Loretta Lee
Jefferson,GA
Summary
Hardworking professional applies official coding conventions and rules established by American Medical Association and Centers for Medicare and Medicaid Services. Confident Medical Coder adheres to data confidentiality and privacy rules in all workflows and promotes dynamic interpersonal skills. Knowledgeable medical office professional talented at correcting and resubmitting claims, preparing patient charts and reviewing health records to identify proper diagnosis codes for billing. Offers background in reviewing, analyzing and managing medical record information to obtain prior authorizations from insurance companies and ensure payment. Medical Billing and Coding Specialist with 25 years providing administrative and patient support in hospital and medical office settings. Advanced knowledge of private insurance processes and codes. Polished professional manages multiple tasks, utilizes electronic medical record systems, and provides excellent customer service to patients and staff. Adheres to medical records policies and procedures to comply with HIPAA regulations. Track record of effectively troubleshooting issues and maintaining patient confidentiality.
Overview
19
19
years of professional experience
Work History
Senior Medical Coder
Athens Orthopedic Clinic
11.2017 - Current
- .Reduced claim denials by identifying and addressing common errors in coding process.
- Established strong relationships with insurance companies, facilitating smoother claim processing and payment negotiations.
- Collaborated with healthcare providers to retrieve missing documentation for accurate code assignment.
- Streamlined coding process for efficiency, resulting in higher volume of claims processed daily.
- Increased revenue recovery through diligent follow-up on outstanding claims and appeals.
- Contributed to quality improvement initiatives by identifying areas for potential enhancement within medical coding department.
- Ensured compliance with industry regulations by staying updated on current coding practices and guidelines.
- Enhanced team productivity by providing ongoing training and support to junior medical coders.
- Provided valuable feedback on coder performance following audits, fostering environment of continuous improvement within team.
- Maintained ICD-10 proficiency, leading to more accurate code assignments and fewer claim rejections.
- Mentored junior team members, helping them to enhance their skills and knowledge in medical coding best practices.
- Assisted in development of internal coding policies, promoting consistency across organization.
- Participated in relevant professional development opportunities to stay abreast of changes in medical coding standards.
- Strengthened communication between departments by participating in interdisciplinary team meetings to discuss patient care plans and documentation requirements.
- Served as liaison between coders, physicians, and other clinical staff to ensure accurate information exchange related to diagnosis codes and treatment plan.
- Optimized billing procedures by working closely with finance department, ensuring timely reimbursement for services rendered.
- Improved medical coding accuracy by conducting thorough reviews and implementing corrective actions.
- Resourcefully used various coding books, procedure manuals, and on-line encoders.
- Improved accuracy of medical coding by thoroughly reviewing patient records and assigning correct codes for diagnoses and procedures.
- Reviewed outpatient records and interpreted documentation to identify diagnoses and procedures.
Secretary
Emory University Orthopedics Department
09.2014 - 11.2017
- Answered multi-line phone system and enthusiastically greeted callers.
- Maintained daily report documents, memos and invoices.
- Scheduled appointments and conducted follow-up calls to clients.
- Handled multiple daily scheduling tasks and provided administrative support for entire department.
- Prepared professional correspondence, including memos, letters, and emails, ensuring accuracy and timeliness.
- Responded to emails and other correspondence to facilitate communication and enhance business processes.
- Managed four executive calendars, scheduling appointments and meetings to optimize time management.
- Provided exceptional customer service by promptly addressing inquiries and resolving issues professionally.
- Contributed to positive work environment by providing support to colleagues when needed in various tasks or projects.
- Promoted positive image of organization through clear communication both internally with colleagues and externally with clients.
Revenue Cycle Specialist
Gwinnett Sports Medicine
08.2005 - 09.2015
- Increased revenue by identifying and resolving billing errors in timely manner.
- Trained new team members on revenue cycle best practices, contributing to more knowledgeable workforce.
- Served as liaison between clinical departments, finance, and administration, ensuring smooth communication for proper revenue cycle management.
- Ensured accurate billing with thorough audits of patient accounts and insurance claims.
- Reached out to insurance companies to verify coverage.
- Contacted responsible parties for past due debts.
- Achieved optimal reimbursement rates by verifying insurance coverage, eligibility, benefits, and authorization prior to service delivery.
- Streamlined revenue cycle process for improved efficiency and faster payment collection.
- Identified and resolved payment issues between patients and providers.
- Assisted patients in understanding complex billing statements, leading to increased trust between patients and healthcare providers.
- Provided regular updates on billing status to upper management through detailed reports.
- Maximized reimbursements by staying current on payer requirements and maintaining strong relationships with insurance providers.
- Balanced and reconciled accounts.
- Managed portfolio of high-risk accounts, effectively reducing bad debt write-offs through proactive communication and negotiation tactic
- Improved cash flow with diligent follow-up on pending claims and appeals processes.
Education
Certificate of Medical Coding - Medical Coding
AAPC
Salt Lake City, UT12.2017
Associate of Applied Science - Computers
DeKalb College
Clarkston, GA06.1978
Skills
- Strong attention to detail
- Medical billing experience
- Decision-making capabilities
- Organizational abilities
- Continuing Education Commitment
- Revenue Cycle Management
- Outpatient Coding Knowledge
- Certified Professional Coder Certification
- Certified Outpatient Coder Certification
- Healthcare Reimbursement Expertise
- Expert ICD-10 coding
- Medical Coding Software Proficiency
Timeline
Senior Medical Coder
Athens Orthopedic Clinic
11.2017 - Current
Secretary
Emory University Orthopedics Department
09.2014 - 11.2017
Revenue Cycle Specialist
Gwinnett Sports Medicine
08.2005 - 09.2015
Certificate of Medical Coding - Medical Coding
AAPC
Associate of Applied Science - Computers
DeKalb College
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