Kelsey Beguhn

• Coding all cardiology, electrophysiology, and interventionist claims and procedures for Trinity IHA.
• Utilizes ICD-10 coding and billing methods to ensure accuracy and adherence to applicable regulations.
• Review medical records to ensure documentation accurately reflects and supports code selections based on ICD-10 coding guidelines.
• Determine proper usage of modifiers when necessary.
• Participate in internal audits. Has maintained a 98% audit rating.
• Interact with physicians and other healthcare professionals to ensure proper diagnosis and treatment codes were used.
• Monitored changes in coding regulations and updated coding systems accordingly.
• Maintain up-to-date knowledge of coding procedures and techniques.
• Reduced claim denials by maintaining up-to-date knowledge of insurance guidelines and coding regulations.
• Experience in Epic and 3M.

● Medical billing specialist for a multi-practice revenue company.

● In charge of payment posting, EDI claim submission, follow-up and coding corrections.

● Quickly identify and resolve medical billing and coding discrepancies.

● Direct communication with provider representatives to ensure claims are being reprocessed and issues are being resolved.

● Ability to work multiple specialties for multiple practices at a time.

● Contact managers and physicians for any documentation issues for coding purposes.

● Correct CPT, modifiers and diagnosis when necessary.

● Answering any patient or insurance inquiries pertaining to assigned accounts.

● Experience in eClinicalWorks, eTHOMAS, Centricity, Epic, ESO and all payer websites

● Medical billing follow up specialist and coder for a high volume ambulance billing company.

● Reviewed all medical documentation to determine medical necessity of ambulance transport and assign appropriate CPT and ICD-10 diagnosis.

● Responsible for all follow up claims for Medicare.

● Responsible for coding logs for other employees to properly correct any claims that were billed or coded incorrectly to ensure proper and timely payment.

● Maintained strong knowledge of basic medical terminology to better understand services and procedures.

● Resubmitted claims after editing or denial to achieve financial targets and reduce outstanding debt.

● Medical billing follow up specialist for a multi-specialty physician group.

● Responsible for following up on claims, calling and collecting money from insurance companies.

● Responsible for all follow up on insurance claims for Molina Healthcare and Blue Cross Complete.

● Inpatient/outpatient coding experience.

● Research and resolve denials and EOB rejections within the standard billing cycle timeframe.

● Correcting CPT codes, diagnosis and modifiers when necessary.

● Correct, appeal or resubmit claims denied by the insurance company.

● Charge entry and payment posting duties