Matthew Pilgrim

Ellis Medicine
Medical Coder / Claim Edits

• Assign and validate appropriate ICD-10-CM, CPT, and HCPCS codes based on provider documentation.
• Review medical documentation and coding information for accuracy and compliance.
• Resolved claim edits to ensure accurate and timely claim submission.
• Reviewed claims for compliance with current coding guidelines and payer requirements.
• Review surgical and office-based services for accurate procedure, diagnosis, and modifier assignment.
• Identified coding and claim discrepancies, correcting them based on documentation.
• Managed and processed claim edits for accurate billing submissions. involving diagnosis and procedure coding, modifiers, bundling, and other billing requirements.
• Utilized coding skills across various medical specialties to facilitate billing. across multiple specialties, including Vascular Surgery, General Surgery, Family Medicine

• Performed full abstract coding with precise assignment of CPT and ICD-10 codes to support accurate billing.
• Oversaw claims edits and corrections across various systems, including eClinical, Meditech, and Athena, to maintain coding accuracy.
• Conducted multi-specialty chart reviews (Rural Health, Women's Health-ObGyn) to ensure adherence to coding guidelines.

• Oversaw day-to-day operations and team performance, ensuring quality assurance and meeting service expectations.
• Managed client interactions, leveraging communication skills to assess needs and resolve concerns effectively.
• Ensured compliance with safety regulations and project specifications through thorough review and adherence to protocols.
• Performed meticulous inventory counts and data reconciliation using Excel to track costs and forecast needs.