Melissa Groleau
Parma,Ohio
Summary
Highly-motivated coding manager performs all aspects of medical billing, including coding, charge entry, transmission, correction, and resubmission. Bringing 13 years of experience in working hand-in-hand with departments to validate proper information for claims processing. Detail-oriented and helpful professional with expertise in resolving billing issues and reviewing claim denials. Hands-on coding specialist offering a keen understanding of data confidentiality and HIPAA regulations. Highly trained Medical Coder knowledgeable in AMA and the CMS coding rules.
Overview
15
15
years of professional experience
1
1
Certification
Work History
Coding Manager
Kennedy Group
Strongsville, OH
02.2011 - Current
- Ensured compliance with applicable laws and regulations pertaining to coding practices.
- Performed periodic reviews of coded documents against original source material, verifying accuracy.
- Reviewed incoming requests from other departments requiring changes or additions to existing codes.
- Resolved coding issues in a timely manner, including discrepancies between codes used by different departments.
- Conducted regular audits on coding processes for quality assurance.
- Collaborated with other teams to identify opportunities for streamlining code management process.
- Identified potential challenges associated with implementing new technologies into the organization's code management system.
- Reviewed coded documents for accuracy before submitting them for processing.
- Provided training and support to coding staff on current industry standards.
- Implemented new technologies and processes for improving the efficiency of coding operations.
- Added modifiers as appropriate, coded narrative diagnoses and verified diagnoses.
- Applied coding rules established by American Medical Association and Centers for Medicare and Medicaid Services for assignment of procedural codes.
- Communicated with patients with compassion while keeping medical information private.
- Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements.
- Verified accuracy of patient data in order to assign correct ICD-10 codes.
- Managed daily operations within the department while ensuring compliance with HIPAA regulations.
- Investigated rejected and denied claims, correcting applicable coding.
Customer Service Representative
LIVE OPS
Cleveland, OH
01.2009 - 01.2011
- Answered customer inquiries and provided accurate information regarding products and services.
- Answered incoming calls and emails, providing frontline customer support or assistance with product and service transactions.
- Provided excellent customer service to resolve customer complaints in a timely manner.
- Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.
- Remained calm and professional in stressful circumstances and effectively diffused tense situations.
- De-escalated problematic customer concerns, maintaining calm, friendly demeanor.
- Assisted customers with product selection, ordering, billing, returns, exchanges and technical support.
Education
DIPLOMA - Medical Insurance Coding
ALLIED HEALTH
Boca Raton, FL10-2010
Skills
- HIPAA Compliance
- Insurance Verification
- Claims Processing
- Documentation Oversight
- Medical Billing
- Workflow Management
- Medical Terminology
- Coding Error Resolution
- Training and Mentoring
- Pro Fee Coding
- Healthcare Claim Coding
- Regulatory Guidelines
- Ethical Standards
Certification
- AAPC CPC #02037673
Timeline
Coding Manager
Kennedy Group
02.2011 - Current
Customer Service Representative
LIVE OPS
01.2009 - 01.2011
DIPLOMA - Medical Insurance Coding
ALLIED HEALTH
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