Genesis M. Hairston

• Advanced knowledge of ICD-10 diagnosis coding conventions and requirements
• Knowledge of Quality Coding Program requirements such as Medicare Advantage Coding Program / HCC, as well as medical terminology and abbreviations of disease, illness and injury
• Proficient use of grouper software and / or coding reference books to assign / validate diagnosis codes
• Ability to work independently, as well as be part of group/team settings, including accomplishing multiple tasks without interruptions.
• Demonstrated strong written and verbal communications skills to explain sensitive information clearly and professionally.
• Verified, coded and added modifiers to diagnoses.
• Maintained updated knowledge of coding requirements, through continuing education and certification renewal.
• Coded Observations and Inpatient Professional Services at average rate of [55] per hour.
• Reviewed outpatient records and interpreted documentation to identify diagnoses and procedures.
• Guarded against fraud and abuse by verifying coded data accurately reflected services provided.
• Interacted with physicians and other healthcare staff to ask questions regarding patient services.
• Reviewed, analyzed and managed coding of diagnostic and treatment procedures contained in outpatient medical records.
• Resourcefully used various coding books, procedure manuals and on-line encoders.
• Reviewed patient charts to better understand health histories, diagnoses and treatments.
• Applied official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services to assign diagnostic codes.
• Accurately selected proper descriptive code when more than one anatomical location was indicated.
• Used M CodeRyte & Encoder Pro to assign procedure and diagnostic codes to patient records for billing purposes.
• Performed billing and coding procedures for ambulance, emergency room, impatient and outpatient services.
• Used Epic to input information into computerized patient record system.
• Entered orders into EMR system efficiently and without errors.
• Maintained updated knowledge of coding requirements, through continuing education and certification renewal

• Completes referrals and/or authorizations accurately and consistently with minimal supervision.
• Served clerical role with responsibilities of verifying patient communication-eligibility
• Coordination of benefits
• Determining appropriate coverage for services
• Facilitating insurance authorization submissions for outpatient radiology procedures
• Delegating appeals process for denied services
• Liaison between multiple PPO commercial, and government insurances
• Gathered records pertinent to specific problems, reviewed for completeness and accuracy and attached records to correspondence as necessary.
• Maintained files and controlled records to show correspondence activities.
• Quickly learned new skills and applied them to daily tasks, improving efficiency and productivity.
• Proved successful working within tight deadlines and fast-paced atmosphere.
• Ability to exercise discretion and make independent judgments, seeking review when decisions represent significant departure from established guidelines.
• Ability to maintain composure during challenging interpersonal interactions.
• Active listening skills; including interpersonal skills and telephone communication.
• Organizational skills with attention to detail and follow-up.
• Managed over 100 customer calls per day.
• Actively listened to customers, handled concerns quickly and escalated major issues to supervisor

• Customer Service Multi lined high call volume center
• Outbound calls for physician requested radiology exams
• Management of multi-modality schedules
• Demonstrated exceptional customer service to foster welcoming and professional environment for patients.
• Verified patient's insurance eligibility and benefits coverage through Epic or other insurance verification processes.
• Investigated, triaged and resolved patient issues to encourage positive experience during patient visit.
• Answered over 30 telephone calls per hour to handle rescheduled, missed and reassigned visit requests.
• Scheduled appointments to enter appointment date and time into computerized scheduler.
• Called patient to confirm appointment and prepared paperwork prior to visit to expedite check-in process.
• Inputted accurate patient insurance, billing and payment information in Epic.
• Respected patients by recognizing rights and maintaining confidentiality.
• Verified patient availability during appointment scheduling process to reduce reschedules and cancellations.
• Communicated with primary care offices and insurance companies to obtain authorization.
• Drove proactive patient outreach activities to schedule appointments and follow-up on care and health maintenance.
• Knowledge of medical terminology including varieties of diagnostic tests, surgeries, consultations and procedures.
• Ability to interpret varieties of multi data and instructions, furnished in written, oral, diagram, or schedule form.
• Possess written and verbal communications skills to communicate with fellow team members, supervisors, patients, and other hospital personnel.
• Well-developed time management and organizational skills, including abilities to prioritize assignments and work within standardized policies and procedures to achieve objectives and meet deadlines.
• Work independently, as well as be part of team building, including accomplishing multiple tasks.
• Identify, evaluate and resolve standard problems by selecting appropriate solutions from established options.
• Ensure privacy of each patient’s PHI.
• Build collaborative relationships with peers and other staff members to achieve departmental and corporate

Schedules appointments, and updates Electronic Health record (EHR)

• High call volume center experience
• Determination of appropriate coverage for diagnostic services
• Effective customer service competence
• Basic knowledge of insurance policies and procedures, as well as patient billing.
• Ability to interpret varieties of data and instructions, furnished in written, oral, diagram, or schedule form.
• Possess written and verbal communications skills to communicate with fellow team members, supervisors, patients, and other hospital personnel.
• Well-developed time management and organizational skills, including abilities to prioritize assignments and work within standardized policies and procedures to achieve objectives and meet deadlines.
• Prioritize assignments and work within standardized policies and procedures to achieve objectives and meet deadlines.
• Work independently, as well as be part of team settings, including accomplishing multiple tasks.
• Identify, evaluate and resolve standard problems by selecting appropriate solutions from established options.
• Ensure privacy of each patient’s Protected Health Information (PHI).
• Build collaborate relationships with peers and other staff members to achieve departmental and corporate objectives.
• Received in-bound calls and initiated out-bound daily calls to introduce customers to products and services offered
• Made over 100 phone calls daily to establish first contact with patients

• Verification of patient registration information
• Collection of patient share of costs and co pays
• Documentation of medical history information
• Preparation of examination room
• Vitals assessment and documentation
• Directed patients to exam rooms, fielded questions and prepared for physician examinations.
• Obtained client medical history, medication information, symptoms and allergies.
• Sanitized, restocked and organized exam rooms and medical equipment.
• Collected and documented patient medical information such as blood pressure and weight.
• Performed clerical duties, such as word processing, data entry, answering phones and filing.
• Documented vital signs and health history for patients in clinic and hospital environments.
• Called and faxed pharmacies to submit prescriptions and refills.
• Scheduled appointments, registered patients and distributed sample pharmaceuticals as prescribed.
• Assisted with routine checks and diagnostic testing by collecting and processing specimens.
• Kept medical supplies in sufficient stock by monitoring levels and submitting replenishment orders before depleted.
• Collaborated with medical and administrative personnel to maintain patient-focused, engaging and compassionate environment.
• Obtained pre- and post-treatment vital signs and weight.
• Promoted office efficiency, coordinating charts, completing insurance forms and helping patients with diverse needs.
• Gathered forms and copied insurance cards to collect patient information for billing and insurance filing.
• Tested and recorded blood glucose levels.