Meghan Lake
Eleanor,WV
Summary
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. 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. Medical Billing and Coding Specialist with 17 years providing administrative and patient support in hospital and medical office settings. Advanced knowledge of private insurance processes and codes. To seek and maintain full-time position that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills.
Overview
19
19
years of professional experience
Work History
Medical Biller and Coder
Charleston Gastroenterology
04.2009 - Current
- Correctly coded and billed medical claims for various hospital and nursing facilities.
- Reduced claim denials through meticulous verification of patient eligibility and coverage benefits prior to claim submission.
- Worked closely with physicians to accurately assign ICD-10 diagnostic codes for optimal reimbursement rates from insurance companies.
- Processed insurance company denials by auditing patient files, researching procedures, and diagnostic codes to determine proper reimbursement.
- Reviewed patient charts to better understand health histories, diagnoses, and treatments.
- Resourcefully used various coding books, procedure manuals, and on-line encoders.
- Reviewed, analyzed, and managed coding of diagnostic and treatment procedures contained in outpatient medical records.
- Contributed to team efficiency by maintaining organized records of patient accounts, billing statements, and payment statuses.
- Played a pivotal role in maintaining positive cash flow within the organization by ensuring timely submission of clean claims and diligent follow-ups on outstanding payments.
- Expedited payment processing by promptly addressing any discrepancies or issues raised by insurance carriers.
- Provided support to administrative staff by ensuring proper handling of sensitive patient data according to HIPAA regulations.
- Collaborated with healthcare providers to ensure accurate documentation, leading to timely reimbursements for services rendered.
- Safeguarded practice revenue by diligently following up on outstanding account balances and initiating collection efforts when necessary.
- Streamlined billing processes by implementing efficient coding practices, resulting in reduced errors and improved revenue generation.
- Interacted with physicians and other healthcare staff to ask questions regarding patient services.
- Collaborated with other billing professionals during team meetings to exchange best practices and strategies for overcoming common challenges in the industry.
- Applied official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services to assign diagnostic codes.
- Assisted patients with understanding their insurance coverage and financial responsibilities, fostering positive relationships and trust between the practice and its clients.
- Increased accuracy in medical claims submissions by conducting thorough reviews of patient records and insurance information.
- Optimized workflow efficiency within the office by cross-training in additional administrative tasks such as scheduling appointments or managing phone calls during peak periods.
- Reviewed outpatient records and interpreted documentation to identify diagnoses and procedures.
- Assisted in the preparation of financial reports for practice management, providing insights on revenue trends and areas for improvement.
- Developed effective communication channels with insurance companies to facilitate prompt resolution of claim inquiries and disputes.
- Maintained high levels of customer satisfaction through prompt resolution of disputes related to charges on patient accounts or insurance claims.
- Communicated with insurance companies to research and resolved coding discrepancies.
- Utilized active listening, interpersonal, and telephone etiquette skills when communicating with others.
- Utilized electronic medical record systems to store, retrieve and process patient data.
- Scanned and uploaded medical records into electronic medical records system.
- Communicated effectively with staff, patients, and insurance companies by email and telephone.
Medical Biller/ Coder
Physician's Choice, LLC
01.2008 - 04.2009
- Verified insurance of patients to determine eligibility.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Managed appeals process for denied claims, resulting in successful reimbursements from insurance companies.
- Filed and updated patient information and medical records.
- Collected payments and applied to patient accounts.
- Ensured timely payments from insurance providers through submission of accurate and complete claims.
- Posted payments and collections on regular basis.
- Reduced claim denials by meticulously reviewing patient insurance information and coding practices.
Claims Processing Specialist
HealthSmart
01.2005 - 01.2008
- Developed strong rapport among clients by addressing their concerns promptly, which ultimately resulted in higher client retention rates.
- Collaborated with team members to ensure consistency in claims processing, resulting in reduced discrepancies.
- Contributed to departmental goals by consistently meeting or exceeding individual performance metrics for both quality and quantity of processed claims.
- Improved claim processing efficiency by implementing streamlined procedures and workflow adjustments.
Education
Certified Medical Coder - Medical Coding
AAPC
OnlineNo Degree - Elementary Education
West Virginia State University
Institute, WVHigh School Diploma -
Poca High School
Poca, WV06.2003
Skills
- HIPAA Compliance
- Payment posting
- Insurance Verification
- ICD-10 Proficiency
- CMS-1500 Form Completion
- Patient account management
- Medicare and Medicaid Billing
- Claim submission
- Medical Coding Expertise
- Diagnostic Coding
- Appeals processing
- Procedural Coding
- Commercial Insurance Billing
- Claims Processing
- Denial Management
- Medical Billing
Timeline
Medical Biller and Coder
Charleston Gastroenterology
04.2009 - Current
Medical Biller/ Coder
Physician's Choice, LLC
01.2008 - 04.2009
Claims Processing Specialist
HealthSmart
01.2005 - 01.2008
Certified Medical Coder - Medical Coding
AAPC
No Degree - Elementary Education
West Virginia State University
High School Diploma -
Poca High School
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