Mariam Memon
Torrance,California
Summary
Medical Billing and Coding Specialist with over 10 years of experience in providing administrative and patient support in hospital and medical office settings. Advanced knowledge of private insurance processes and codes. Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.
Overview
18
18
years of professional experience
1
1
Certification
Work History
Medical Coder
Optum360
09.2022 - Current
- Applied official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services to assign diagnostic codes.
- Resourcefully used various coding books, procedure manuals, and on-line encoders.
- Communicated with insurance companies to research and resolved coding discrepancies.
- Reviewed, analyzed, and managed coding of diagnostic and treatment procedures contained in outpatient medical records.
- Reviewed outpatient records and interpreted documentation to identify diagnoses and procedures.
- Utilized active listening, interpersonal, and telephone etiquette skills when communicating with others.
- Generated reports to identify coding trends and discrepancies.
- Trained and mentored junior coders to support growth and development amd apply high-quality coding practices.
- Assisted in training new coder and audit and review the outcome of the accounts till they hit the accuracy of 95 %.
Medical Record -Coder
Del-Amo Hospital
01.2022 - Current
- Accurately abstracts patient data into the AS-400 computerized data base system in accordance with the department policies and guidelines
- Maintains abstracting of discharged records, enters data accurately into 3M
- Interfaces with the medical staff in order to acquire the required data to complete the interim and final coding of charts
- Demonstrates complete understanding of all procedures concerning sequencing of diagnosis and other abstracting information as outlined in procedure manual and the coding guidelines
- Accurately codes admission, interim and discharge diagnosis in patient medical records and enters codes on face sheet without abbreviation on completion
- Assists in the development and revision of hospital policies and procedures relating to coding and abstracting of discharge records
- Always safeguards and preserves the confidentiality of patient identifiable information in accordance with hospital and departmental policy.
Patient Account Representative
Amplus Group
01.2018 - 01.2020
- Read patients reports thoroughly to determine the correct CPT codes
- Coded medical records for the complete and correct assignment of CPT codes and submitted insurance claims
- Resolved unpaid claims by performing timely follow-up with government, commercial, and third-party payers, gathering needed information by contacting patients, insurance companies, and hospitals
- Verified and entered patient demographics and insurance into the electronic health record system, guaranteeing accuracy and reducing avoidable revenue cycle delays.
Medical Biller, Coder and Trainer/Auditor
American Medical Response, Inc.
01.2009 - 01.2014
- Started as an Insurance Verification Representative and was promoted into medical coding and staff training positions
- Coded ambulance transport records for the complete and correct assignment of CPT and ICD codes, and proper HCC codes for Medicare charts following strict coding guidelines
- Managed ambulance transportation billing, verifying service reports and trip tickets before entering the data into the billing system and generating insurance bills
- Resolved billing and coding errors from weekly and monthly reports, ensuring appropriate reimbursement for services rendered.
Revenue Associate
Pathology, Inc.
01.2007 - 01.2008
- Prepared HCFA-1500 billing forms and submitted them to insurance companies for payment
- Ensured the integrity, completeness, and accuracy of billing records through scanning and archiving patient invoices, payment batches, and Explanation of Benefits forms (EOBs).
Math Tutor
Sylvan Learning Center
01.2006 - 01.2007
- Instructed students in mathematics, managing students, tasks and time to create balanced and robust group sessions for students in first through eighth grades
- Gathered and prepared materials for each session, managing multiple tasks and being flexible with planning when needed.
Education
Southern California Regional Occupational Center
Bachelor of Science - Health Care Administration
California State University, Long Beach
Skills
- Knowledgeable in Cerner, Epic, 3M MS4
- Documentation Oversight
- Medical Record Security
Relevant Skills And Training
- CPT
- ICD-9/10-CM
- HCPCS
- Medical Terminology
- Anatomy & Physiology
- Coding Guidelines
- HIPAA Policies
- Modifiers
- Coding Payment Policies
- NCD and LCD Edits
- NCCI Edits
- CMS-1500 Form
- Medical Billing
- Compliance
- Medicare Parts A, B, C, D
- Data Entry
- Remote Work Environment
- Microsoft Office Suite
- EPIC Systems
- 3M
- Jaguar Billing Systems
- AS 400/Cerner
- QA Billing Software
- Workflow EHR
Professional Affiliations And Certifications
- American Academy of Professional Coders (AAPC), Member in good standing
- Certified Professional Coder, CPC
Certification
CPC - Certified Professional Coder
Timeline
Medical Coder
Optum360
09.2022 - Current
Medical Record -Coder
Del-Amo Hospital
01.2022 - Current
Patient Account Representative
Amplus Group
01.2018 - 01.2020
Medical Biller, Coder and Trainer/Auditor
American Medical Response, Inc.
01.2009 - 01.2014
Revenue Associate
Pathology, Inc.
01.2007 - 01.2008
Math Tutor
Sylvan Learning Center
01.2006 - 01.2007
Southern California Regional Occupational Center
Bachelor of Science - Health Care Administration
California State University, Long Beach
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