance coverage additions/terminations for Iowa Medicaid members using ECare, OnBase and MMIS systems.
- Lien Recovery Case Worker - Create, modify and release liens asserted in recovery of claims paid from liable third parties
- Take incoming calls and respond to requests in a timely manner
- Review, keyword and follow-up on Onbase queues daily.
Education
Associate of Arts - General Studies
Indian Hills Community College
Centerville, IA05.1995
Skills
- Certified Professional Coder (CPC)
- Medical billing code accuracy
- CPT coding knowledge
- ICD-10 Proficiency
- Regulatory Guidelines Adherence
- Doctor Communication
- Medical Terminology Familiarity
- EMR Systems
- Electronic Health Record Applications
- Hospital Inpatient and Outpatient Records
- HIPAA compliance awareness
- Clinical Documentation Review
- Continuing Education Commitment
- Appeals and Adjustments Handling
Affiliations
- AAPC Membership
Timeline
Medical Coder
Iowa Ortho
11.2020 - Current
Apprentice Coder
Unity Point Health Grinnell
11.2017 - 02.2020
Yield Management Supervisor
Health Management Systems
02.2007 - 03.2016
Verification Specialist
The Palmer Group
08.2006 - 02.2007
Associate of Arts - General Studies
Indian Hills Community College
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