LeeAnna E. Demelo
Irwin,PA
Summary
Professional Coding leader with 9+ years of experience, and a strong foundation in medical coding systems, compliance regulations, and healthcare documentation. Adept at ensuring precise and accurate code assignment, optimizing reimbursement processes, and maintaining high standards of data integrity. Known for collaborative teamwork and adaptability in dynamic environments, contributing to team success and achieving organizational goals.
Overview
14
14
years of professional experience
1
1
Certification
Work History
RCM Coding Manager
National Spine and Pain Centers
02.2025 - Current
- Organizes regular team meetings to foster collaboration, share updates on project status, and address any challenges or concerns as they arose.
- Streamlines processes, improving code review efficiency and accuracy.
- Performs coding quality reviews and tracked, trended and managed coding quality performance.
- Established clear performance metrics to monitor progress and drive continuous improvement within the department.
- Facilitates communication between coders, billers, clinicians, and administrative staff for seamless information exchange cross departments.
- Implements ongoing training initiatives to keep staff up-to-date on industry trends and best practices in medical coding.
- Participates in hiring and training coding team.
- Mentors newer coders, fostering skill growth and enhancing team performance.
Certified Medical Coder
National Spine & Pain Centers
05.2017 - 02.2025
- Reviews medical records and interprets documentation to identify correct diagnoses and procedure charges.
- Reviews multiple edits put in place to ensure accuracy of charges being billed.
- Enhances revenue cycle management by identifying under-coded or unbilled services and submitting accurate claims for reimbursement.
- Proficient in reviewing medical policies to ensure medical necessity and billing guidelines are being met.
- Maintains compliance with industry regulations by staying up-to-date on the latest changes in medical coding guidelines.
- Provides education to Medical Providers/Center Managers regarding guideline updates pertaining to different procedures or office visits.
- Assists on provider audits for coding accuracy in EMA.
- Helps to identify template issues within our EMR system, that create billing inaccuracies resulting in denials.
- Reduces claim denials by consistently applying knowledge of payer-specific coding requirements while preparing claims for submission.
Patient Service Representative
Katzen Eye Group
04.2016 - 05.2017
- Obtain prior authorization by submitting paperwork to insurance carriers for eye injections/procedures
- Check in/check out patients as they arrive/depart from their appointments
- Schedule appointments and procedures for patients
- Get authorization and verify eligibility prior to appointments and procedures
- Call patients daily to remind them of upcoming appointments
- Collect money for copayments as well as previous dates of service
- Obtain medical records and take care of patient requests
Business Office Administrator
Advanced Medical Management
10.2015 - 04.2016
- Assisted the Office Director and Assistant Manager in the daily workflow of the business office
- Oversaw more than 50 onsite employees and assisted over 100 employees in our treating offices
- Participated and assisted in the training and support of ICD-10 implementation
- Analyzed and audited productivity/efficiency data from daily logs submitted by employees
- Reviewed, processed, and posted refunds and collections checks
- Payroll review and approved/denied and managed time off requests
- Participated in disciplinary process
- Ordered, received and kept inventory office supplies as well as directly oversaw front receptionist
Surgical Center Billing Specialist
Advanced Medical Management
11.2014 - 10.2015
- Posted charges and payments for the Surgery Center
- Generated and processed billing statements for the Surgery Center
- Handled incoming calls/requests for records, billing, and settlements
- Called insurance companies to dispute claim denials
- Drafted appeals and forwarded them for payment
Quality Assurance Specialist
Advanced Medical Management
10.2013 - 11.2014
- Covered transcription duties such as requests for medical reports and moving reports for different offices
- Reviewed and grammatically corrected medical reports and compared them to posted charges for accuracy
- Corrected inaccurate charges
- Communicated with the treating offices about medical reports, records, and charges
Health Care Access Associate II
Cole Memorial Hospital
07.2011 - 09.2013
- Worked diligently under pressure and in stressful situations within the Emergency Department
- Handled all discharge and admission paperwork for patients.
- Scheduled surgeries and tests and confirmed information with patients, confidentially
- Handled billing processes within the patient access department
- Kept track of patient flow in the Emergency Department
- Handled all Transfers to outside facilities
Education
Bachelor of Science - Speech Pathology and Audiology, Education of Exceptional Individuals
Bloomsburg University of Pennsylvania
Bloomsburg08.2011
Skills
- Certified Professional Coder through AAPC
- Certified Professional Medical Auditor through AAPC
- ICD-10 proficiency
- CPT proficiency
- HIPAA compliance awareness
- Auditing and quality assurance
- Electronic Medical Records
- Claim Scrubbing and Billing
- Medical Terminology
- Payroll
- Proficient in Microsoft programs
- Proficient with Practice Management Software
Certification
- CPC - Certified Professional Coder - 07/2016
- CPMA - Certified Professional Medical Auditor 07/2020
Specializing in
- Medical Coding and Billing
- Medical Auditing
- Business Administration and Management
Timeline
RCM Coding Manager
National Spine and Pain Centers
02.2025 - Current
Certified Medical Coder
National Spine & Pain Centers
05.2017 - 02.2025
Patient Service Representative
Katzen Eye Group
04.2016 - 05.2017
Business Office Administrator
Advanced Medical Management
10.2015 - 04.2016
Surgical Center Billing Specialist
Advanced Medical Management
11.2014 - 10.2015
Quality Assurance Specialist
Advanced Medical Management
10.2013 - 11.2014
Health Care Access Associate II
Cole Memorial Hospital
07.2011 - 09.2013
Bachelor of Science - Speech Pathology and Audiology, Education of Exceptional Individuals
Bloomsburg University of Pennsylvania