Quinann Taitague Gardner

Medical Coding and Billing Specialist

Gold Cross EMS

Augusta, GA

01.2009 - 08.2024

Verified patient information, including medical history and insurance coverage, to ensure accuracy of coding and billing.
Conducted audits of medical records to identify missing or incorrect documentation that could affect accurate coding and billing.
Submitted claims electronically to insurance companies in accordance with regulations.
Researched denied claims to determine the cause of denial and corrected errors as needed.
Analyzed trends in denials in order to recommend process improvements which would reduce the number of denials received.
Generated reports from software systems to track claim status and denials.
Assigned appropriate codes using ICD-10-CM for diagnosis, CPT for procedures, HCPCS for supplies and modifiers as required by payers.
Facilitated payment arrangements with patients and guarantors who were unable to make full payment at time of service.
Provided customer service support via phone or email regarding account balances or other inquiries related to billing issues.
Performed data entry into electronic health record system for all relevant patient information including diagnoses, procedures performed, medications prescribed .
Updated patient demographics information within practice management system.
Reviewed account information to confirm patient and insurance information is accurate and complete.
Read through patient health data, histories, physician diagnoses and treatments to gain understanding for coding purposes.
Actively maintained current working knowledge of CPT and ICD-9 coding principles, government regulation, protocols and third party requirements regarding billing.
Added modifiers as appropriate, coded narrative diagnoses and verified diagnoses.
Applied coding rules established by American Medical Association and Centers for Medicare and Medicaid Services for assignment of procedural codes.
Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements.
Acted as liaison between business department, billers and third party payers in resolving billing and reimbursement accuracy.
Interpreted medical reports to apply appropriate ICD-9, CPT-4 and HCPCS codes.
Reconciled clinical notes, patient forms and health information for compliance with HIPAA rules.
Assigned additional diagnosis codes based on specific clinical findings (laboratory, radiology and, pathology reports as well as clinical studies) in support of existing diagnoses.
Quickly responded to staff and client inquiries regarding CPT codes.
Maintained high accuracy rate on daily production of completed reviews.
Verified proper coding, sequencing of diagnoses and accuracy of [Type] procedures.
Entered patient insurance, demographic and health information into software and confirmed records.
Pulled patient records and transferred information to appropriate parties.
Safeguarded medical records to maintain patient confidentiality.
Maintained positive working relationship with fellow staff and management.
Proofread documents carefully to check accuracy and completeness of all paperwork.
Handled incoming calls and directed callers to appropriate department or employee.
Released information to persons or agencies according to regulations.
Answered questions and fulfilled requests with friendly and knowledgeable service.
Compiled and coded patient data using standard classification systems.
Located and retrieved files, assisting public with general information.
Streamlined day-to-day office processes to meet long-term goals.

Overview

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Medical Coding and Billing Specialist

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Medical Coding and Billing Specialist

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