Holly Buchanan
Benton,Missouri
Summary
Seasoned professional with over 20 years of extensive experience in the coding and billing radiology field. Demonstrated track record of reliability, dedication, and strong work ethic. Proven ability to solve complex problems efficiently and take initiative to drive process improvements. Committed to staying current with industry trends and regulations through continuous learning and professional development initiatives.
Overview
19
19
years of professional experience
1
1
Certification
Work History
Senior Diagnostic Coder
Advocate RCM
08.2022 - Current
- Perform quality assurance audits on internal coders, clients, and procedures to improve accuracy and reduce risk of claims denials, compliance issues and revenue loss
- Present audit findings and recommendations to senior management, facilitating informed decision-making and proactive risk management strategies
- Ensure compliance with medical coding policies and guidelines to avoid costly penalties
- Communicate with Clients and Physicians to address documentation issues and provide feedback on areas needing improvement to improve patient care
Coding Accounts Receivable Analyst
Zotec Partners
05.2018 - 07.2022
- Resolve denials related to coding issues, resubmitting with corrected coding as necessary
- Track billing process and identify areas of inefficiency and errors in claims submission and payment, communicating to management
- Research insurance policies and procedures, including LCD and NCD policies, to ensure claims are paid properly.
Coding Specialist
Cape Radiology Group
06.2016 - 04.2018
- Reviewed radiology reports to appropriately assign CPT, ICD-10, and HCPCS codes
- Researched documentation to relate to insurance guidelines to optimize billing and reimbursement
- Queried physicians regarding documentation issues to ensure correct documentation
- Posted patient and insurance payments and performed records reconciliation to support correct internal billing processes, along with balancing and closing payment batches daily
- Created reporting for aging accounts of Worker’s Compensation claims, reducing accounts receivable
- Resolved patient inquiries regarding billing issues, applying knowledge of Medicaid claims as needed
- Completed claim audits for governmental and commercial insurance, resubmitting to optimize payment.
Accounts Receivable/Payment posting specialist
Cape Radiology Group
05.2007 - 05.2016
- Reviewed radiology reports to appropriately assign CPT, ICD-10, and HCPCS codes
- Researched documentation to relate to insurance guidelines to optimize billing and reimbursement
- Queried physicians regarding documentation issues to ensure correct documentation
- Posted patient and insurance payments and performed records reconciliation to support correct internal billing processes, along with balancing and closing payment batches daily
- Created reporting for aging accounts of Worker’s Compensation claims, reducing accounts receivable
- Resolved patient inquiries regarding billing issues, applying knowledge of Medicaid claims as needed
- Completed claim audits for governmental and commercial insurance, resubmitting to optimize payment.
Collections Representative
Cape Radiology Group
06.2005 - 05.2007
- Reviewed radiology reports to appropriately assign CPT, ICD-10, and HCPCS codes
- Researched documentation to relate to insurance guidelines to optimize billing and reimbursement
- Queried physicians regarding documentation issues to ensure correct documentation
- Posted patient and insurance payments and performed records reconciliation to support correct internal billing processes, along with balancing and closing payment batches daily
- Created reporting for aging accounts of Worker’s Compensation claims, reducing accounts receivable
- Resolved patient inquiries regarding billing issues, applying knowledge of Medicaid claims as needed
- Completed claim audits for governmental and commercial insurance, resubmitting to optimize payment.
Education
Associate of Applied Science degree - Business Management and Computer Specialist
Metro Business College
Skills
- CPT/ICD 10-CM
- HCPCS
- Anatomy/Physiology
- Medical Terminology
- Payment posting/billing knowledge
- Excellent analytical skills
- Keen eye for detail
- Auditing and Quality Assurance
Certification
Radiology Certified Coder, RCC
Timeline
Senior Diagnostic Coder
Advocate RCM
08.2022 - Current
Coding Accounts Receivable Analyst
Zotec Partners
05.2018 - 07.2022
Coding Specialist
Cape Radiology Group
06.2016 - 04.2018
Accounts Receivable/Payment posting specialist
Cape Radiology Group
05.2007 - 05.2016
Collections Representative
Cape Radiology Group
06.2005 - 05.2007
Associate of Applied Science degree - Business Management and Computer Specialist
Metro Business College
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