Epic, Athena, Cerner, Medi-Mobile, Optum, Meditech, SNChart, 3M, Microsoft Office,
Marianne Madden
Marlborough,MA
Work Preference
Summary
Outpatient Medical Coder with extensive experience for 15 years, 7 years as a remote medical coder specializing in ICD-10 and CPT coding and compliance. Specialties include Pain Management, General Surgery, Physician office, Ambulatory, and Ancillary Outpatient Services. Demonstrated success in educating staff, improving coding accuracy, and resolving complex billing issues. Committed to continuous improvement and staying current with coding guidelines to enhance patient care outcomes.
Overview
14
14
years of professional experience
1
1
Certification
Work History
Outpatient Medical Coder
Tenet Healthcare - Physician Services
Northborough, Massachusetts
08.2020 - 12.2025
- Conducted regular audits to ensure compliance with quality assurance in coding practices. This was for both physicians, practices, and coding team members. Example of audits: AWV, E/M office, OMT, EKG, Preventative, outpatient hospital visits, outpatient procedures, ER, Observation, Global Surgical Pkg. etc. followed by education if needed.
- Educated staff on updates to coding guidelines and regulatory changes. Training included physicians and practice personnel with TPR Corp. presentations. Example: E/M changes, hernia procedure updates, CPT yearly updates, ICD-10 updates for medical necessity, specificity ICD-10 updates, etc. per TPR and AMA guidelines along with CMS guidelines.
- Educated TPR Staff on updates to LCD and Articles for specialty physicians and practices or insurance updates where needed.
- Analyzed patient charts for missing information by verifying diagnosis codes and reviewing clinical documentation for accuracy, along with verification of CPT’s. In some cases, a query to the physician may need to have been made to complete the claim.
- Collaborated with healthcare professionals to resolve coding issues and questions. Ex: consulted with upper-management and coding educator when needed for unlisted procedures for proper billing/coding.
- Maintained up-to-date knowledge of CPT and ICD-10 coding principles through training.
- Resolved claim denials and rejections from payers through EOB process, or appeals if needed by working closely with billing organization for resolutions for payments.
- Specialties include: For Physician Services - General Surgery (Hospital Outpatient, Ambulatory Surgical Center, Minor In-office, Pain Management (injections) Outpatient (Clinic) and Ambulatory Surgical Center, Vascular (Physician Services) outpatient, Pain Management, Physician Services for Practices – Family, General Surgery, Pain Management, Cardiac Services, i.e.: EKG, Breast Surgical, Infectious Disease, Endocrinology, and back up to Pathology (lab coding). This included E/M office visits etc.
Outpatient Medical Coder
MT. AUBURN HOSPITAL
Watertown, Massachusetts
04.2012 - 06.2020
- Performed accurate medical coding and abstracting per national guidelines, including AHA Coding Clinics.
- Accurate Coding through attention to detail, and assigning ICD-10 diagnosis codes for Laboratory, Radiology, Pretests, including Prenatal/Antenatal claims for both Physician and Hospital Outpatient.
- Actively participated in continuing education courses related to outpatient medical coding practices.
- Assist Management in assigned tasks and projects.
- Resolve Claim Edits and Denials on all outpatient pre and post coding and billing issues through current EMR systems (EPIC,3M for abstracting and in the past Meditech).
- Assist in providing Medical Coding Training to others in specialty and EMR systems.
Education
Certified Medical Coder - CPC, ICD-10 certified
AAPC (American Assoc. Professional Coders)
300 Hr. Medical Coding Course - undefined
Assabet Valley Adult Education
Project Management - undefined
Assabet Valley Adult Education
Graduate - undefined
Burdett School
Continued Education - undefined
Massachusetts Bay Community College
Skills
- Medical terminology and anatomy
- Training and mentoring
- Successful and Independent Remote Medical Coder
- Management and goal setting
- Motivation skills
- Customer service
- Process improvement
- Knowledge of Coding guidelines
- Extensive knowledge HCPCS
- CPT and ICD-10 coding
- Prioritization skills
- Strong analytical skills
- Attention to detail
- Verbal and written communication skills
- Office equipment proficiency
- EHR/Software Proficiency
- Insurance Knowledge with Payer access
- Communicate effectively with management and peers
- Outpatient billing expertise
- Self-Management/Independence
- HIPAA compliance
Certification
- CPC - Certified Professional Coder – AAPC
- Continued Education through Webinars, on-line Optum training
Affiliations
- AAPC
- Education Specialist
- Burlington Chapter - Past Education and Secretary Officer for Local Chapter
- Worcester Chapter
- Marlborough Lions Club, Officer Tail Twister - Past Member
Previous Work Experience
High Tech Sales and Sales Management
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Software
Timeline
Outpatient Medical Coder
Tenet Healthcare - Physician Services
08.2020 - 12.2025
Outpatient Medical Coder
MT. AUBURN HOSPITAL
04.2012 - 06.2020
Certified Medical Coder - CPC, ICD-10 certified
AAPC (American Assoc. Professional Coders)
300 Hr. Medical Coding Course - undefined
Assabet Valley Adult Education
Project Management - undefined
Assabet Valley Adult Education
Graduate - undefined
Burdett School
Continued Education - undefined
Massachusetts Bay Community College