Nastacia Sloan Hutcherson CPC RHIT
Claim Auditor
Lombard,IL
Summary
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 promotes dynamic interpersonal skills.
Overview
3
3
years of professional experience
1
1
Certification
Work History
Claim Auditor
Blue Cross Blue Shield Of Illinois
10.2023 - Current
- Enhanced claim accuracy by meticulously reviewing and auditing claim submissions.
- Streamlined the claims process for increased efficiency through thorough documentation and recordkeeping.
- Reduced claim overpayments with comprehensive analysis of billing discrepancies and adherence to company policies.
- Collaborated with claims adjusters, ensuring proper investigation and resolution of complex cases.
- Supported the implementation of new software programs to enhance claim processing, increasing productivity and reducing errors.
Radiology Reimbursement Analyst
Duly Healthcare
07.2022 - Current
- Reviewed all ICD-10, CPT, and HCPCS charges for entry into the respective systems for providers in clinics, hospitals and out of office procedures
- Provided coding/documentation education to Physicians and Advance Practice Clinicians Demonstrates high attention to detail and uses resources
- Managed denials and work with the billing team to correct claims for resubmission Experience in a provider-based billing method
- Reversed a six-month backlog within 90 days in coding and billing audits, while also improving processes, educating physicians, and resolving long-standing patient complaints.
Pharmacy Technician
Walgreens
11.2021 - Current
- Solving insurance problems with the accuracy of issue and clarity of solution in a timely manner
- Complied with a process that addresses all state and federal guidelines regarding medication and prescriptions including HIPAA.
- Improved patient satisfaction by efficiently processing prescriptions and managing inventory in a timely manner.
- Enhanced pharmacy workflow by assisting pharmacists with medication dispensing, labeling, and packaging.
Medicare Collector
UOC Hospital
03.2021 - 06.2022
- Performed follow up with insurance claims department on unpaid medical accounts
- Successfully negotiated account resolution through full payments, settlements, or partial payments
- Followed-up on claims processing to ensure timely payment, ensure that all patient information is accurately entered in the proper billing or practice management systems
- Worked with all Medicare replacements, Humana PPO and HMO, most commercial Insurance
- Followed-up on claims processing to ensure timely payment
Education
Associate Degree - Registered Health Information Technology
Rasmussen College
Aurora, IL05.2022
Skills
- Well-versed in Compliance and Quality Improvements, Information Technology, legal aspects as they pertain to health records and revenue cycle management
- Knowledgeable in Data Analysis/Management that includes Calculating Healthcare Statistics ICD-10-CM/10- PCS, HCPCS Level I and II codes and CPT coding/modifiers in adherence to coding guidelines
- Skilled in Microsoft Office and Encoder software and Epic system, Next gen EHR application and Medical Insurance plus Billing and Collection
- Accounting Practices
- Payment Analysis
Certification
CPC (AAPC)
RHIT (AHIMA)
CEMC in process(AAPC)
Timeline
Claim Auditor
Blue Cross Blue Shield Of Illinois
10.2023 - Current
Radiology Reimbursement Analyst
Duly Healthcare
07.2022 - Current
Pharmacy Technician
Walgreens
11.2021 - Current
Medicare Collector
UOC Hospital
03.2021 - 06.2022
Associate Degree - Registered Health Information Technology
Rasmussen College
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