Joan Brock
Willard,OH
Summary
Hands-on professional offering a keen understanding of data confidentiality and HIPAA regulations. Highly trained Medical Coder knowledgeable in AMA and the CMS coding rules.
Overview
10
10
years of professional experience
Work History
Medical Coder
NOMS Healthcare
Sandusky, Ohio
01.2024 - Current
- Validated accuracy of diagnosis codes as well as modifiers used on claims before final submission to payer and insurance companies.
- Verified accuracy of procedure codes to ensure proper reimbursement levels.
- Provided support for coding queries raised by coders or staff members regarding specific cases or coding issues.
- Coded diagnoses and procedures from patient medical records using ICD-10-CM and CPT-4 codes.
- Maintained confidentiality of patient information according to HIPAA regulations.
- Reviewed patient medical records for accuracy, completeness and compliance with coding regulations.
- Researched discrepancies between documentation and billing information in order to resolve any issues prior to submission.
- Performed audits on coded claims to ensure that all required data elements are included for accurate payment processing.
- Collaborated with other departments such as billing, clinical documentation improvement, quality assurance to ensure accurate coding practices are being followed.
- Maintained up-to-date knowledge of coding changes, updates, and new rules.
- Maintained updated knowledge of coding requirements, which included continuing education and certification renewal.
- Read through patient health data, histories, physician diagnoses and treatments to gain understanding for coding purposes.
- Communicated with healthcare personnel, including practitioners to promote accuracy.
- Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements.
- Quickly responded to staff and client inquiries regarding CPT codes.
- Applied coding rules established by American Medical Association and Centers for Medicare and Medicaid Services for assignment of procedural codes.
- Assigned additional diagnosis codes based on specific clinical findings (laboratory, radiology and, pathology reports as well as clinical studies) in support of existing diagnoses.
- Performed quality assurance checks on coded data.
- Verified proper coding, sequencing of diagnoses, and accuracy of procedures.
- Added modifiers as appropriate, coded narrative diagnoses and verified diagnoses.
- Monitored and analyzed coding error trends to improve coding accuracy.
- Kept abreast of updates and changes in coding guidelines and reporting requirements.
- Entered coded data into electronic health record (EHR) systems.
- Educated healthcare staff on coding standards and changes in coding guidelines.
- Coordinated with billing department to clarify billing issues related to coding.
- Resolved coding discrepancies and denials to maximize reimbursement.
- Utilized ICD-10, CPT, and HCPCS coding systems to process claims and billing.
LPN
NOMS Healthcare
Sandusky, OH
06.2014 - Current
- Assisted physicians with patient care by taking vital signs, administering injections and performing other nursing duties.
- Maintained accurate medical records of each patient's health condition.
- Evaluated effectiveness of interventions implemented based on patient responses or feedback from family members.
- Educated staff members regarding infection control protocols or best practices when caring for a particular type of illness or injury.
- Provided emotional support during difficult times such as end-of-life decisions or family disputes over treatment options.
- Coordinated with interdisciplinary team members such as doctors, nurses and social workers to ensure quality patient care was provided.
- Instructed patients and their families about disease prevention, proper nutrition, medication management and other health related topics.
- Interviewed patients to obtain medical history.
- Answered patient and family questions to educate on optimal treatment procedures.
- Communicated concerns regarding patients' status, care and environment to nursing supervisors, clinical care supervisors and case managers.
- Managed inventory levels of medical supplies within the unit ensuring adequate stock is always available.
- Provided direct physical and emotional support to patients and their families.
- Participated in educational programs to keep up-to-date on new developments in nursing practice.
- Performed triage to maximum team productivity and effectiveness.
- Observed strict confidentiality and safeguarded all patient-related information.
- Answered patient calls, identified issues and determined how best to provide assistance within parameters established by facility and supervisor.
- Answered patients' calls to determine how to assist.
- Communicated effectively with patients and loved ones to explain diagnoses, treatment options and procedures.
- Maintained strict patient data procedures to comply with HIPAA laws and prevent information breaches.
- Charted changes in patient conditions and discussed concerns with supervising healthcare provider.
- Educated clients, patients and caregivers on medical diagnoses, treatment options, chronic disease self-management and wound management.
Education
Professional Billing And Coding - Billing And Coding
NOMS Academic Institution
Sandusky, OH06-2024
LPN - Nursing
North Central State College
Mansfield, OH08-2001
Skills
- Document Management
- Qualified pain management coder
- Performance Improvement
- Insurance Verification
- Medical Billing
- Data security procedures
- Workflow Management
- Medical Terminology
- Proficiency in [Software]
- Clinical Documentation
- HIPAA Compliance
- Patient data identification
- Knowledgeable in [Software]
- Data Entry
- Healthcare claim coding
- Data Verification
- [Type] coding
- Medical record security
- Records Management
- Coding Error Resolution
Timeline
Medical Coder
NOMS Healthcare
01.2024 - Current
LPN
NOMS Healthcare
06.2014 - Current
Professional Billing And Coding - Billing And Coding
NOMS Academic Institution
LPN - Nursing
North Central State College