Melissa Gossman
Belmont,MI
Summary
Hardworking healthcare professional applies established official coding conventions and rules. Confident Medical/Mental Health Coder and Biller adheres to data confidentiality and privacy rules in all workflows and promotes dynamic interpersonal skills.
Overview
16
16
years of professional experience
Work History
Facility Coder
Pine Rest Christian Mental Health
12.2020 - Current
- Maintained high coding standards by adhering to industry best practices and staying current with emerging technologies.
- Resourcefully used various coding books, procedure manuals, and on-line encoders.
- Applied official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services to assign diagnostic codes.
- Reviewed patient charts to better understand health histories, diagnoses, and treatments.
- Correctly coded records, including diagnosis and inpatient procedures and billed medical and mental health claims for the hospital.
- Demonstrates a thorough knowledge of ICD 10-CM/PCS medical coding, DRG's, CPT, and APC's.
- Followed up with medical staff regarding missing information in patient records.
Professional Coder
Pine Rest Christian Mental Health
10.2013 - 12.2020
- Demonstrates a strong working knowledge of medical terminology and ask questions to clarify misunderstandings.
- Conducted ongoing provider audits for accuracy and compliance of the organization along with audits for other facilities that contracted our services.
- Delivered consistent results under pressure by prioritizing tasks effectively during periods of high workload or tight deadlines.
- Interacted with physicians and other healthcare staff to ask questions regarding patient services.
- Timely and accurate coding review of all HRS professional records for the purpose of reimbursement and compliance with regulatory agencies according to diagnoses and procedures guidelines.
Medical Biller
Pine Rest Christian Mental Health
07.2008 - 10.2013
- 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.
- Enhanced revenue collections for the medical practice with diligent follow-ups on unpaid claims.
- Reviewed patient diagnosis codes to verify accuracy and completeness.
- Collaborated with customers to resolve disputes.
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
- Established strong relationships with insurance representatives, facilitating prompt resolution of billing issues.
Education
Associate of Applied Science - Health Information Technology
Ferris State University
Grand Rapids05.2008
Bachelor of Science - Elementary And Early Childhood Education
Eastern Michigan University
Ypsilanti, MI12.2002
Skills
- 3M Encoder
- Epic Systems
- ICD-10 Coding
- Medical Billing
- Attention to Detail
- EMR Systems
- Protected Health Information
- Medical Terminology
- HIPAA Compliance
- Multitasking and Organization
- Anatomy and Physiology
- Microsoft Office
Timeline
Facility Coder
Pine Rest Christian Mental Health
12.2020 - Current
Professional Coder
Pine Rest Christian Mental Health
10.2013 - 12.2020
Medical Biller
Pine Rest Christian Mental Health
07.2008 - 10.2013
Associate of Applied Science - Health Information Technology
Ferris State University
Bachelor of Science - Elementary And Early Childhood Education
Eastern Michigan University