James Wuest
Boca Raton,US
Summary
Proactive and goal-oriented professional with excellent time management and problem-solving skills. Known for reliability and adaptability, with swift capacity to learn and apply new skills. Committed to leveraging these qualities to drive team success and contribute to organizational growth.
Overview
2
2
years of professional experience
Work History
Medical Coding and Billing Specialist
Be the One Counsleing
11.2024 - Current
- Code and bill telehealth counseling encounters. Submitted claims to both commercial payers and Medicare. Addressed any rejections and denials of these claims and pursue payments from patients for co-pays, deductibles and uncovered treatments.
- Helped clinician get credentialed with various payers.
- Processed insurance company denials by auditing patient files, researching procedures, and diagnostic codes to determine proper reimbursement.
- Attained up-to-date knowledge of coding requirements through continuing education courses and certification renewal.
- Applied official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services to assign diagnostic codes.
- Shepherded revenue cycle from submitting claims, communicating with payers about rejections and denials, Contacting patients for deductible and copays, and sending delinquent accounts to collections
Medical Coding and Billing Specialist
High Desert Psychiatry
04.2023 - Current
- My responsibilities include coding and billing inpatient psychiatric encounters, submitting claims to both commercial payers and Medicare/Medicaid, and diligently addressing any rejections and denials for these claims. I also pursue payments from patients for co-pays, deductibles, and uncovered treatments.
- Maximized productivity through effective time management, prioritizing tasks based on urgency and importance.
- Monitored trends in medical billing denials, implementing corrective actions to prevent future occurrences of similar issues.
- Established positive relationships with insurance companies, facilitating open communication lines for efficient claim processing.
- Developed a comprehensive understanding of ICD-10-CM, CPT, and HCPCS codes to ensure proper use in medical coding assignments.
- Optimized revenue generation through diligent monitoring of denied claims, resubmitting corrected information when needed.
- Provided exceptional customer service to patients, addressing their concerns regarding insurance claims or billing issues with empathy and professionalism.
Education
Bachelor of Science - Information Science, United States
Syracuse University
Medical Billing And Coding
Penn Foster College,
11.2022
Skills
- NHA Certified Billing and Coding Specialist, Current
- Experience with Multiple Practice Management Systems (AdvancedMD, Encompass PowerChart, OpenPractice, Simple Practice)
- CPT, ICD-10, & HCPCS Code Proficiency
- Insurance Verification
- Prior Authorization & Approval Management
- Payment Posting
- Patient Confidentiality
- HIPAA Compliance
- Teamwork and Collaboration
- Medical Record Review
- Experienced Credentialing Specialist
Timeline
Medical Coding and Billing Specialist
Be the One Counsleing
11.2024 - Current
Medical Coding and Billing Specialist
High Desert Psychiatry
04.2023 - Current
Medical Billing And Coding
Penn Foster College,
Bachelor of Science - Information Science, United States
Syracuse University
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