KEIAUNTA ALLEN
Summary
Self-motivated, enthusiastic professional with 14+ years healthcare experience, data entry, and customer service. Sound knowledge and in-depth understanding of patient information management. Detail oriented and highly organized with a strong focus on accuracy and timeliness. Strong interpersonal and communication skills, maintaining effective working relationships with both internal and external stakeholders. Highly familiar with ethical, legal and administrative requirements of the healthcare system.
Overview
14
14
years of professional experience
1
1
Certification
Work History
MRA/HEDIS Chart Compliance and Coding Specialist
PLAZA MEDICAL CENTER, ACQUIRED BY CLAREMEDICA
03.2013 - 07.2023
- Prepared, reviewed, and transmitted claims using EMR system in a timely manner
- Analyzed and reviewed hospital and specialist records for newly diagnosed HCC and diagnosis codes and corresponded with Physicians for review and confirmation
- Analyzed and reviewed medical records for accuracy and completion as required by Insurance, HIPAA, and HEDIS guidelines
- Accurately assigned ICD-10 and CPT codes based on clinical findings
- Performed coding audits and prepared reports documenting results
- Professionally presented audit results to department supervisor, manager, physicians and other related internal and external departments
- Educated Physicians on best documentation practices according to Insurance and HIPAA guidelines
- Reviewed HEDIS Gap reports and closed measures as needed
- Trained new hires
- Performed a variety of general clerical duties, including telephone calls, data entry, completion of forms, and other routine functions
- Data Entry
- Handled all confidential material in appropriate manner
Occupational Therapist Practice, MEDICAL BILLER
PRO NETWORKING PLUS INC
04.2009 - 05.2013
- Managed the billing process for medical and occupational therapy services rendered by healthcare providers
- Accurately documented and assigned appropriate ICD-9 and CPT codes
- Submitted claims to Medicaid /insurance companies in a timely manner
- Claim follow-up on outstanding accounts
- Claim maintenance
- Resolved denial instances
- Achieved maximum reimbursement for services provided
- Inbound/outbound calls
- Other clerical duties as assigned
- Data Entry
- Handled all confidential material in appropriate manner
Education
Medical Insurance Coding
MedVance Institute
Miami, FL03.2009
Blood Borne Pathogens | HIPAA | OSHA | HIV/AIDS | Domestic Violence -
Skills
- Customer Service
- Data Entry
- Auditing
- Medical Records
- Microsoft Office Proficient (Word, Excel, Works, Outlook, Powerpoint)
- HIPAA Compliance
- Document management
- Ability to multitask
- Attention to detail
- Organization
Certification
- NCICS - Insurance and Coding Specialist
- CBCS - Certified Billing and Coding Specialist
- Data Entry
- CPR
Timeline
MRA/HEDIS Chart Compliance and Coding Specialist
PLAZA MEDICAL CENTER, ACQUIRED BY CLAREMEDICA
03.2013 - 07.2023
Occupational Therapist Practice, MEDICAL BILLER
PRO NETWORKING PLUS INC
04.2009 - 05.2013
Medical Insurance Coding
MedVance Institute
Blood Borne Pathogens | HIPAA | OSHA | HIV/AIDS | Domestic Violence -
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