Jennifer Loftin
Burlington,KY
Summary
Certified Professional Coder (CPC) and Certified Professional Medical Auditor (CPMA) with over five years of expertise in OB/GYN coding and auditing. Proven track record in compliance, reimbursement optimization, and minimizing claim denials through accurate code assignment and comprehensive documentation reviews. Skilled in Epic EHR, ICD-10-CM, CPT, and HCPCS Level II coding, adept at interpreting payer guidelines, collaborating with providers, and supporting coding team members.
Overview
13
13
years of professional experience
1
1
Certification
Work History
Specialty Coder 1 OB/GYN
Baptist Health Medical Group
08.2020 - Current
- Conducted regular internal audits of OB/GYN coded encounters to ensure accuracy, adherence to CMS and payer-specific guidelines, and compliance with federal regulations.
- Reviewed provider documentation to validate code selection and identify opportunities for documentation improvement.
- Assigned appropriate ICD-10-CM, CPT, and HCPCS codes for a wide range of OB/GYN services, including high-risk pregnancies, laparoscopic surgeries, hysterectomies, and deliveries.
- Collaborated directly with OB/GYN physicians and clinical staff to clarify documentation and resolve discrepancies, leading to improved coding accuracy and reduced denials.
- Stayed current with evolving guidelines from CMS, ACOG, and commercial payers to ensure consistent compliance and optimal reimbursement.
- Provided ongoing support and mentoring to peer coders on OB/GYN-specific coding questions and complex scenarios.
- Used coding tools such as AAPC’s Codify, AMA resources, and Optum’s EncoderPro to ensure precision in code assignment.
- Maintained internal QA standards, implementing personal auditing practices that improved coding precision and reduced denial rates.
- Participated in departmental initiatives to streamline documentation workflows and improve first-pass claim acceptance.
- Verified documentation completeness, checked signature compliance, and followed up on missing chart elements.
CPC CODER 1 Urgent Care & OccMed
Baptist Health Medical Group
08.2020 - 12.2021
- Conducted regular internal audits of Urgent Care & OccMed coded encounters to ensure accuracy, adherence to CMS and payer-specific guidelines, and compliance with federal regulations.
- Reviewed provider documentation to validate code selection and identify opportunities for documentation improvement.
- Assigned appropriate ICD-10-CM, CPT, and HCPCS codes for a wide range of services, including Worker's Compensation paper claims.
- Collaborated directly with physicians and clinical staff to clarify documentation and resolve discrepancies, leading to improved coding accuracy and reduced denials.
- Stayed current with evolving guidelines from CMS, ACOG, and commercial payers to ensure consistent compliance and optimal reimbursement.
- Provided ongoing support and mentoring to peer coders on Urgent Care and Occupational Medicine specific coding questions and scenarios.
- Used coding tools such as AAPC’s Codify, AMA resources, and Optum’s EncoderPro to ensure precision in code assignment.
- Maintained internal QA standards, implementing personal auditing practices that improved coding precision and reduced denial rates.
- Participated in departmental initiatives to streamline documentation workflows and improve first-pass claim acceptance.
- Verified documentation completeness, checked signature compliance, and followed up on missing chart elements.
Medical Billing Specialist
Paradigm Pain and Spine Consultants
08.2018 - 08.2020
- AAPC-A certified professional coder, processing and submitting claims, assisting in loss prevention through Accounts Receivable, posting payments, disputing unpaid claims, resolving patient account concerns.
- AAPC Certified Professional Coder Apprentice; proficient in navigating ICD10, CPT, and HCPCS coding.
- Generates revenue by creating payment arrangements; collecting accounts; monitoring and pursuing delinquent accounts.
- Enters payments from insurance companies and patients.
- Reviews and submits Commercial, Medicare, Medicaid, Va, Worker’s Compensation, and Auto claims.
- Assists in loss prevention through working accounts receivable.
- Generates and reviews Advanced Beneficiary Notices with patients; seeks consent.
- Disputes claim denials through telephone calls, appeals, and reconsideration request letters with insurance companies.
