Summary
Overview
Work History
Education
Skills
Affiliations
Timeline
Generic

Claire Mahon

St .Albans,NY

Summary

15 Years of knowledgeable medical billing and coding. Professional talented at correcting and resubmitting claims, preparing patient charts, and reviewing health records to identify proper diagnosis codes for billing. Offers background in reviewing, analyzing, and managing medical record information to obtain prior authorizations from insurance companies and ensure payment.

Overview

14
14
years of professional experience

Work History

  • Demonstrated a high level of initiative and creativity while tackling difficult tasks.

Medical Biller and Coder

Arthur M.Cotliar MD PLLC
08.2007 - 09.2021


  • Performed on-site coding audits to determine accuracy and compliance with coding guidelines.
  • Resourcefully used various coding books, procedure manuals, and on-line encoders.
  • Verified accuracy of patient information in medical records.


  • Interacted with physicians and other healthcare staff to ask questions regarding patient services.
  • Monitored changes in coding regulations to provide recommendations for compliance.
  • Utilized active listening, interpersonal, and telephone etiquette skills when communicating with others.
  • Trained and mentored junior coders to support growth and development and apply high-quality coding practices.
  • Tracked and monitored requests for medical records release.
  • Communicated with insurance companies to research and resolved coding discrepancies.
  • Communicated effectively with staff, patients, and insurance companies by email and telephone.



  • Verified Patient eligibility prior to submitting claims to minimize claim denials.
  • Assist Patients with billing inquiries.
  • Follow up on monthly aging reports.
  • Analyze unpaid claims and explanation of benefits (EOB) to correct and reprocess rejected claims.
  • Processed insurance company denials by auditing patient files, researching procedures, and diagnostic codes to determine proper reimbursement.


  • Used classification manuals to gain additional knowledge of disease and diagnoses processes



  • Correctly coded and billed medical claims for various hospital and nursing facilities.
  • Guarded against fraud and abuse by verifying coded data accurately reflected services provided.
  • Reviewed outpatient records and interpreted documentation to identify diagnoses and procedures.


Education

Medical Billing And Coding Certificate - Medical Billing And Coding

National Health Career Association
Washington, DC
06.2020

GED -

Adult Learning Center
Brooklyn, NY
06.2014

Medical Billing Certificate - Medical Billing

Manhattan Institute
New York, NY
08.2007

Skills

  • ICD-10 (International Classification of Disease Systems)
  • Documentation Oversight
  • Medical Claims Coding
  • Patient Data Identification
  • Medical Billing Code Accuracy
  • Demographic Information
  • Medical Terminology
  • Data Verification
  • Medical Billing and Collections
  • CPT Code Modifiers
  • Reviewing Patient Information
  • Electronic Health Record Applications
  • Diagnostic Codes
  • Data Entry
  • Coding Appeals

Affiliations

American Academy of Professional Coders (AAPC)

Timeline

Medical Biller and Coder

Arthur M.Cotliar MD PLLC
08.2007 - 09.2021

Medical Billing And Coding Certificate - Medical Billing And Coding

National Health Career Association

GED -

Adult Learning Center

Medical Billing Certificate - Medical Billing

Manhattan Institute
Claire Mahon