Accomplished CPC at Change Healthcare, Optum, adept in medical coding and fostering team collaboration. Excelled in reducing claim denials and enhancing software transition through meticulous pathology report reviews and AI-assisted error minimization. Demonstrated expertise in HIPAA compliance and pathology coding, significantly improving client communication and problem resolution.
Review pathology reports for appropriate CPT, ICD 10 and HCPCS per AMA/CAP guidelines.
Assign MIPS/PQRS/PQRI to appropriate cases for both claim based and registry clients.
Review for MUE as well as NCCI edits to ensure that clean claims go out the first time to reduce denials as well as to cut cost for claims clearinghouses.
Train fellow coders new to currently used software.
Network with and assist Business Support Services and programmers with AI reviews looking to reduce potential errors as clients transition to new coding software.
Review hospital systems for signs and symptoms when not included on report.
Prepare spreadsheets for client communication when all information is not provided on reports.
Research into finding and implementing solutions to resolve problems as they arise and strive to eliminate them on a daily basis.
Medical Coding
Medical Terminology
Data Entry
Customer Service/Call Center
HIPPA requirements
Ability to work in a team environment or independently
CPC through AAPC since September 16, 2006
CPC through AAPC since September 16, 2006