REGINA SOK
Masury,OH
Summary
Detail-oriented Medical Billing and Coding Specialist with expertise in medical coding, claims processing, and revenue cycle management. Assigns CPT, ICD-10-CM, ICD-10-PCS, and HCPCS codes accurately, manages claim submissions, and resolves denials to ensure timely reimbursement. Collaborates with healthcare providers and insurance carriers to address billing inquiries while adhering to HIPAA regulations and payer guidelines.
Overview
1
1
Certification
18
18
years of professional experience
Work History
Medical Coder, Medical Biller
EYECARE ASSOCIATES/ CENTER FOR ADVANCED SURGERY
10.2022 - Current
- Coded medical records using CPT, ICD-10-CM, and HCPCS coding systems to ensure accurate claim submission and compliance with payer guidelines.
- Monitored claims throughout reimbursement cycle, resolved front-end claim denials, and ensured accurate insurance payments for timely reimbursements.
- Responded to 20+ patient billing inquiries weekly, clarifying account balances, payment questions, and insurance-related concerns effectively.
- Communicated with insurance carriers to verify claim status and resolve reimbursement issues, facilitating timely payment processing.
Medical Coder
YOUNGSTOWN ORTHOPAEDIC ASSOCIATES
01.2020 - 10.2022
- Accurately coded medical records using CPT, ICD-10-CM, and HCPCS coding systems to ensure compliant claim submission and proper reimbursement.
- Monitored insurance claims from submission through payment, investigated denials, and followed up to secure timely reimbursement.
- Assisted 20+ patients weekly by addressing billing inquiries, clarifying account balances, and resolving payment-related concerns to enhance customer satisfaction.
- Communicated with commercial and government insurance providers to verify claim status, resolve billing issues, and expedite payment processing for improved cash flow.
Inpatient Medical Coder
TRUMBULL REGIONAL HOSPITAL
01.2019 - 01.2020
- Maintained compliance with AHA Coding and Reporting Guidelines, CMS directives for ICD-10-CM, ICD-10-PCS, and CPT Coding through annual coding seminars and ongoing professional development.
- Clarified diagnosis and procedural information through a query process to ensure accurate coding and optimize reimbursement.
- Abstract data elements to satisfy statistical requests by the hospital staff, etc. and enters all coded/abstracted information into the hospital information system
Medical Coder, Medical Biller
TOTAL PRACTICE MANAGEMENT
06.2016 - 01.2019
- Accurately coded medical records using CPT, ICD-10-CM, and HCPCS coding systems to ensure compliant claim submission and accurate reimbursement.
- Oversaw billing process for clinical services, ensuring compliance and accuracy across health and wellness, family planning, reproductive health, and prenatal care.
- Processed and reviewed over 100 claims weekly, achieving accurate charge entry and timely submission to insurance carriers.
- Partnered with clinical staff and insurance providers to resolve billing issues, enhancing claim accuracy and expediting reimbursement turnaround times.
Medical Coder, Medical Biller
MEDSYS CONSULTING
06.2008 - 06.2016
- Coded medical records using CPT, ICD, and HCPCS systems, ensuring compliance with payer requirements and industry regulations to support accurate claims processing.
- Processed 100+ billing transactions weekly, facilitating charge entry, payment posting, and insurance adjustments for commercial, private, and government payers to maintain revenue flow.
- Resolved coding and billing discrepancies, supporting timely claims processing and reducing potential payment delays.
- Maintained a 98%+ billing accuracy rate by performing detailed quality checks and supporting efficient revenue cycle operations in a fast-paced healthcare environment.
Education
ASSOCIATE'S DEGREE - ADMINISTRATIVE ASSISTANT
Boehcker College
Ravenna, OHNo Degree - Inpatient Coding
Reilly Coding Education
VirtualSkills
- CPT
- ICD-10-CM
- ICD-10-PCS
- HCPCS
- Outpatient Coding
- Surgical Coding
- Specialty Coding
- Musculoskeletal Coding
- Maternal Coding
- Vision Coding
- Disease Classification
- Coding Compliance
- Charge Entry
- AR follow-up
- Billing management
- Prior Authorization
- Claim Appeals
- Revenue Cycle Optimization
- Payer Guidelines
- Clinical Documentation
- Excel & software
- Microsoft Office Suite
- Meditech
- 3M Encoder
- Anatomy/Physiology
- Medical Terminology
Certification
Certified Coding Specialist, CCS, Certified Professional Coder, CPC
ACTIVITIES AND HONORS
American Health Information Management Association (AHIMA), Member in good standing, ICD-10 Proficiency
Timeline
Medical Coder, Medical Biller
EYECARE ASSOCIATES/ CENTER FOR ADVANCED SURGERY
10.2022 - Current
Medical Coder
YOUNGSTOWN ORTHOPAEDIC ASSOCIATES
01.2020 - 10.2022
Inpatient Medical Coder
TRUMBULL REGIONAL HOSPITAL
01.2019 - 01.2020
Medical Coder, Medical Biller
TOTAL PRACTICE MANAGEMENT
06.2016 - 01.2019
Medical Coder, Medical Biller
MEDSYS CONSULTING
06.2008 - 06.2016
ASSOCIATE'S DEGREE - ADMINISTRATIVE ASSISTANT
Boehcker College
No Degree - Inpatient Coding
Reilly Coding Education