Confident Certified Professional Coder adheres to data confidentiality and privacy rules in all workflows and promotes dynamic interpersonal skills. Highly experienced in resolving claim denials and disputes. Proficient in electronic health records/ practice management software of various systems. Skilled in patient and physician interactions, data entry/management and claims processing.
Overview
4
4
years of professional experience
Work History
Medical Coding Specialist
Medix Staffing, Houston Methodist
06.2023 - Current
Worked with team members and providers to code medical observations and professional services.
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.
Communicated with insurance companies to research and resolve coding discrepancies.
Responsible for submitting claims within two day period and having majority submitted by end of month in order to keep up with budget goals.
Reviewed outpatient records and interpreted documentation to identify diagnoses and procedures.
Participated in training webinars and meeting to update self of any changing or existing policies to ensure proper reimbursement.
Medical Coding Specialist
Houston Medical Records, UT Physicians
07.2019 - 06.2023
Daily usage of ICD-10-CM diagnosis and CPT codes for entry in UT billing system, EPIC.
Responsible for establishing accuracy of majority of billed charges.
Specialized in outpatient and inpatient clinical and surgical cardiology services.
Ability to meet quota of at least 100 claims per day.
Experience with accounts receivable and correspondence for pain management practice and UT cardiology.
In charge of submitting appeals and reconsiderations through various payer sites in timely manner.
Proficient in decreasing number of claims in high volume work queue's by certain time frame.
Ability to identify and correct trending patterns if necessary.
Familiar and stays educated with CMS and insurance policy updates, both commercial and private.
Utilizing optum encoder pro/ Medicare novitasphere for LCD verification.
Reviewing and extraction of information from medical records for coding and billing cardiology services.
Responsible for adding and correct use of CPT modifiers.
Communicates effectively with physicians and staff for any follow up needed to bill.
Education
Associate of Science - Licensed Vocational Nurse
Houston Community College
Houston, TX
07.2024
Certified Professional Coder -
American Academy of Professional Coders
Salt Lake City, UT
04.2020
High school diploma -
Elsik High School
Houston, Tx
06.2016
Skills
HIPAA Compliance
IDC-10/CPT
Strong Medical Terminology
Effective communication
E-Clinical Experience
Epic Experience
Athena Experience
Waystar/Zirmed clearinghouse Experience
Timeline
Medical Coding Specialist
Medix Staffing, Houston Methodist
06.2023 - Current
Medical Coding Specialist
Houston Medical Records, UT Physicians
07.2019 - 06.2023
Associate of Science - Licensed Vocational Nurse
Houston Community College
Certified Professional Coder -
American Academy of Professional Coders
High school diploma -
Elsik High School
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