Summary
Overview
Work History
Education
Skills
Certification
Timeline
Generic

RALENA WILBON

Waddell,Az

Summary

Medical Coding Specialist with 7 years providing administrative and patient support in hospital and medical office settings. Advanced knowledge of private insurance processes and codes.

Overview

8
8
years of professional experience
1
1
Certification

Work History

Profee Coder

Nuvance Health
03.2023 - Current
  • Attained perfect 100% accuracy on quarterly coding audits through precise execution of ICD-10 CM and CPT coding for primary care offices, palliative care, vascular labs and EKG’s
  • Demonstrated exceptional efficiency by expertly processing 75-100 claims daily, leveraging extensive understanding of both commercial and government payer systems
  • Exceed organizations expectations in customer service, and teamwork, contributing to positive and collaborative work environment
  • Collaborate with physicians, nurses and other healthcare professionals to clarify documentation and ensure accurate coding assignment.
  • Applied official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services to assign diagnostic codes.
  • Resourcefully used various coding books, procedure manuals, and on-line encoders.
  • Generated reports to identify coding trends and discrepancies.

Profee Coder

Regency Specialties
05.2020 - 03.2023
  • Accurately reviewed and analyzed medical records related to trauma and dermatology cases
  • Assigned appropriate codes in accordance with ICD-10 CM and CPT guidelines
  • Consistently went extra mile in supporting coworkers, offering extensive assistance and guidance with their medical coding inquiries
  • Utilized understanding of 2020-2023 coding guidelines, ICD-10 and CPT codes to meticulously rectify denied claims, leading to significant increase in successful reimbursement rates
  • Conducted 10 comprehensive E/M audits monthly for dermatology, guaranteeing adherence to regulatory requirements and precision in coding.
  • Applied official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services to assign diagnostic codes.
  • Resourcefully used various coding books, procedure manuals, and on-line encoders.

Home Health Coder

Select Data Home Care
12.2019 - 07.2020
  • Collaborates with clinical supervisor and field staff to ensure comprehensive and accurate coding of 485’s
  • Diligently inspects medical records to verify accuracy and completeness, meeting criteria stipulated by insurance companies
  • Consistently achieved coding of minimum of 300 charts per month or daily number of admissions, ensuring accurate and efficient medical coding
  • Meticulously followed coding updates, ensuring prompt access to most recent information
  • Attained 95% accuracy on monthly coding audits through precise execution of ICD-10 CM and CPT coding.

Home Health Coder

Team Select Home Care
08.2015 - 01.2020
  • Collaborates with clinical supervisor and field staff to ensure comprehensive and accurate coding of 485’s
  • Diligently inspects medical records to verify accuracy and completeness, meeting criteria stipulated by insurance companies
  • Consistently achieved coding of a minimum of 300 charts per month or daily number of admissions, ensuring accurate and efficient medical coding
  • Vigilantly tracked coding updates to ensure immediate access to latest information
  • Attained 96% accuracy on monthly coding audits through precise execution of ICD-10 CM and CPT coding.

Education

Bachelor’s - Business Management

University of Phoenix
Phoenix, Az
2005

Skills

  • Healthcare Documentation Review
  • Revenue Cycle Management
  • Auditing and Quality Assurance
  • Claim Denial Management
  • Strategic Thinking and Planning
  • Data Analysis and Interpretation
  • Cross Functional Collaboration
  • Insurance Verification

Certification

  • CRC - Certified Risk Adjustment Coder
  • CPC - Certified Professional Coder
  • CPC-I- AAPC Approved Instructor
  • HCS-D Certified Home Health Coder

Timeline

Profee Coder

Nuvance Health
03.2023 - Current

Profee Coder

Regency Specialties
05.2020 - 03.2023

Home Health Coder

Select Data Home Care
12.2019 - 07.2020

Home Health Coder

Team Select Home Care
08.2015 - 01.2020

Bachelor’s - Business Management

University of Phoenix

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