Cynthia Holloway
Certified Medical Coder
Fayetteville,GA
Summary
Performance-oriented individual with a passion for medical coding. Looking to add to your coding environment . Coupled with my vast of knowledge and expertise in the medical revenue cycle industry, I am sure to add value to your team. I am Committed to excellence and looking for a position that allows my keen eye for detail to be put to work. Authorized to work in the US for any employer Knowledgeable medical office 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. 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
16
16
years of professional experience
1
1
Certificate
Work History
Senior Medical Coder
RELI Group, Inc
02.2020 - 05.2023
- Reviewed medical record and translated information into codes to insure claims processing
- Described and identified missing information and submitted forms to insures for reimbursement
- Ensured accuracy and smooth billing
- Liaison between insurance company and patient
- Extracted relevant information from patient records
- Examined documents for missing information
- Assigned CPT, HCPCS, ICD 10-CM and ASA codes
- Also assigned APC and DRG codes.
- Applied official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services to assign diagnostic codes.
- Resourcefully used various coding books, procedure manuals, and on-line encoders.
- Correctly coded and billed medical claims for various hospital and nursing facilities
- Trained and mentored junior coders to support growth and development and apply high-quality coding practices.
Medical Coder
United Health Group, Optum Via CSI Companies
05.2015 - 11.2019
- Reviewed and interpreted medical record documentation to identify pertinent diagnosis and procedure codes using ICD-10, ICD10-CM and CPT codes
- Through knowledge of Medicare and commercial guidelines and coding chronic conditions
- Maintained accuracy and production standards.
- 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
- Monitored changes in coding regulations to provide recommendations for compliance.
Medical Coder
Advantmed LLC
03.2015 - 11.2019
- Reviewed medical charts for compliance with federal coding regulations and guidelines
- Reviewed, developed, and/or modified client procedures, systems, and protocols to achieve and maintain billing requirements and standards
- Possessed great ability to understand logic of standard medical coding
- 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
- Interacted with physicians and other healthcare staff to ask questions regarding patient services
- Correctly coded and billed medical claims for various hospital and nursing facilities
- Verified signatures and checked medical charts for accuracy and completion
Coding Specialist II
Kaiser Permanente
01.2013 - 01.2016
- Reviewed Clinical documentation to extract data and apply appropriate codes for billing, concentrating on, inpatient, outpatient, E/M urgent care, emergency room, pediatrics,infusions, injections and cardiology
- Ability to determine primary diagnosis, commodities, complications,secondary conditional and surgical procedures.
- Reviewed, analyzed, and managed coding of diagnostic and treatment procedures contained in outpatient medical records.
- Reviewed, analyzed, and managed coding of diagnostic and treatment procedures contained in outpatient medical records
- Resourcefully used various coding books, procedure manuals, and on-line encoders
- Performed on-site coding audits to determine accuracy and compliance with coding guidelines
Senior Billing/Coding Analysts
McKesson
03.2007 - 07.2013
- Advanced knowledge of revenue cycle claims and claims processing
- Through knowledge of DRGS, APCS and ICES
- Responsible for investigating rejected claims, making necessary corrections according to payer specifics and coding guidelines and resubmitting within timely filing deadlines
- Maintained 24-48 hour turn around for 50 hospitals.
- Used data entry skills to accurately document and input statements.
- Skilled at working independently and collaboratively while in team environment
- Proven ability to learn quickly and adapt to new situations
- Worked well within team setting, providing support and guidance
- Self-motivated, with a strong sense of personal responsibility
Education
AS - Health Information Technology
DeVry University
Downers Grove, IL07.2013
Associate of Science - Science
Georgia Medical Institute-Dekalb
Atlanta, GA06.2010
Skills
- Diagnosis and CPT coding
- Medical Billing
- Insurance Verification
- HIPAA compliance and regulations
- DRG coding/verification
- Medical collections
Certifications and Licenses
- RHIT
- April 2014 to December 2024
- AHIMA
- Medical Coding Certification
- Pending CCS certification through AHIMA
- Medical Billing — Proficient
- Electronic Medical Records Knowledge — Expert Medical billing — Proficient
- Electronic health records: Best practices — Expert
- Experienced with DRG, APC, and Outpatient Code Editor (OCE)
Accomplishments
- Achieved superior audit results by completing reliable coding with accuracy and efficiency.
Certification
- RHIT - Registered Health Information Technician
- CCS - Certified Coding Specialist (pending 06/16/2023)
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Quote
There is a powerful driving force inside every human being that, once unleashed, can make any vision, dream, or desire a reality.
Tony Robbins
Timeline
Senior Medical Coder
RELI Group, Inc
02.2020 - 05.2023
Medical Coder
United Health Group, Optum Via CSI Companies
05.2015 - 11.2019
Medical Coder
Advantmed LLC
03.2015 - 11.2019
Coding Specialist II
Kaiser Permanente
01.2013 - 01.2016
Senior Billing/Coding Analysts
McKesson
03.2007 - 07.2013
AS - Health Information Technology
DeVry University
Associate of Science - Science
Georgia Medical Institute-Dekalb
- RHIT - Registered Health Information Technician
- CCS - Certified Coding Specialist (pending 06/16/2023)
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