Quteshia Wright
Montgomery,AL
Summary
Dedicated and detail-oriented medical coder with extensive experience in analyzing documentation and accurately assigning diagnosis and procedure codes for proper patient classification. Expertise in compliance with regulatory guidelines. Link appropriate diagnosis to procedures and determine the level of E/M service provided, and reimbursement optimization. Skilled in reviewing codes for accuracy, efficacy, and updating codes for inpatient admissions. Performs all aspects of medical billing, including coding, charge entry, transmission, correction and resubmission. Experience in working hand-in-hand with proper information for claims processing and helpful professionalism with experience in resolving billing issues and reviewing claim denials.
Overview
10
10
years of professional experience
Work History
Hospice Pharmacy Services Specialist
United Healthcare
Montgomery , AL
01.2021 - Current
- Followed up with doctors' offices regarding any clarification needed on prescriptions or refills requested by customers.
- Prioritized and organized tasks to efficiently accomplish service goals.
- Displayed strong telephone etiquette, effectively handling difficult calls.
- Maintained schedule of class assignments to meet deadlines.
- Provided assistance communicating, typing correspondence or obtaining information.
- Checked documents for accuracy and completeness prior to typing.
- Code inpatient professional fee services for identified inpatient admissions,
- Establish primary and secondary diagnosis and procedure codes for inpatient professional encounters, following applicable regulations, instructions, and reimbursement requirements.
- Link appropriate diagnosis to procedures and determine the level of E/M service provided.
- Code all inpatient procedures reported inapplying ICD and CPT coding guidelines.
- Select proper codes using the current code set and encoder product suite, ensuring all procedures file correctly to the appropriate Patient Care Encounter .
- Proficient in ICD and CPT coding guidelines
- Strong understanding of regulatory fraud and abuse guideline's
- Excellent attention to detail and accuracy
- Ability to establish primary and secondary diagnosis and procedure codes
- Skilled in reviewing and correcting codes for accuracy
- Experience with inpatient and outpatient coding processes
- Familiarity with electronic health record systems
- Strong communication and teamwork
Social Worker Assistant
Brantwood Children’s Home
Montgomery , AL
05.2023 - 03.2024
- Supported patients' needs by maintaining positive, supportive and structured environment.
- Assessed mental health needs of each child and coordinated appropriate services when needed.
- Monitored self-administered medications and set up strategies to help patients maintain schedules during periods away from program facilities.
- Developed workable solutions for recurring problems for individuals and families.
- Created individualized service plans based on each client's specific needs and goals.
- Provided crisis intervention services such as counseling or referral information when needed.
- Collaborated with other professionals to coordinate interventions and long-term plans for clients.
- Researched new methods of delivering mental health services in order to improve outcomes.
Pharmacy Technician
Walgreens
Montgomery , AL
07.2014 - 06.2020
- Teamed with peers, technicians and pharmacists to prioritize and complete orders.
- Created new customer profiles and updated demographics, allergies and new medications in pharmacy computer systems.
- Assisted pharmacist with clearing high volume of prescriptions and responded to customer questions.
- Maintained strict patient confidentiality to adhere to HIPAA regulations and avoid data compromises.
- Worked with insurance companies to process claims, resolve problems and obtain payments.
- Transmitted claims to insurance companies for payment and reconciled EOBs.
- Experience with inpatient and outpatient coding processes
- Familiarity with electronic health record systems
- Strong communication and teamwork skills
Education
Associate of Healthcare - Billing And Coding Specialist
Phlebotomy Ink
Birmingham, AL04-2024
High School Diploma -
Jefferson Davis High School
Montgomery, AL06-2012
Skills
- Collaboration and Teamwork
- Pharmaceutical Calculations
- Insurance Billing
- HIPAA
- Labeling prescriptions
- Healthcare regulations
- Resolving customer issues
- Supporting pharmacy operations
- Problem-solving skills
- Processing payments
- Insurance Verification
- Billing support
- Certified Billing and Coding #R5X4Q3A7
- Pharmacy Technician #T44876
- Proficient in ICD and CPT coding guidelines
- Strong understanding of regulatory fraud and abuse guidelines
- Excellent attention to detail and accuracy
- Ability to establish primary and secondary diagnosis and procedure codes
- Skilled in reviewing and correcting codes for accuracy
- Experience with inpatient and outpatient coding processes
- Familiarity with electronic health record systems
- Strong communication and Pharmacy's
- Select proper codes using the current code set and encoder product suite, ensuring all procedures file correctly to the appropriate Patient Care Encounter
- Add Anesthesia and Pathology codes to PCE encounters for all billable surgical cases
Timeline
Social Worker Assistant
Brantwood Children’s Home
05.2023 - 03.2024
Hospice Pharmacy Services Specialist
United Healthcare
01.2021 - Current
Pharmacy Technician
Walgreens
07.2014 - 06.2020
Associate of Healthcare - Billing And Coding Specialist
Phlebotomy Ink
High School Diploma -
Jefferson Davis High School