Danielle Berglund
Portersville,PA
Summary
Results-driven Certified Medical Coder with over 10 years of experience in medical claims coding and clinical documentation review. Proven track record in optimizing reimbursement processes and maintaining compliance with industry standards through continuous education and collaboration with healthcare providers.
Overview
22
22
years of professional experience
1
1
Certification
Work History
Certified Medical Coder
Allegheny Health Network
Pittsburgh, PA
11.2015 - Current
- Review and code medical records for accuracy, ensuring compliance with industry standards.
- Collaborate with healthcare providers to clarify documentation requirements and coding guidelines.
- Analyze coding practices to identify areas for improvement and enhance reimbursement processes.
- Maintain compliance with industry regulations by staying up-to-date on the latest changes in medical coding guidelines and conventions.
- Support continuous improvement initiatives within the coding department by actively participating in team meetings, trainings, and sharing best practices with colleagues.
Patient Information Coordinator
UPMC North Park Women's Health Specialties
Wexford, PA
01.2009 - 11.2015
- Coordinated patient scheduling and managed appointment workflows to enhance operational efficiency.
- Implemented electronic health record updates, ensuring data accuracy and compliance with healthcare regulations.
- Optimized front desk operations by implementing efficient check-in/check-out processes for patients.
- Ensured timely responses to inquiries from healthcare providers, patients, or family members regarding treatment plans or medications.
- Maintained confidentiality by strictly adhering to HIPAA regulations when handling sensitive patient data.
- Supported clinical staff during high-stress periods by taking on additional administrative tasks as needed.
- Increased accuracy of insurance billing by verifying coverage details and promptly addressing discrepancies.
Medical Biller and Coder
North Park OB-GYN
Wexford, PA
03.2004 - 01.2009
- Managed billing processes, ensuring accurate coding and compliance with healthcare regulations.
- Oversaw claims submissions, resolving discrepancies to expedite reimbursement cycles.
- Collaborated with healthcare providers to clarify documentation requirements, optimizing billing accuracy.
- Worked closely with physicians to accurately assign ICD-9 diagnostic CPT procedure codes for optimal reimbursement rates from insurance companies.
- Processed insurance company denials by auditing patient files, researching procedures, and diagnostic codes to determine proper reimbursement.
- Reviewed patient charts to better understand health histories, diagnoses, and treatments.
- Played a pivotal role in maintaining positive cash flow within the organization by ensuring timely submission of clean claims and diligent follow-ups on outstanding payments.
- Contributed to team efficiency by maintaining organized records of patient accounts, billing statements, and payment statuses.
- Collaborated with healthcare providers to ensure accurate documentation, leading to timely reimbursements for services rendered.
- Safeguarded practice revenue by diligently following up on outstanding account balances and initiating collection efforts when necessary.
- Streamlined billing processes by implementing efficient coding practices, resulting in reduced errors and improved revenue generation.
Education
Professional Writing
La Roche
Pittsburgh, PAHigh School Diploma -
Pine Richland High School
Gibsonia PA06-1998
English Literature, History
University of Pittsburgh
Pittsburgh, PACertificate - Medical Coding And Billing
Butler Community College
Butler, PA05-2006
Skills
- Medical claims coding
- CPT coding
- Diagnostic coding accuracy
- Clinical documentation review
- Denial management strategies
- Continuing education commitment
- Medical terminology
- HIPAA compliance awareness
Certification
- CPC - Certified Professional Coder
Timeline
Certified Medical Coder
Allegheny Health Network
11.2015 - Current
Patient Information Coordinator
UPMC North Park Women's Health Specialties
01.2009 - 11.2015
Medical Biller and Coder
North Park OB-GYN
03.2004 - 01.2009
Professional Writing
La Roche
High School Diploma -
Pine Richland High School
English Literature, History
University of Pittsburgh
Certificate - Medical Coding And Billing
Butler Community College