Certified coding specialist with 3 years of experience in medical billing and patient account management. Demonstrates proficiency in coding accuracy, healthcare compliance, and claims processing. Adept at collaborating with healthcare providers to ensure precise documentation and resolve coding discrepancies, committed to maintaining the highest standards in medical billing practices.
Overview
3
3
years of professional experience
1
1
Certification
Work History
Billing Manager
Kidney and Hypertension Specialist of Alabama
01.2022 - Current
Maintain a high level of productivity while consistently meeting deadlines for claim submissions.
Review medical records and assigns accurate codes for diagnoses and procedures.
Assigns and sequences codes accurately based on medical record documentation.
Review open AR to evaluate what is needed to collect the outstanding cash.
Understand, locate, and review payer websites and manuals for guidance and resolution.
Provide feedback to physicians and office staff on findings and makes recommendations to coding management for improvement
Assigns or verifies CPT, ICD-10 CM coding and modifiers based upon documentation
Prepared cash flow projections, cost analysis and monthly, quarterly and annual reports.
Medical Biller/Coder
Southern Speciality Physcians
06.2021 - 01.2022
Reviewed and analyzed documentation present in the medical record for inpatient, outpatient and/or professional services to assign diagnoses, procedure(s), and charge codes as described by the physician(s) of record
Communicated with insurance providers to resolve denied claims and resubmitted.
Managed appeals process for denied claims, resulting in successful reimbursements from insurance companies.
Filed and updated patient information and medical records.
accurately and completely coding the medical record for all appropriate ICD-10 CM and ICD-10 PCS codes
Ensured all procedures are captured per Official Coding and Reporting Guidelines to ensure accurate DRG assignment
Stay up to date with coding regulations, guidelines, and changes in Medicaid rules, ensuring compliance with coding and billing requirements
charge capture daily
Education
associates of science - Medical Billing and Coding
associates of science - Ultimate Medical Academy
01.2019
Skills
Advanced of medical terminology, anatomy, and physiology
Advanced computer skills including the use of Microsoft Office, email and exposure or experience with electronic coding systems or applications
Excellent organization and prioritization skills; ability to manage multiple priorities in a stressful, fast-paced work environment
Communicate with insurance companies to ensure that claims are paid; identify and correct account and/or insurance error; and post all actions and maintain permanent record of patient accounts
Oversee claims appeals and reviews; review claims aging status and follow up on open claims
Answer patient questions, inquiries, and concerns regarding their accounts; verify balances and refunds for accuracy
Participate in professional development efforts to stay current with health care best practices and trends
Review and analyze medical records to assign appropriate codes using DRG, ICD-9, and ICD-10 coding systems
Collaborate with healthcare providers to clarify documentation and resolve coding discrepancies
Collected and processed charges for physicians
Audited charts to verify all reportable services are captured
Coordinated with coding staff to assign correct ICD and CPT codes, and modifiers according to established guidelines.
Managed monthly charge reconciliations and collaborate with the business office to resolve any coding or billing discrepancies.
Researched, initiated followed-up, and resolved all unpaid or underpaid system debit balances on Medicare insurance claims; includes but is not limited to remit review, calling payer(s) and clinics, rebilling, navigating payer portals, and taking adjustments
Used exceptional organization, written, and verbal communication skills to produce detailed documentation of research and actions taken on claims
Certification
CPC- Certified Professional Coder(AAPC)
Timeline
Billing Manager
Kidney and Hypertension Specialist of Alabama
01.2022 - Current
Medical Biller/Coder
Southern Speciality Physcians
06.2021 - 01.2022
associates of science - Medical Billing and Coding
associates of science - Ultimate Medical Academy
CPC- Certified Professional Coder(AAPC)
Similar Profiles
Alexis KellyAlexis Kelly
Acute Care Nurse Practitioner Student at Diab Agha Kidney And Hypertension ClinicAcute Care Nurse Practitioner Student at Diab Agha Kidney And Hypertension Clinic