NICOLE BARTHULY
Jonesborough,TN
Summary
Detail-oriented medical coding specialist with outpatient and multi-specialty experience across primary care, OB/GYN, radiology, and surgical services. Applies ICD-10-CM, CPT, HCPCS, and E/M guidelines to support accurate charge capture, compliant maternity billing, and timely resolution of claim denials through close collaboration with providers and billing teams.
Overview
1
1
Certification
18
18
years of professional experience
Work History
MEDICAL CODING SPECIALIST
Banyan Health Systems
Doral, Florida
07.2025 - 09.2026
- Supported primary care, OB/GYN, surgical, and procedural coding for remote operations.
- Processed outpatient encounters with E/M, ICD-10-CM, CPT, and HCPCS coding standards.
- Closed care gaps by coding wellness exams, chronic condition follow-up visits, and preventive screening services for adult and pediatric visits.
- Managed global OB package billing for prenatal, delivery, and postpartum services in line with payer rules.
- Assisted with billing and coding for labor and delivery services, including vaginal deliveries, cesarean deliveries, and sterilization.
- Coded minor procedures such as IUD insertion and removal, skin excisions, ear cerumen removal, vaccines, and injections.
- Reviewed medical records to support accurate coding and billing for obstetric services.
- Resolved billing edits, claim denials, and coding discrepancies for maternity services to improve revenue cycle accuracy.
- Applied ICD-10, CPT, and HCPCS guidelines to support HEDIS measure capture.
- Queried providers for missing details in patient records.
- Coordinated with billing staff on charge capture and reimbursement issues.
- Completed continuing education programs related to medical coding procedures.
OUTPATIENT DHA MEDICAL CODER
Mindseeker
03.2025 - 07.2025
- Coded high-volume multi-specialty outpatient encounters to support DHA compliance and reimbursement through remote work.
- Coded primary care, endocrinology, rheumatology, OB/GYN, physical therapy, minor procedures, and infusions.
- Applied E/M, CPT, HCPCS, and ICD-10-CM codes with modifiers, units, and payer guidelines.
- Reviewed documentation for gaps and inconsistencies to improve coding accuracy and maintain productivity standards in MHS Genesis.
- Completed remote coding tasks to support timely processing of patient encounters and keep workflow organized.
MEDICAL CODING SPECIALIST
ETSU Health
Johnson City, TN
08.2023 - 03.2025
- Coded high-volume records for family medicine, OBGYN, behavioral health, inpatient, and chronic care management for compliance billing.
- Reviewed diagnoses, modifiers, charges, and billing completeness against provider documentation to support accurate reimbursement.
- Managed global OB package monitoring to ensure accurate prenatal charge capture and optimize reimbursement.
- Supported maternal billing workflows for prenatal, delivery, and postpartum services.
- Calculated maternal provider billing portion when delivery was completed by another provider or when patients exited maternity care.
- Processed NST (non-stress test) billing to support accurate coding and charge entry.
- Supported maternal and pediatric inpatient billing workflows for accurate charge capture and claim submission.
- Coordinated billing processes for newborn inpatient services to ensure proper charge capture., including circumcisions and frenotomy procedures, to facilitate accurate charge capture.
- Streamlined workflow processes to minimize errors and enhance ongoing regulatory compliance.
CODING SPECIALIST (CBO)
State of Franklin Healthcare
Johnson City, TN
04.2022 - 08.2023
- Reviewed documentation and encounter forms for accuracy and specificity, improving coding quality and reducing errors.
- Reviewed and validated patient charges for accuracy before billing, ensuring compliance with coding standards. and encounter completion before monthly closing.
- Confirmed accuracy of charges for patient encounters and completed encounters prior to monthly closing, facilitating timely billing processes.
- Assigned E/M, ICD-10-CM, CPT, and HCPCS codes for family medicine, radiology, and diagnostic procedure.
BILLING SPECIALIST
CBS Medical Billing
06.2021 - 04.2022
- Oversaw billing accounts and addressed claim denials, facilitating prompt reimbursement processes.
- Managed billing accounts and resolved claim denials to secure reimbursements.
- Coordinated with clients and internal teams to ensure accuracy in billing and documentation, while minimizing errors and enhancing compliance.
- Distributed tasks among team members to enhance workflow efficiency. and team productivity.
- Worked remotely to manage tasks and communication effectively.
INSURANCE VERIFICATION SPECIALIST
Sahara Behavioral Health
Glendale, AZ
07.2020 - 10.2020
- Verified insurance eligibility and benefits, ensuring accurate patient financial responsibility.
- Resolved insurance discrepancies to prevent billing errors and minimize claim denials.
- Clarified coverage and benefits for patients and insurers to ensure understanding.
MEDICAL BILLER
UC Irvine Health
Anaheim, CA
07.2018 - 07.2020
- Reviewed clinical documentation for coding accuracy and ensured HIPAA compliance, safeguarding data integrity.
- Verified patient demographics and insurance information, contributing to accurate billing outcomes.
- Resolved claim denials through collaboration with internal departments and third-party payers, enabling timely reimbursements.
PRINCIPAL ADMITTING CLERK
UC Irvine Health
Orange, CA
03.2009 - 07.2018
- Coordinated patient registration, admissions, discharges, scheduling, and insurance verification, ensuring efficient front-office operations.
- Facilitated registration and admissions for laboratory, surgery, and radiology services, improving patient flow.
- Verified insurance and third-party coverage prior to service.
Education
High School Diploma -
Loara High School
Anaheim, CAMedical Billing And Coding
Career Step
Remote Skills
- E/M coding and CPT & HCPCS
- ICD-10-CM proficiency
- Medical record review
- Epic
- MHS Genesis
- E-Clinical Works
- Citrix
- HIPAA compliance
- Problem solving skills
- Written communication
- Provider collaboration
- Encoder systems knowledge
- Charge capture techniques
- Attention to detail
- Customer service excellence
- Front office operations
- Multi-line phone management
Certification
AAPC Certified Professional Coder (CPC) — Certified Professional Coder Program, Career Step Academy — Professional Billing and Coding
Timeline
MEDICAL CODING SPECIALIST
Banyan Health Systems
07.2025 - 09.2026
OUTPATIENT DHA MEDICAL CODER
Mindseeker
03.2025 - 07.2025
MEDICAL CODING SPECIALIST
ETSU Health
08.2023 - 03.2025
CODING SPECIALIST (CBO)
State of Franklin Healthcare
04.2022 - 08.2023
BILLING SPECIALIST
CBS Medical Billing
06.2021 - 04.2022
INSURANCE VERIFICATION SPECIALIST
Sahara Behavioral Health
07.2020 - 10.2020
MEDICAL BILLER
UC Irvine Health
07.2018 - 07.2020
PRINCIPAL ADMITTING CLERK
UC Irvine Health
03.2009 - 07.2018
High School Diploma -
Loara High School
Medical Billing And Coding
Career Step