Word
Jennifer Sexton
Rathdrum,ID
Summary
Adept at medical coding and fostering healthcare collaboration, I significantly enhanced coding accuracy and efficiency at Pain Management Of North Idaho. Leveraging expertise in ICD-10 and CPT coding, along with a continuous learning mindset, I streamlined billing processes and improved compliance, demonstrating a strong commitment to organizational growth and patient confidentiality.
Overview
14
14
years of professional experience
1
1
Certification
2
2
years of post-secondary education
Work History
Certified Physician Coder
Pain Management Of North Idaho
Coeur D'Alene, ID
02.2011 - Current
- Coded diagnoses and procedures from patient medical records using ICD-10-CM and CPT-4 codes.
- Applied coding rules established by American Medical Association and Centers for Medicare and Medicaid Services for assignment of procedural codes.
- Researched discrepancies between documentation and billing information in order to resolve any issues prior to submission.
- Assigned additional diagnosis codes based on specific clinical findings (laboratory, radiology and, pathology reports as well as clinical studies) in support of existing diagnoses.
- Reviewed patient records and assigned accurate codes for diagnoses and procedures.
- Collaborated with other departments such as billing, clinical documentation improvement, quality assurance to ensure accurate coding practices are being followed.
- Transmitted information or documents to customers through email, mailings or facsimile machine.
- Maintained updated knowledge of coding requirements, which included continuing education and certification renewal.
- Utilized ICD-10, CPT, and HCPCS coding systems to process claims and billing.
- Supported external audits by providing coded data and documentation as requested.
- Answered questions and fulfilled requests with friendly and knowledgeable service.
- Pulled patient records and transferred information to appropriate parties.
- Reviewed received payments for accuracy and applied to intended patient accounts.
- Analyzed patient accounts for errors, inaccuracies or discrepancies in billing documentation.
- Verified proper coding, sequencing of diagnoses, and accuracy of procedures.
- Participated in coding team meetings to discuss challenges and best practices.
- Performed quality assurance checks on coded data.
- Kept abreast of updates and changes in coding guidelines and reporting requirements.
- Reconciled accounts receivable to ensure accuracy of payments received.
- Responded promptly to requests from insurance companies regarding clarification on claim submissions.
- Collaborated with healthcare providers to verify necessary documentation for coding accuracy.
- Developed an understanding of how various insurance plans process claims for reimbursement purposes.
- Educated healthcare staff on coding standards and changes in coding guidelines.
- Documented and filed patient data and medical records.
Education
Bachelor of Science - Healthcare Administration
Capella University
12-2024
Associate of Science - General Education
North Idaho College
Coeur D'alene, ID 08.2014 - 05.2016
Skills
- Medical coding
- ICD-10 coding
- CPT coding
- Healthcare collaboration
- Data analysis
- Attention to detail
- Billing processes
- Insurance verification
- Documentation review
- HIPAA regulations
- Medical billing procedures
- Continuous learning mindset
- Anatomy and physiology
- Healthcare compliance
- Claims processing experience
- Patient confidentiality practices
- Problem-solving capacity
- Medical coding expertise
- Organizational growth
- ICD-10 proficiency
- Data security procedures
- Medicare insurance regulations
- Records management
- Clinical documentation
- ASC coding
- HIPAA compliance
- Claims processing
- Knowledgeable in AdvancedMD
- Medical billing
- Anatomy
- Medical terminology
- Insurance processing
- Verbal and written communication
- Professionalism
- Patient rights
Certification
- CPC
- CASC
References
References available upon request.
Software
Excel
Powerpoint
AdvancedMD
NextGen
Meditech
Stentor
Epic
Timeline
Associate of Science - General Education
North Idaho College
08.2014 - 05.2016
Certified Physician Coder
Pain Management Of North Idaho
02.2011 - Current
Bachelor of Science - Healthcare Administration
Capella University
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