REBECCA MILES
Spotsylvania,Virginia
Summary
Highly-motivated employee with desire to take on new challenges. Strong worth ethic, adaptability and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills.
Overview
25
25
years of professional experience
Work History
Medical Coder
Optum, UnitedHealth Group
REMOTE, VA
09.2000 - Current
- Maintained updated knowledge of coding requirements, which included continuing education and certification renewal.
- Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements.
- Added modifiers as appropriate, coded narrative diagnoses and verified diagnoses.
- Maintained high accuracy rate on daily production of completed reviews.
- Communicated with healthcare personnel, including practitioners to promote accuracy.
- Verified proper coding, sequencing of diagnoses and accuracy of radiology procedures.
- Quickly responded to staff and client inquiries regarding CPT codes.
- Acted as liaison between business department, billers and third party payers in resolving billing and reimbursement accuracy.
- Maintained positive working relationship with fellow staff and management.
- Mentored junior team members and managed employee relationships.
- Streamlined day-to-day office processes to meet long-term goals.
- Identified errors and re-filed denied or rejected claims quickly to prevent payment delays.
- Posted charges, payments and adjustments.
- Entered procedure codes, diagnosis codes and patient information into MDIV, EXCODE, and PC7.
- Collaborated closely with other departments to resolve claims issues.
- Maintained timely and accurate charge submission through electronic charge capture, including billing and account receivables (BAR) system and clearing house.
- Checked claims coding for accuracy with ICD-10 standards.
- Participated in workshops, seminars and training classes to gain stronger education in industry updates and federal regulations.
- Identified discrepancies and carrier issues regarding billing and reimbursements.
- Performed monthly offshore audits and verified proper coding, sequencing of diagnoses and accuracy of radiology procedures.
- Performed AI audits prior to go-live and verified proper coding, sequencing of diagnoses and accuracy of radiology procedures.
Education
High School Diploma -
Chancellor High School
Fredericksburg, VA06.2020
CERTIFIED PROFESSIONAL CODER - MEDICAL CODING
AAPC
Salt Lake City, UT02.2015
Skills
- Attention to Detail
- Clear Communication
- Critical Thinking and Analysis
- Report Preparation
- Verbal and Written Communication
- Microsoft Office Proficient
- Team Collaboration
- Coding Error Resolution
- Medical Terminology
- Epic Systems
- Certified Professional Coder
- HIPAA Compliance
Timeline
Medical Coder
Optum, UnitedHealth Group
09.2000 - Current
High School Diploma -
Chancellor High School
CERTIFIED PROFESSIONAL CODER - MEDICAL CODING
AAPC