Denise M. Rodriguez-Semidey, CPC

• Referral Management: Intake, transcription, scanning, order processing, and assignment; determination of new vs. established patients and visit type (EMG, spine, WC/MVA)
• Patient Coordination: Outbound/inbound calls, voicemail management, demographic verification, new patient scheduling, detailed appointment documentation, NPPW distribution
• Insurance & Authorizations: Eligibility verification, WC/MVA documentation, injection and surgical authorizations, global period entry
• Scheduling & Phone Support: Appointment scheduling, cancellations/reschedules, provider messaging, call routing
• Medical Records & Audits: Records retrieval, documentation review, imaging/referral processing
• Surgical Administration: Consent and booking preparation, calendar management (Epic/Google), charge posting, and surgery tracking spreadsheets.
• Billing & Coding Support: Daily charge entry, surgical charge posting, claims follow-up, denial support
• Workers’ Compensation & Legal: WC prescription coordination, IME/deposition scheduling, legal log maintenance, invoicing, report proofreading
• Office Operations: Front desk support, chart management, supply ordering, scanning, payroll/timecard review, PTO tracking, email monitoring

• Taught Anatomy & Physiology, Medical Terminology, Healthcare Computer Applications, Pathophysiology, ICD-10-CM Coding, CPT Coding, HCPC Coding

• Handling collection calls.
• Claims follow-up for Blue Cross Blue Shield.
• Updated patient demographics.

• Duties involve hospital charge entry, open appointment reconciliation, physician tasking, ICD-10, CPT and HCPCs coding.

• Handling and entry of insurance claims for collection.
• Provided daily, up-to-date collections reporting.
• Responsible for all Blue Cross Blue Shield accounts and reaching out to the client directly regarding provider overpayments and subscriber overpayments.
• Responsible for reassignment of the billing for insurance claims.
• Including verifying accuracy of coding assignment; assigned claims for collection based on billing and coding guidelines.
• Common coding errors included, but were not limited to, age and or gender related coding, E/M level coding, as well as various other coding inaccuracies.
• Common billing errors would include eligibility, authorizations, referrals and timely filing guidelines.

Related coursework: ICD-9, ICD-10, CPT & HCPCs Coding

• Entire Program - Dean's List
• M.A.P Award Recipient
• AAPC CPC Certification
• Student Government MCB Representative
• 4.0 GPA