Detail-oriented and focused medical coder and insurance verification specialist with a proven track record in reviewing clinical and procedural notes, as well as claims processing. Experienced in accurately coding patient records and ensuring compliance with healthcare regulations. Utilizes sophisticated coding software to maintain detailed and precise documentation. Possesses a strong understanding of healthcare billing processes and regulatory requirements, thriving in fast-paced professional environments.
Overview
10
10
years of professional experience
1
1
Certification
Work History
Medical Coder
McKenzie Physician Services
02.2023 - 03.2025
Increased coding accuracy by diligently reviewing medical documentation and applying appropriate codes.
Resourcefully used various coding books, procedure manuals, and on-line encoders.
Reviewed patient charts to better understand health histories, diagnoses, and treatments.
Applied official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services to assign diagnostic codes.
Reviewed outpatient records and interpreted documentation to identify diagnoses and procedures.
Correctly coded and billed medical claims for various hospital and nursing facilities.
Ensured compliance with industry regulations and guidelines by staying up-to-date on the latest coding changes.
Collaborated with physicians to obtain necessary documentation, improving claim approval rates.
Promoted teamwork within the department through effective communication and collaboration on complex cases.
Prior Authorization Specialist
McKenzie Heart Group
06.2022 - 02.2023
Collaborated with physicians to obtain necessary clinical information for prior authorization submissions.
Maintained thorough knowledge of insurance plan requirements, facilitating accurate and timely completion of authorization forms.
Analyzed medical records and other documents to determine approval of requests for authorization.
Verified eligibility and compliance with authorization requirements for service providers.
Spearheaded the training protocol for the prior authorization position by writing out spreadsheets of current insurance information and authorization conditions according to each insurance company and relevant CPT codes.
Maintained a good relationship with hospital staff to ensure optimum patient care through timeliness and understanding of procedure authorizations.
Trained clinic staff members how to navigate insurance portals and submit authorization requests during my absence.
Maintained continuous access of all relevant portals and resources conducive to submitting authorization requests.
Scheduler
McKenzie Heart Group
02.2022 - 06.2022
Reduced scheduling conflicts and ensured timely execution of tasks through proactive rescheduling and referral management.
Maintained high levels of patient satisfaction and communication through diligent scheduling coordination
Worked with physicians and team members to understand patient appointment needs and bring levels within desired tolerances.
Provided accurate pre-visit instructions to patients in anticipation of upcoming clinical tests.
Verified and provided resources to medical records and medical assistant departments regarding past patient care, including hospital records.
Worked through buckets to schedule patient visits and testing in a timely manner according to individual patient needs.
Participated in special projects to schedule patent referrals and increase clinic productivity.
Front End Manager
Market of Choice
06.2019 - 01.2022
Manages the store's front end, including supervising, scheduling, and training
Guarantees that all customers receive fast and accurate service
Properly handles safe money and procedures including accurately recording checker loans, pick-ups and deposits as needed
Positively and appropriately handles pricing disputes and customer complaints
Promotes and creates a positive department image
Demonstrates accuracy and proper handling of money, food, errors, refunds, returns, and voids
Maintains and ensures register and safe security
Tracks employee and customer activities and quickly reports concerns to senior store leadership
Helps create a pleasant in-store atmosphere for the customer
Stocks, faces, and rotates products (when needed)
Cashiers and performs courtesy and freight duties as needed
Works in an office setting with Microsoft Applications
Enforces compliance with procedures by monitoring activities and immediately correcting issues
Keeps front end stocked, clean, and ready for customer demands to boost team productivity
Grocery representative on the store's Safety Committee
Cashier
Market of Choice
09.2017 - 06.2019
Rang up customer orders in an accurate and prompt manner
Maintained positive customer relations
Knowledgeable of weekly ads, specials, and PLU's
Generally cleaned and maintained sales area
Stocked products when necessary
Properly handled cash
Maintained a balanced till
Properly processed EBT and WIC purchases
Kitchen Clerk
Market of Choice
05.2016 - 09.2017
Completed end-of-day kitchen cleaning and sanitizing according to health code requirements
Prepared ingredients and restocked supplies to support kitchen team
Backed up senior kitchen staff with light food preparation
Followed OSHA regulations and safety protocols for correct handling and use of workplace chemicals
Sanitized pots, pans, and utensils using high-temperature commercial dishwashers
Monitored and recorded food temperatures on regular cycle time
Maintained clean kitchen stations and storage areas
Assisted customers in selection and recommendations of food
Accurately prepared made-to-order and/or ready-made cuisine in a prompt and courteous manner
Maintained consistently clean and appealing presentation of full-service and self-service areas
Kitchen representative on the store's Safety Committee
Housekeeper
The Days Inn
06.2015 - 09.2015
Cleaned guestrooms during stayovers and after departure
Made beds
Replaced dirty linens and towels
Restocked guestroom amenities like toiletries, drinking glasses, and notepads
Removed garbage, recycling, and room service trays
Completed cleaning duties on time and according to schedule
Education
CPC - Medical Coding
AAPC
Eugene, OR
11-2024
Skills
Courteous interaction face-to-face and over the phone with the public
Experienced in team supervision
Scheduling management and proficiency
Current AAPC member
Experienced in Microsoft Office Applications
Maintaining an organized workspace
Medical terminology
Medical billing and HIPAA compliance
Insurance verification and coding (ICD-10 and CPT)
Clinical documentation and management
Claims processing
Continuing education
Certification
CPC - Certified Professional Coder
Interests
Getting involved in local advocacy groups to promote positive change in the community I volunteer with the American Foundation for Suicide Prevention most often
Music- I am a 17 year flute player
I participate in a variety of outdoor recreational activities
Timeline
Medical Coder
McKenzie Physician Services
02.2023 - 03.2025
Prior Authorization Specialist
McKenzie Heart Group
06.2022 - 02.2023
Scheduler
McKenzie Heart Group
02.2022 - 06.2022
Front End Manager
Market of Choice
06.2019 - 01.2022
Cashier
Market of Choice
09.2017 - 06.2019
Kitchen Clerk
Market of Choice
05.2016 - 09.2017
Housekeeper
The Days Inn
06.2015 - 09.2015
CPC - Medical Coding
AAPC
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