Debbie Boylen
Goldsboro,PA
Summary
Certified Professional Coder with 8 plus years in outpatient and inpatient medical coding. Detail oriented and quality focused professional, with full understanding of ICD-10-CM and CPT coding procedures.
Highly-motivated employee with desire to take on new challenges. Strong work ethic, adaptability, and exceptional interpersonal skills.
Adept at working effectively unsupervised and quickly mastering new skills.
Hands-on professional offering a keen understanding of data confidentiality and HIPAA regulations. Highly trained Medical Coder knowledgeable in AMA and the CMS coding rules.
Overview
7
7
years of professional experience
1
1
Certification
Work History
Professional Coding Specialist II
West Virginia University Medicine
Morgantown , WV
08.2021 - Current
- Utilized Level 1 HCPCS and Level 2 HCPCS systems to complete coding tasks.
- Maintained strict confidentiality with adherence to HIPAA guidelines and regulations.
- Submitted clean claims to insurance companies electronically to secure payments.
- Conducted user training sessions in order to educate staff members on proper use of coding protocols.
- Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements.
- Added modifiers as appropriate, coded narrative diagnoses and verified diagnoses.
- Applied coding rules established by American Medical Association and Centers for Medicare and Medicaid Services for assignment of procedural codes.
- Maintained updated knowledge of coding requirements, which included continuing education and certification renewal.
- Maintained high accuracy rate on daily production of completed reviews.
- Quickly responded to staff and client inquiries regarding CPT codes.
- Maintained positive working relationship with fellow staff and management.
- Mentored junior team members and managed employee relationships.
Medical Coder
Grafton City Hospital
Grafton , WV
09.2016 - 12.2021
- Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements.
- Maintained high accuracy rate on daily production of completed reviews.
- Maintained up-to-date knowledge of coding changes, updates, and new rules.
- Verified proper coding, sequencing of diagnoses and accuracy of surgical procedures.
- Coded diagnoses and procedures from patient medical records using ICD-10-CM and CPT-4 codes.
- Reviewed patient medical records for accuracy, completeness and compliance with coding regulations.
- Applied coding rules established by American Medical Association and Centers for Medicare and Medicaid Services for assignment of procedural codes.
- Maintained updated knowledge of coding requirements, which included continuing education and certification renewal.
- Assigned additional diagnosis codes based on specific clinical findings (laboratory, radiology and, pathology reports as well as clinical studies) in support of existing diagnoses.
- Verified accuracy of procedure codes to ensure proper reimbursement levels.
- Added modifiers as appropriate, coded narrative diagnoses and verified diagnoses.
- Communicated with healthcare personnel, including practitioners to promote accuracy.
- Participated in meetings with physicians, nurses, case managers and other healthcare professionals in order to discuss complex cases or clarify documentation requirements.
- Analyzed data from various sources including electronic health records databases, insurance websites, in order to identify potential errors in the coded data sets.
- Collaborated with other departments such as billing, clinical documentation improvement, quality assurance to ensure accurate coding practices are being followed.
- Researched discrepancies between documentation and billing information in order to resolve any issues prior to submission.
- Provided support for coding queries raised by coders or staff members regarding specific cases or coding issues.
- Educated staff members about new developments related to medical coding practices.
- Maintained positive working relationship with fellow staff and management.
- Compiled and coded patient data using standard classification systems.
Education
Certified Outpatient Coder
AAPC (American Academy of Professional Coders)
Finished Schooling, Need To Schedule Certification11-2023
CPC (Certified Professional Coder)
AAPC (American Academy of Professional Coders)
04-2016
Associate of Science - Medical Assistant
West Virginia Junior College - Morgantown
Morgantown, WV09-1988
High School Diploma -
Grafton High School
Grafton05-1983
Skills
- Clinical processes and procedures as they relate to coding
- Code Optimization
- ICD-10, CPT and HCPCS Coding
- Training and Mentoring
- Coding Error Resolution
- Healthcare Claim Coding
- Medical Terminology
- Workflow Management
- Medical Billing
- HIPAA Compliance
Certification
- Certified Professional Coder
References
References available upon request.
Timeline
Professional Coding Specialist II
West Virginia University Medicine
08.2021 - Current
Medical Coder
Grafton City Hospital
09.2016 - 12.2021
Certified Outpatient Coder
AAPC (American Academy of Professional Coders)
CPC (Certified Professional Coder)
AAPC (American Academy of Professional Coders)
Associate of Science - Medical Assistant
West Virginia Junior College - Morgantown
High School Diploma -
Grafton High School
- Certified Professional Coder
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