MELANIE CHAPMAN
Stone Mountain,GA
Summary
Dynamic Profee Denials Coder with a proven track record at Children’s Healthcare of Atlanta, achieving a 98% accuracy rate. Expert in ICD-10 coding and denial management, demonstrating exceptional attention to detail and effective communication skills to maximize patient reimbursement strategies. Committed to enhancing revenue cycle management through analytical decision-making.
Overview
10
10
years of professional experience
Work History
Profee Denials Coder, IP,OP,ED,Urgent Care
Children’s Healthcare of Atlanta
12.2023 - 12.2025
- Production rate 150 per week, Met production rate of 210 charts per week
- Epic EMR system used
- Maintaining a verified 98% accuracy rate
- Ensured maximization of prospective risk factors for future reimbursement
- Successfully prioritized workloads between working denials and radiology coding
- Coded radiology, general surgery, urgent care, ED, orthopedics, endocrinology, labs, private practice
Profee Denial Review, Inpatient and Outpatient Coding
Lee Health
01.2023 - 10.2023
- Successfully prioritized workloads and maintained production requirements
- Ensured maximization of prospective risk factors for future reimbursement
- Provided strict attention to detail requiring analytical decision making
- Ensured correct diagnosis codes were provided for patient visits
- EMR system used was Epic
- Coded denial reviews for the ED, urgent care, office visits, inpatient and outpatient visits.
- Coded inpatient cardiology, pre and post op surgery (mostly general surgery), orthopedics, OB/GYN
- Comply with records management programs, including retention schedule requirements
- Production rate 250 charts per week. Met production rate of 300 charts per week
Profee Coding Specialist, IP and OP coding
RIDGEVIEW MEDICAL CENTER
01.2022 - 04.2022
- Assigned ICD 10 diagnosis codes for outpatient charts and ED
- Successfully prioritized workloads and maintained production requirements
- Ensured maximization of prospective risk factors for future reimbursement
- Provided strict attention to detail requiring analytical decision making
- Ensured correct diagnosis codes were provided for EKG’s
- Queried physicians regarding lack of documentation and provided updates and reentered coding denials for insurance companies
- Ensured correct CPT codes were provided for Family Practice (Wellness visits PHQ-9, GAD-7, ASQ-2 and 3) and vaccinations.
- Assisted with NCCI and CPI edits
- Coded charts for Urgent Care, Drug Screens, Covid Cases, Lacerations, Telehealth, ED. DOT physicals, etc.
- EMR system Epic
- Production rate 120 charts per day, met and exceeded goal average 175 per day.
Inpatient and Outpatient Coding Specialist
PIEMONT URGENT CARE
12.2020 - 05.2021
- Assigned ICD 10 diagnosis codes for outpatient charts. Assigned diagnosis codes for Urgent Care Centers in GA
- Successfully prioritized workloads and maintained production requirements (150 per day)
- Ensured maximization of prospective risk factors for future reimbursement
- Provided strict attention to detail requiring analytical decision making
- Ensured maximization of prospective risk factors for future reimbursement
- Correct insurance denials; correct any missing CPT or diagnostic codes
- Queried physicians regarding lack of documentation and provided updates and reentered coding denials for insurance companies
- Comply with records management programs, including retention schedule requirements
- Completed claim reviews and assisted with coding for denials and appeals
- Assisted with NCCI and CPI edits
- Coded charts for Urgent Care, Drug Screens, Covid Cases, Lacerations, Telehealth, etc.
- EMR system Agility and Epic
- Production rate 150 charts per day, met and exceeded goal.
Sr. Remote HCC and profee Coding Specialist
CAROLINAS MEDICAL CENTER
03.2019 - 12.2019
- Assigned ICD 10 diagnosis codes for inpatient and outpatient charts. Assigned diagnosis codes for ED
- Assigned diagnosis codes according to the CMS hierarchical condition categories (HCC)
- Successfully prioritized workloads and maintained production requirements
- Coded profee charts and completed E/M leveling for orthopedics, cardiac, pediatrics, family practice, etc.
- Worked on software system Cerna
Sr. Remote Coding Specialist
UNIVERSAL CODING SOLUTIONS
11.2016 - 01.2019
- Assigned ICD 10 diagnosis codes for inpatient and outpatient. Assigned diagnosis codes for ED
- Assigned ICD 10 PCS and CPT
- Assigned diagnosis codes for outpatient visits according to the CMS hierarchical condition categories (HCC) with MEAT
- Ensured maximization of prospective risk factors for future reimbursement
- Assist with recruiting and staff development
- H.I.M supervisor training
- Support teams conducting medical records indexing
- Correct insurance denials; correct any missing CPT or diagnostic codes
- Maintained strong organizational and time management skills with the ability to prioritize heavy workloads
- Provided strict attention to detail requiring analytical decision making
- Ensured maximization of prospective risk factors for future reimbursement
- Queried physicians regarding lack of documentation
Coding Specialist
LOGIX HEALTH SOLUTIONS
10.2015 - 11.2016
- Assigned diagnosis codes for outpatient visits according to the CMS hierarchical condition categories (HCC) with MEAT
- Ensured maximization of prospective risk factors for future reimbursement
- Comply with records management programs, including retention schedule requirements
- Responsible for assigning and correcting ICD-10, ICD-10 PCS, and CPT codes to outpatient records and inpatient records, such as ED/ER, observations, and SDS
- Validated accuracy of the ICD-10 coding and provided feedback and supporting documentation for code changes
Education
AAPC Medical Coding CPC Certification -
GWINNETT TECHNICAL COLLEGE
Lawrenceville, GA07.2015
Bachelor of Science - Business Administration
GEORGIA STATE UNIVERSITY
Atlanta, GA12.2014
Skills
- ICD-10 CM/PCS Trained
- Detail Orientation
- CPT and HCPCS Codes
- Coding Denials
- Customer Service Skills
- Database Creation
- Data Entry
- Interpreting Correspondences
- Analyzing Programs
- Proficient in Microsoft Programs
- Data entry accuracy
- Quality assurance
- Problem solving
- Time management
- EPIC charting
- ICD-10 coding
- CPT coding
- HCC coding
- Denial management
- Medical record compliance
- Patient reimbursement strategies
- Attention to detail
- Effective communication
- Coding error resolution
- Revenue cycle management
- HIPAA compliance
- HCPCS coding
- Workflow management
Timeline
Profee Denials Coder, IP,OP,ED,Urgent Care
Children’s Healthcare of Atlanta
12.2023 - 12.2025
Profee Denial Review, Inpatient and Outpatient Coding
Lee Health
01.2023 - 10.2023
Profee Coding Specialist, IP and OP coding
RIDGEVIEW MEDICAL CENTER
01.2022 - 04.2022
Inpatient and Outpatient Coding Specialist
PIEMONT URGENT CARE
12.2020 - 05.2021
Sr. Remote HCC and profee Coding Specialist
CAROLINAS MEDICAL CENTER
03.2019 - 12.2019
Sr. Remote Coding Specialist
UNIVERSAL CODING SOLUTIONS
11.2016 - 01.2019
Coding Specialist
LOGIX HEALTH SOLUTIONS
10.2015 - 11.2016
AAPC Medical Coding CPC Certification -
GWINNETT TECHNICAL COLLEGE
Bachelor of Science - Business Administration
GEORGIA STATE UNIVERSITY