Judy Copeland
Greenville,MI
Summary
Experienced Medical Billing & Coding Specialist with 24 years in the healthcare industry. Proficient in medical chart auditing, identifying discrepancies, and ensuring compliance with healthcare regulations. Demonstrated analytical skills and attention to detail in reviewing patient records for accurate coding.
Overview
22
22
years of professional experience
3
3
Certification
Work History
Medical Chart Auditor
Uecker Medical Billing and Coding Consultant
03.2023 - Current
- Enhanced the accuracy of medical records by conducting thorough chart audits and identifying discrepancies.
- Supported clinical departments in achieving accreditation goals through diligent monitoring of documentation practices and timely identification of non-compliance issues.
- Increased overall efficiency of auditing processes by refining audit methodologies and implementing best practices.
- Improved patient care quality by ensuring compliance with regulatory requirements through comprehensive chart audits.
Billing and Follow Up / Coding Payment Resolution Specialist
Trinity Health Network Shared Services
10.2017 - Current
- Handle the tasks of identifying billable claims, correcting and submitting insurance claims.
- Verifying third party insurance on multiple websites.
- Working knowledge in WebDenis, Availity, Optum, NaviNet, Champs, Indiana Medicaid, Delaware Medicaid, Epaces, UHC
- Working knowledge in Cerner, Powerchart, Chartmaxx, Trac, Epic, Athena
- Retrospective review of coding denials for multiple procedures for outpatient facility and professional charges
- Assisted colleagues in navigating challenging situations by sharing expertise and offering guidance when requested or needed.
Outpatient Professional and Facility Coder
Insight Revenue Management LLC
08.2023 - 02.2024
- Code charts for Pain Management, Allergy, Orthopedics, Neurology, Podiatry and Same day surgery
- Work closely with the billing staff on coding denials and educate on coding guidelines
- Provide Education to providers on documentation issues and compliance
- Working knowledge of Meditech and Eclinicalworks
- Applied official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services to assign diagnostic codes.
Billing specialist /Charge entry
Midwifery Matters/ Naturally Simple, LLC
03.2017 - 07.2017
- Responsible for coding and billing out charges that are applicable to the services rendered
- Build fee schedule for charge master
- Perform verification of benefits of upcoming appointments and do estimations of midwifery services based on services patients choose and set up payment plans
- Implement collection processes for self-pay accounts
- Working accounts receivable in practice software program, Athena, and cleaning up balances from 2014, 2015 and 2016
- Posting money to time of services payments, balances and payment plans.
- Performing credentialing process when needed
- Educating clinic staff on HIPPA compliance
- Educating midwifery matters on coding compliance
- Work on any other tasks that are assigned
Billing specialist /Front Desk Receptionist
Cascade Pediatrics, LLC
02.2016 - 03.2017
- Enter charges for visits for dos and any other missed encounters. Check for correct CPT coding and ICD 10 CM coding before entering charges in the bill program.
- Work accounts in AR to resolve issue to bring AR down to current acceptable status set by practice guidelines
- Work front desk checking in patients, checking out patients, scheduling return visits. Assist in billing questions and collect payments and post money from insurance and patients.
- Balance monies at the end of day and take deposits to the bank.
- Work patient accounts for unpaid balances and perform collection processes
- Working knowledge of Office Practicum EHR
- Per diem
Practice Access Specialist/ Charge Entry, Billing Specialist
Sparrow Medical Group (Carson City Hospital Clinic)
09.2003 - 02.2016
- Scheduling appointments for patients in accordance with established procedures.
- Answering the telephone calls in a professional and courteous manner within minimum rings.
- Receiving and conveying messages in writing, electronically and verbally.
- Receiving requests for medication and preparing prescriptions for the signature by the general practitioner.
- Handle responsibilities of reviewing provider charge tickets like dates of service, procedures, diagnosis, patient identification and provider signature for accuracy
- Perform the tasks of returning incomplete charge tickets for correction
- Handle the tasks of identifying billable claims, correcting and submitting insurance claims.
- Responsible for posting payable bills and adjustments in billing databases. Perform the tasks of creating, organizing, updating and maintaining accounts on data spreadsheets by using medical billing software.
- Responsible for assisting patients, carriers, and other concerned parties in areas of insurance payment issues.
- Perform the tasks of assisting in training new staff.
- Perform responsibilities of conducting investigations in case of rejected claims and ensure that the medical facility is correctly billed by using different corresponding codes.
- Comprehensive knowledge of ICD 9 cm coding and CPT coding and familiar with icd-10 cm
- Working knowledge of Allscripts pm, Allscripts EHR and Microsoft word
- Leveraged knowledge of various software platforms to optimize the management of patient information and streamline daily tasks.
Skills
- CPT certification holder
- Experience with HCPCS classification
- Proficient in CMS LCDs
- Knowledge of NCD management
- NCCI Edits proficiency
- Medical record review
- Medical coding
- Teamwork and collaboration
- Attention to detail
- Problem-solving abilities
- Insurance verification
- Microsoft Excel
- EMR systems
- Insurance billing
- 3M encoder
Certification
- At Home Professions, Correspondence Class — Medical Billing and Coding Certification 2000
- American Academy Professional Coders — Certified Professional Coder 2018
- American Academy professional Coders — Certified Outpatient Facility Coder 2021
Affiliations
- AAPC Grand Rapids Local Chapter Board
- Chapter President 2022-2023
- Chapter Treasurer 2019-2021
Timeline
Outpatient Professional and Facility Coder
Insight Revenue Management LLC
08.2023 - 02.2024
Medical Chart Auditor
Uecker Medical Billing and Coding Consultant
03.2023 - Current
Billing and Follow Up / Coding Payment Resolution Specialist
Trinity Health Network Shared Services
10.2017 - Current
Billing specialist /Charge entry
Midwifery Matters/ Naturally Simple, LLC
03.2017 - 07.2017
Billing specialist /Front Desk Receptionist
Cascade Pediatrics, LLC
02.2016 - 03.2017
Practice Access Specialist/ Charge Entry, Billing Specialist
Sparrow Medical Group (Carson City Hospital Clinic)
09.2003 - 02.2016
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