Summary
Overview
Work History
Education
Skills
Accomplishments
Additional Information
Affiliations
Software
Certification
Timeline
RegisteredNurse
Holly Winzenburg

Holly Winzenburg

Medical Coder and Billing
Thousand Oaks,CA

Summary

Leadership ability and positive work ethic. Desire for excellence, motivation and results driven. Customer focused, team oriented and professional, excellent people skills. Excellent verbal and written. communication skills. Ability to troubleshoot and problem solve. Ability to handle multiple tasks easily. Detail oriented, conscientious, thorough, and reliable. Demonstrated success in a leadership role in sales and management. Proven exceptional customer service skills. Certified Virtual Assistant. Evaluate the accuracy of provider charges, including dates of service, procedures, level of care, locations, patient identification and provider signature. Assigned additional diagnosis codes based on specific clinical findings (laboratory, radiology and, pathology reports in support of existing diagnoses. Provide administrative support for multiple medical practices. Quickly respond to staff and client inquiries regarding CPT, ICD-10-CM, HCPC and DRG coding. Verify and abstract all medical data to assign appropriate codes for hospital inpatient/out-patient records. Analyze and interpret patient medical and surgical records to determine billable services. Added modifiers as appropriate, coded narrative diagnoses and verified diagnoses. Ensured timely and accurate charge submission through electronic charge capture, including the billing and account receivables (BAR) system and clearing house. Carefully reviewed medical records for accuracy and completion as required by insurance companies. Examined diagnosis codes for accuracy, completeness, specificity and appropriateness according to services rendered. Strictly followed all federal and state guidelines for release of information. Provided administrative support for multiple physicians & mid-level providers. Knowledgeable medical office professional talented at correcting and resubmitting claims, preparing patient charts and reviewing health records to identify proper diagnosis codes for billing. Offers background in reviewing, analyzing and managing medical record information to obtain prior authorizations from insurance companies and ensure payment. Hardworking professional applies official coding conventions and rules established by American Medical Association and Centers for Medicare and Medicaid Services. Confident Medical Coder adheres to data confidentiality and privacy rules in all workflows and promotes dynamic interpersonal skills. Medical Billing and Coding Specialist 7 years providing administrative and patient support in hospital and medical office settings. Advanced knowledge of private insurance processes and codes. Medical Billing and Coding Specialist 7 years providing administrative and patient support in hospital and medical office settings. Disciplined individual skilled in collecting and verifying patient demographic and insurance information and preparing and maintaining medical records. Proficient in using medical terminology and classifying diagnostic procedures, treatments and medications. Dedicated to providing highest quality care to patients.

Overview

6
6
years of professional experience
1
1
Certificate

Work History

Certified Professional Medical Coder / Certified EHR / Trainer

Medical Billing Associates
Thousand Oaks, CA
11.2018 - Current
  • Coding and Billing of Orthopedic Practice and Surgery Centers
  • Coding and Billing of Pediatric Physicians Clinics
  • Coding and Billing of Family Practice / Internal Medicine
  • Coding and Billing of Podiatry
  • Injection therapy coding and billing for Ophthalmology/Pediatric Offices
  • Work with Revenue Cycle Team to maximize reimbursement
  • Claims submissions
  • Appeals and Clearinghouse updates
  • Electronic Health Records training for patient portals for the Physicians’ offices
  • Medical Coding and Billing training to the office staff and coders
  • HCP training and education
  • Work closely with the Board Members for the Revenue Cycle Team to maximize reimbursement
  • Insurance benefit review for patients
  • Contracting and credentialing for the physicians

Medical Coder / Certified EHR

Conejo Valley Practice Management
Newbury Park, CA
10.2021 - 05.2022
  • Coding and Billing for Family Practice and Pediatric Physicians
  • Perform audits on all medical records contained in the office
  • Review for accuracy of the records and quality patient care
  • Claim fixes
  • Inpatient coding - DRG, Injectables
  • Coding of professional medical claims according to medical coding guidelines of ICD 10 CM, CPT, HCPs
  • Work with Revenue Cycle Team to ensure accuracy of billing and coding issues
  • Clearinghouse and Claim submissions.

