Knowledgeable medical office professional talented at correcting and resubmitting claims, preparing patient charts and reviewing health records to identify proper diagnosis codes for billing. Offers background in reviewing, analyzing and managing medical record information to obtain prior authorizations from insurance companies and ensure payment.
Overview
11
11
years of professional experience
Work History
Coding Specialist
UF Health
Jacksonville, FL
02.2019 - Current
Reviewed outpatient records and interpreted documentation to identify diagnoses and procedures.
Reviewed, analyzed, and managed coding of diagnostic and treatment procedures contained in outpatient medical records.
Communicated with insurance companies to research and resolved coding discrepancies.
Applied official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services to assign diagnostic codes.
Utilized active listening, interpersonal, and telephone etiquette skills when communicating with others.
Monitored changes in coding regulations to provide recommendations for compliance.
Reviewed patient charts to better understand health histories, diagnoses, and treatments.
Correctly coded and billed medical claims for various hospital and nursing facilities.
Interacted with physicians and other healthcare staff to ask questions regarding patient services.
Insurance Specialist
St Vincent's Health Care System
Jacksonville, FL
02.2013 - 06.2019
Building relationships with vendors and insurance carriers
Training and managing Front Desk staff to carry out administrative duties
Managed insurance files while maintaining customer information privacy
Processing insurance denials with the appropriate paperwork to submit appeals as needed
Inputting insurance payments and adjustments correctly by remittance reviews.
Submitted for prior authorization with required documentation to appropriate funding source.
Maintained consistent follow-up on status of prior authorization requests.
Reviewed authorizations from payer to determine approved or denied items.