Katrina Newton
Sugar Hill,Georgia
Summary
Experienced Professional Medical Coder and Billing Specialist with over 12 years of dedicated service in the healthcare industry. Demonstrates exceptional expertise in Evaluation and Management (E/M) level coding, ensuring precise coding and maximizing reimbursement for healthcare providers. Adept at utilizing various coding systems including ICD-10, CPT, and HCPCS. Proven track record in compliance with AMA and CMS guidelines, collaborating effectively with healthcare providers to ensure precise code assignment. Skilled in managing billing processes, maintaining high accuracy rates, and optimizing revenue cycle efficiency.
Overview
10
10
years of professional experience
Work History
Certified Professional Coder
Piedmont Urgent Care by WellStreet
2021.12 - Current
- Code medical records with precision, ensuring accurate assignment of CPT, ICD, and HCPCS codes following AMA and CMS guidelines.
- Collaborate closely with physicians and healthcare providers to clarify diagnoses and procedures for precise code assignment.
- Utilize coding books, manuals, and online encoders effectively to support coding accuracy.
- Maintain strict confidentiality of patient information in adherence to HIPAA guidelines.
- Manage high-volume workload by prioritizing tasks and maintaining attention to detail.
- Ensure coding sequences comply with government and insurance regulations.
- Analyze medical records to identify documentation deficiencies and ensure completeness.
- Serve as a resource and subject matter expert to other coding staff.
- Achieve and maintain a quality accuracy rate of 98%, exceeding production goals and supporting team performance.
Billing Specialist
Piedmont Urgent Care by WellStreet
2018.12 - 2021.12
- Monitored aging accounts, ensuring prompt follow-up to secure payments as per payor contracts.
- Investigated and resolved coding-related denials, facilitating claims reprocessing as needed.
- Addressed insurance-related denials through thorough research, submitting appeals or reconsiderations for reprocessing.
- Collaborated with clinical staff and organizational leadership to implement claim processing updates in compliance with Federal, State, and Local regulations.
- Maintained exceptional quality assurance with 98% accuracy, consistently exceeding productivity goals.
Anesthesia Billing Analyst, Billing Specialist
Jackson Revenue Management
2014.08 - 2018.11
- Perform accurate and timely coding of anesthesia services using CPT, ICD-10, and HCPCS codes. Ensure all codes are compliant with federal and state regulations.
- Submit claims to insurance companies and follow up on unpaid claims to ensure timely reimbursement. Resolve any issues related to claim denials or rejections.
- Enter anesthesia charges into the billing system accurately, ensuring all necessary information is included to prevent claim delays
- Manage patient accounts, including billing, payment posting, and account reconciliation. Respond to patient inquiries regarding billing and payment issues.
- Generate and analyze billing reports to identify trends, discrepancies, and opportunities for improvement. Provide regular updates to management on billing performance and issues.
- Conducted regular account reconciliations to verify invoice accuracy, resulting in reduced disputes and improved cash flow management.
Education
Associate of Science - Healthcare Administration
University of Phoenix
Philadelphia, PA06.2011
Skills
- E/M Level Coding Expertise
- ICD-10, CPT, and HCPCS Coding Proficiency
- Medical Billing and Insurance Claims Processing
- Compliance with Healthcare Regulations
- Proficient in Electronic Health Records (EHR) Systems
- Microsoft Office Suite
Professional Certifications
- American Academy of Professional Coders (AAPC), Member in good standing
- CPC - Certified Professional Coder
- CPMA - Certified Professional Medical Auditor
Timeline
Certified Professional Coder
Piedmont Urgent Care by WellStreet
2021.12 - Current
Billing Specialist
Piedmont Urgent Care by WellStreet
2018.12 - 2021.12
Anesthesia Billing Analyst, Billing Specialist
Jackson Revenue Management
2014.08 - 2018.11
Associate of Science - Healthcare Administration
University of Phoenix
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