Coder / Certified EHR

Sansum Clinic
Santa Barbara, CA
02.2018 - 01.2022
  • Coding of professional medical claims according to the appropriate coding guidelines
  • Work together with the entire Revenue Cycle Team to maximize reimbursement
  • Inpatient (DRG) / Outpatient Coding
  • Performed audits of patient medical history in compliance of state law
  • Performs DRG reimbursement, data quality/accuracy, physician services and compliance audits
  • Assist with other audits such as hospital visits, consultations, compliance, charge entry and reimbursement
  • Work closely with the Billing and Accounts Receivable Departments to make sure our claim submissions are clean and accurate
  • Liaison between physicians and Coding Department
  • Specialties are E/M, Family Practice, Internal Medicine, Pediatrics & Dermatology
  • Software EPIC and Encoder Pro

Anthem, Inc
Newbury Park, CA
- 01.2016
  • Anthem is a large, U.S
  • Based Health Insurance Company and the largest member of the BlueCross BlueShield Association
  • Agency Service Rep- Medicare Programs Sales Support October 9, 2013, Working with twenty (20) plus software systems such as aims, adobe, citrix, callcare browser, facets, medco, mainframe, medisys, licensing, certifications, and call tracking
  • Researching benefits related to Medicare, billing, claims, commissions, and application processes
  • XO documenting and facilitating correct information for Senior Brokers
  • Customer service with strong phone experience and follow through
  • Help brokers with credentialing and training with online broker portal support
  • Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA)
  • Ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers, and brokers
  • Ability to maintain attendance to support required quality and quantity of work
  • General knowledge of industry related issues, including Medical Billing and Claims

Education

High School Diploma -

Williston High School
Williston, ND

Health Administration

Santa Barbara City College
Santa Barbara, CA

Certified Medical Coder - Medical Coding

Conejo Adult School
Thousand Oaks, CA

Skills

Social Media, branding, SEO fundamentals, Online Marketing, Certified Virtual Assistantundefined

Accomplishments

  • Compensation $130K - $175K

Additional Information

  • Accomplishments Extensive anatomy/physiology knowledge, Electronic Medical Record (EMR), CPT, HCPCS coding, ICD-10-CM coding, DRG Coding, Surgery coding, PQR, CEHRT, HIPAA compliance, Multiple billing software’s (Athenia, Claimtek,,EPIC, Medisys, Kareo, etc.) Patient-focused care, Strong work ethic, Knowledge of HMOs, Medicare, Maintains strict confidentiality, Patient-oriented, Relationship and team building, Personal and professional integrity, Cultural awareness and sensitivity. Performs inpatient, outpatient and evaluation/management coding audits. Experienced in Medicare Insurance, Property Management, Accounting and Administrative duties handling accounts receivable, accounts payable and reconciliation knowledge. Extensive background in customer service effectively analyzing and resolving problems, in person and over the phone, including strong follow –up.

Affiliations

AAPC - Medical Coding association

NCCT - National Center for Competency testing

BNI - Marketing Consulting Group

Software

EPIC

Microsoft Excel

Microsoft Document

Electronic Health Records

Athenia

Claimtek

Cisco

Certification

Certified Medical Coder

Timeline

Medical Coder / Certified EHR

Conejo Valley Practice Management
10.2021 - 05.2022

Certified Professional Medical Coder / Certified EHR / Trainer

Medical Billing Associates
11.2018 - Current

Coder / Certified EHR

Sansum Clinic
02.2018 - 01.2022

Anthem, Inc
- 01.2016

High School Diploma -

Williston High School

Health Administration

Santa Barbara City College

Certified Medical Coder - Medical Coding

Conejo Adult School
Holly WinzenburgMedical Coder and Billing