- HIPAA compliant
- Proficient in the use and navigation of ecw as an Electronic Health Records platform to input billing claims, payments, notes, documentation, etc...
- Maintains work operations by following policies and procedures; reporting compliance issues.
- Maintains quality results by following office protocols and National standards.
- Processes patient payments.
- Schedules patients.
- Opens office and manages phones and incoming patients
- Cover responsibilities of New Patient/Prior Authorization specialist and/or front desk when they are out of the office.
New Patient Coordinator/Prior Authorization Specialist
12.2016 - 08.2018
- Assist prospective patients with getting started at the practice.
- Gather personal information and verify insurance with all patients.
- Work with Humana, Medicaid, Medicare, Anthem, United Healthcare, Blue Cross Blue Shield, Cigna, MedBen and numerous other insurance companies to obtain pre-authorization for pain management treatments and procedures and verify active policies.
- Communicate with patients on their authorizations and/or denials.
- Take patient payments.
- Schedule patients.
- Open office and manage phones and incoming patients.
Licensed Staff & Listings Coordinator / Personal Assistant
HUFF Realty - Mike Parker Team - Florence, KY
01.2016 - 12.2016
- Administrative duties included: managing schedule for owner; researching and preparing documents needed for owner’s listing and buying appointments; preparations and reservations for team events; maintaining weekly meeting minutes, provide agenda and update team after meeting; answering phones, check owner’s voicemail daily, monitor owner’s email; developing and maintaining ongoing “To-Do” list for owner.
- Extensive detail available on request.
Agency Liaison & LTC Specialist
Helping Hands NKY – Florence, KY
05.2015 - 01.2016
- Front person for representing company to the public, selling in-home care services, hiring and managing caregivers.
- Extensive detailed job description available upon request. Responsibilities included: sales, marketing, human resources, LTC research and implementation for patients, management, and administration tasks for a grassroots in-home care company.
Licensed Staff – Homeowner’s Specialist
State Farm Insurance – Florence, KY
12.2012 - 05.2015
- Extensive detail of responsibilities available upon request.
Education
Bachelor of Arts - Communications (Minor in English Composition)
NORTHERN KENTUCKY UNIVERSITY
Highland Heights, KY01.2014
Skills
- Medical Coding Audits (OB/GYN)
- ICD-10-CM, CPT, HCPCS Level II
- Compliance & Regulatory Review
- EHR Systems: Epic
- CMS Guidelines & ACOG Standards
- Claim Denial Reduction
- Documentation Improvement
- Peer Training & Mentorship
- Quality Assurance
- Communication & Collaboration
Affiliations
- AAPC
Certification
AAPC
- CPC - Certified Professional Coder (SEPT 2019)
- CPMA - Certified Professional Medical Auditor (DEC 2022)
- Certified AAPC Instructor: Current - Enrolled (JULY 2025)
Community Service
Elder Maltreatment Alliance participant, 2015-05, 2016-12
Training
- Fred Pryor Seminar – Managing Stress and Emotions, Conflict and Confrontation
- State Farm Bank Bootcamp
- State Farm Life & Health Bootcamp
- State Farm Auto, Fire, and Bank Training
- Computer Program Knowledge and Experience:
- Microsoft Suite including PowerPoint, Word and Excel
- QuickBooks
Timeline
Specialty Coder 1 OB/GYN
Baptist Health Medical Group
08.2020 - Current
CPC CODER 1 Urgent Care & OccMed
Baptist Health Medical Group
08.2020 - 12.2021
Medical Billing Specialist
Paradigm Pain and Spine Consultants
08.2018 - 08.2020
New Patient Coordinator/Prior Authorization Specialist
12.2016 - 08.2018
Licensed Staff & Listings Coordinator / Personal Assistant
HUFF Realty - Mike Parker Team - Florence, KY
01.2016 - 12.2016
Agency Liaison & LTC Specialist
Helping Hands NKY – Florence, KY
05.2015 - 01.2016
Licensed Staff – Homeowner’s Specialist
State Farm Insurance – Florence, KY
12.2012 - 05.2015
Bachelor of Arts - Communications (Minor in English Composition)
NORTHERN KENTUCKY UNIVERSITY
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