D'RESE WERRY, CPC
Meridian,ID
Summary
Specializing in medical billing and coding. Talented at correcting and resubmitting claims, preparing patient charts for registration and reviewing health records to identify proper relationships between procedure and diagnosis codes. Over 27 years of experience in billing recovery, reviewing, analyzing and managing medical record information to identify appropriate coding.
Overview
15
15
years of professional experience
1
1
Certification
Work History
Billing and Coding Account Manager
Practice Pro of Idaho, LLC
07.2018 - Current
- Responsibilities include all insurance billing (paper and electronic), coding (ICD-10, CPT, HCPCS), insurance appeals, research claim denials, account followup and chart auditing, employee training and provider training, credentialing, posting daily charges and payments, collections, answering phones, and handling all billing inquiries
- AIR management
- Experience with all commercial carriers, Medicare and Worker's Comp.
Coder 2
St. Luke's Health System
01.2022 - 04.2023
Responsibilities
- Reviews notations, diagnosis, or procedure information in medical record to assign appropriate diagnosis and procedure codes, ensuring accuracy and appropriateness of codes.
- Applies basic knowledge of coding to solve unique or new cases resulting in the assignment and sequencing of diagnosis and procedure codes related to the following:
- Outpatient non-surgical/interventional procedure coding (ie injection/infusion), charge reconciliation, laboratory, diagnostic radiology, ancillary, Evaluation and Management, office procedures, and emergency department records.
- Inpatient: coding less with charges less than $150,000.
- Ensures documentation supports the level and type of service billed in compliance with billing regulations, provider documentation, procedures and coding guidelines.
- Maintains a thorough understanding of coding classification systems, anatomy and physiology, medical terminology, pharmacology, disease processes, and surgical techniques.
- Maintains compliance with quality and quantity standards along with demonstrated competency coding all types of records as outlined in Coding Policies.
- Other duties and responsibilities as assigned.
Medical Coding and Billing Specialist
Mountain States Hand Clinic
05.2012 - 08.2020
- Responsibilities included all insurance billing (paper and electronic), some coding (ICD-10, CPT, HCPCS), insurance appeals, obtained insurance authorizations/referrals, surgery scheduling, appointment scheduling, filing, reception, posting daily charges and payments, collections, answering phones, and handling all billing inquiries
- Experience with all commercial carriers and Worker's Comp.
Coding Specialist
St. Luke's Health System
08.2010 - 11.2011
- Responsibilities include reviewing charges and codes submitted for data entry to insure codes are in accordance with current principles of ICD9CM, CPT, and HCPCS guidelines HCPCS guidelines
- Receives and reviews billing forms or EMR information from physician making sure coding is appropriate
- Appends necessary modifiers and check for bundling edits
- Identifies patient services that need to be audited
- Enters charges into the billing system
- Interacted with physicians and other healthcare staff to ask questions regarding patient services
- Processed insurance company denials by auditing patient files, researching procedures and diagnostic codes to determine proper reimbursement
- Reviewed patient charts to better understand health histories, diagnoses and treatments
- Verified signatures and checked medical charts for accuracy and completion
- Correctly coded and billed medical claims for various hospital and nursing facilities
- Used various software applications to assign procedure and diagnostic codes to patient records for billing purposes
- Reviewed, analyzed and managed coding of diagnostic and treatment procedures contained in outpatient medical records
- Reviewed outpatient records and interpreted documentation to identify all diagnoses and procedures
- Applied official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services to assign diagnostic codes.
Medical Billing Specialist
Saint Alphonsus Physician Services
04.2009 - 11.2009
- Responsibilities include producing, editing and submitting insurance claims
- Post payments, credit and debit adjustments and data entry
- Follow-up on patient accounts to ensure prompt payment and resolution
- CPT/ICD-9 coding, cashiering, and collections
- Excellent skills in working AIR, coding, and auditing
- Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy
- Maintained and updated collections tracking spreadsheet to help organize payment information
- Printed and reviewed monthly patient aging report and solicited overdue payments
- Located errors and promptly refiled rejected claims
- Communicated effectively and extensively with other departments to resolve claims issues
- Precisely evaluated and verified benefits and eligibility
- Transferred balances to correct payers.
Education
Certificate of Applied Science - Medical Assisting
College Of Southern Idaho
Twin Falls, ID01.1993
Skills
- Coding (ICD-10 proficient)
- Billing systems and software programs (Datapulse, Kareo, Nextgen and Epic)
- AIR management
- Appeals
- Authorizations, and scheduling
- Auditing
- Billing
- Data entry
- Front office
- Research
- Scheduling
- Answering phones
- Employee training
- Billing systems and software
- Records organization and review
- Collection practices
- Accurate payment posting
- Conflict resolution
- Good listening skills
- Organization and Time management
Certification
Certified Professional Coder ( AAPC), 08/2011, AAPC, Salt Lake City, UT
Timeline
Coder 2
St. Luke's Health System
01.2022 - 04.2023
Billing and Coding Account Manager
Practice Pro of Idaho, LLC
07.2018 - Current
Medical Coding and Billing Specialist
Mountain States Hand Clinic
05.2012 - 08.2020
Coding Specialist
St. Luke's Health System
08.2010 - 11.2011
Medical Billing Specialist
Saint Alphonsus Physician Services
04.2009 - 11.2009
Certificate of Applied Science - Medical Assisting
College Of Southern Idaho
Certified Professional Coder ( AAPC), 08/2011, AAPC, Salt Lake City, UT
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