Accomplished Medical Coder with a proven track record at Memorial Hermann Medical Group, enhancing coding accuracy and reducing claim denials. Expert in HCPCS Coding and adept at fostering teamwork, I've led initiatives that streamlined processes and increased revenue recovery. A comprehensive knowledge in medical terminology and regulatory guidelines ensures compliance and efficiency in coding practices.
Overview
26
26
years of professional experience
1
1
Certification
Work History
Coder II
Memorial Hermann Medical Group
01.2022 - Current
Maintained high coding standards by adhering to industry best practices and staying current with emerging technologies.
Resourcefully used various coding books, procedure manuals, and on-line encoders.
Applied official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services to assign diagnostic codes.
Reviewed patient charts to better understand health histories, diagnoses, and treatments.
Delivered consistent results under pressure by prioritizing tasks effectively during periods of high workload or tight deadlines.
Expedited project completion timelines with strong time management skills and adherence to deadlines.
Senior Medical Coder
White River Orthopaedic Clinic
07.2018 - 12.2021
Reduced claim denials by identifying and addressing common errors in the coding process.
Served as a liaison between coders, physicians, and other clinical staff to ensure accurate information exchange related to diagnosis codes and treatment plans.
Strengthened communication between departments by participating in interdisciplinary team meetings to discuss patient care plans and documentation requirements.
Ensured compliance with industry regulations by staying updated on current coding practices and guidelines.
Collaborated with healthcare providers to retrieve missing documentation for accurate code assignment.
Developed procedures for handling complex cases requiring specialized knowledge or expertise in specific medical coding areas.
Assisted in the development of internal coding policies, promoting consistency across the organization.
Increased revenue recovery through diligent follow-up on outstanding claims and appeals.
Streamlined the coding process for efficiency, resulting in a higher volume of claims processed daily.
Maintained ICD-10 proficiency, leading to more accurate code assignments and fewer claim rejections.
Interacted with physicians and other healthcare staff to ask questions regarding patient services.
Medical Coder
White River Medical Center
01.2008 - 06.2018
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.
Reviewed outpatient records and interpreted documentation to identify diagnoses and procedures.
Correctly coded and billed medical claims for various hospital and nursing facilities.
Maintained a high level of productivity while consistently meeting deadlines for claim submissions.
Ensured compliance with industry regulations and guidelines by staying up-to-date on the latest coding changes.
Medical Coder/Medical Insurance Billing Supervisor
Medical Park Orthopaedic Clinic
02.1999 - 12.2007
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 outpatient records and interpreted documentation to identify diagnoses and procedures.
Maintained a high level of productivity while consistently meeting deadlines for claim submissions.
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 the latest coding changes.
Enhanced team efficiency with regular training sessions on new coding updates and best practices.
Collaborated with physicians to obtain necessary documentation, improving claim approval rates.
Promoted teamwork within the department through effective communication and collaboration on complex cases.
Supported the implementation of electronic health record systems, simplifying the coding process.
Trained and mentored junior coders to support growth and development and apply high-quality coding practices.
Reduced claim denials by maintaining thorough knowledge of payer-specific requirements and guidelines.
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.
Generated reports to identify coding trends and discrepancies.
Communicated with insurance companies to research and resolved coding discrepancies.
Prevented costly fines by ensuring adherence to HIPAA regulations when handling sensitive patient information.
Kept coding team informed of changes in coding standards and healthcare regulations through monthly newsletters.
Conducted comprehensive training sessions for new coders, enhancing team proficiency and coding accuracy.
Education
Some College (No Degree) - Coding/Insurance Billing
Ozarka College
Melbourne, AR
High School Diploma -
Lynn High School
Lynn, AR
05.1991
Skills
Medical Terminology
Anatomy knowledge
HIPAA Compliance
HCPCS Coding
Medical Billing
Teamwork capabilities
Insurance Verification
Clinical Documentation
Regulatory guidelines
Document Management
Procedural Coding
Diagnostic Coding
Training and mentoring
CPC registration
Certification
CPC - Certified Professional Coder
Timeline
Coder II
Memorial Hermann Medical Group
01.2022 - Current
Senior Medical Coder
White River Orthopaedic Clinic
07.2018 - 12.2021
Medical Coder
White River Medical Center
01.2008 - 06.2018
Medical Coder/Medical Insurance Billing Supervisor
Medical Park Orthopaedic Clinic
02.1999 - 12.2007
Some College (No Degree) - Coding/Insurance Billing