Iris Maric
Jacksonville,FL
Summary
Highly skilled and dedicated Quality Assurance Medical Coding and Billing Specialist with 15 years of experience seeking a position in a reputable healthcare facility. Committed to accuracy, efficiency, and compliance, with a strong knowledge of medical coding guidelines and reimbursement processes. Seeking to contribute expertise in medical coding, billing, and revenue cycle management to optimize healthcare operations.
Overview
19
19
years of professional experience
Work History
Senior Coding Specialist
VENTRA Health
Jacksonville, FL
04.2012 - 09.2024
- Daily Quality Assurance audits
- Resolving coding inquiries
- Chart research
- Accurately assign diagnostic and procedural codes using ICD-10-CM, CPT, and HCPCS coding systems for outpatient and inpatient encounters
- Review and analyze medical records to ensure proper coding, documentation, and compliance with reimbursement guidelines
- Resolve coding discrepancies and denials by collaborating with healthcare providers and medical staff
- Conduct coding audits and provide feedback to physicians and coders to improve coding accuracy and optimize revenue cycle management
- Verify and update patient demographic and insurance information, ensuring accurate billing and claims submission
- Prepare and submit electronic and paper claims to insurance companies and follow up on claim status and payment
- Stay updated on industry changes, coding guidelines, and reimbursement regulations to ensure compliance and accurate coding practices
- Collaborate with interdisciplinary teams to develop and implement coding and billing policies and procedures
- Assist in training and mentoring new coding and billing staff members
- Maintain patient confidentiality and adhere to HIPAA regulations throughout the coding and billing processes
Medical Billing and Coding Specialist (QA)
Optimal Billing Solutions
Jacksonville, FL
11.2009 - 04.2012
- Lead and manage a team of 6 facility coders to ensure timely and accurate coding of inpatient and outpatient medical records
- Oversee coding operations, prioritize workloads, and optimize resources to meet productivity and quality targets
- Implement and monitor coding guidelines, procedures, and policies to ensure compliance with relevant coding regulations and industry standards
- Conduct regular coding audits to assess accuracy, identify areas for improvement, and provide feedback and training to coding staff
- Collaborate with clinical and revenue cycle teams to address coding-related issues, resolve denials, and optimize revenue cycle processes
- Act as a subject matter expert in ICD-10, CPT, and HCPCS coding systems, staying updated with the latest coding updates and industry changes
- Maintain a high level of confidentiality and data security in handling sensitive patient information during the coding process
- Implement and monitor performance metrics, reporting on coding accuracy, productivity, and quality to senior management
- Conduct regular performance evaluations, provide constructive feedback, and foster a positive work environment that promotes professional growth
Medical Billing and Coding Specialist
Medical Management Resources of Team Healh
Jacksonville, FL
03.2006 - 10.2009
- Excellent interpersonal and communication skills, both in person and over the phone
- Proficient in managing multi-line phone systems, scheduling appointments, and maintaining patient records
- Strong knowledge of medical terminology and procedures to assist patients with inquiries
- Skilled in handling insurance verification, billing, and processing payments
- Highly organized and capable of managing administrative tasks with precision and attention to detail
- Proficient in using electronic health record (EHR) systems and Microsoft Office Suite
Medical Office Front Desk Clerk
The Pain Center
Orange Park, Florida
09.2006 - 12.2008
- Greeted patients warmly and professionally, ensuring a positive first impression of the facility
- Managed a busy multi-line phone system, answering patient inquiries and directing calls to appropriate staff members
- Scheduled patient appointments and maintained an organized calendar for the healthcare providers
- Verified patients' insurance coverage, collected necessary co-pays, and processed payments accurately
- Assisted with administrative tasks, including filing patient records, updating charts, and maintaining the reception area
- Collaborated with medical staff to ensure smooth patient flow and address urgent patient needs promptly
- Responded to patient inquiries regarding medical procedures, office policies, and general healthcare questions
- Maintained patient confidentiality and adhered to HIPAA guidelines
Education
Medical Insurance and Coding Program - Healthcare
Remington College
Jacksonville, FL03.2007
Skills
- CODING
- CPT
- ICD
- CAMS
- CLAIMS
- ICD-10
- Medical Coding
- ICD-9
- Medical Billing
- Medical Records
- Physiology Knowledge
- Anatomy Knowledge
- Medical Scheduling
- Auditing
- Customer service
- Triage
- Typing
- Word processing
- EMR systems
- Documentation review
Additionalinformation
Microsoft Office Word 2015, Microsoft Office PowerPoint 2015, Microsoft Excel 2015, VeriCode and VeriNet, Appeals for Denied Claims, Insurance Filling and Coding, Meditech Systems, CAMS, ICD-10 and CPT, 87 wpm 98% accuracy
Personal Information
Work Permit: Authorized to work in the US for any employer
Languages
Bosnian
Native or Bilingual
Timeline
Senior Coding Specialist
VENTRA Health
04.2012 - 09.2024
Medical Billing and Coding Specialist (QA)
Optimal Billing Solutions
11.2009 - 04.2012
Medical Office Front Desk Clerk
The Pain Center
09.2006 - 12.2008
Medical Billing and Coding Specialist
Medical Management Resources of Team Healh
03.2006 - 10.2009
Medical Insurance and Coding Program - Healthcare
Remington College