Patrice Baumann
Hudson,WI
Summary
Accomplished Coding and Appeals Analyst with a proven track record at Blue Cross Blue Shield of Minnesota, adept in policy interpretation and teamwork. Excelled in enhancing the appeals process and ensuring coding accuracy, demonstrating exceptional attention to detail and problem-solving abilities. Skilled in managing high-stakes audits and improving operational efficiency..
Overview
20
20
years of professional experience
1
1
Certification
Work History
Coding and Appeals Analyst
Blue Cross Blue Shield of Minnesota
11.2012 - 06.2022
- Reviewed, analyzed and processed non-complex grievances and appeals.
- Maintained detailed records and organized documentation to facilitate smooth appeals processing, ensuring all relevant information was readily available for review.
- Evaluated internal policies and procedures regularly to identify areas for improvement in the overall appeals process.
- Followed department guidelines and tools to conduct reviews.
- Prepay and postpaid auditing.
- High dollar audits.
- E & M audits
- HCC audits
- Examined diagnosis codes for accuracy, completeness, specificity and appropriateness according to services rendered.
Coding Specialist
Hudson Physicians
11.2002 - 02.2012
- Managed medical records efficiently while maintaining strict attention to detail during the coding process.
- Reviewed outpatient records and interpreted documentation to identify diagnoses and procedures.
- Ensured accuracy in coding through regular audits, identifying discrepancies and areas for improvement.
- Maintained strict confidentiality in accordance with HIPAA regulations, ensuring secure storage and handling of sensitive patient information
- E & M coding, some labs, radiology, nursing home visits, same day surgery, OB Gyn visits and delivery.
Education
No Degree - Medical Coding (Certification)
Northwood Technical College
New Richmond, WI05-2004
Skills
- Policy interpretation
- Teamwork and collaboration
- Problem-solving
- Insurance policy knowledge
- Time management
- Problem-solving abilities
- Attention to detail
- Multitasking
- Claims investigation
- Organizational skills
- Adaptability and flexibility
- Claims
- Professionalism
Accomplishments
Took a Refresher course through ARHCP (Association of Registered HealthCare Professionals)
Certification
- Coding Certification through Northwoods Technical College
- Certified through AHIMA -CCS-P
- Certified through AHIMA-CCA
- Registered Medical Coder -RMC through Association of Registered Healthcare Professionals
Timeline
Coding and Appeals Analyst
Blue Cross Blue Shield of Minnesota
11.2012 - 06.2022
Coding Specialist
Hudson Physicians
11.2002 - 02.2012
- Coding Certification through Northwoods Technical College
- Certified through AHIMA -CCS-P
- Certified through AHIMA-CCA
- Registered Medical Coder -RMC through Association of Registered Healthcare Professionals
No Degree - Medical Coding (Certification)
Northwood Technical College
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