Summary
Overview
Work History
Education
Skills
Additional Information
Timeline
Generic

Sandra Pope

Longview,TX

Summary

Hardworking professional applies official coding conventions and rules established by American Medical Association and Centers for Medicare and Medicaid Services. Confident Medical Coder adheres to data confidentiality and privacy rules in all workflows and promotes dynamic interpersonal skills. Knowledgeable medical office professional talented at correcting and resubmitting claims, preparing patient charts and reviewing health records to identify proper diagnosis codes for billing. Offers background in reviewing, analyzing and managing medical record information to obtain prior authorizations from insurance companies and ensure payment. Medical Billing and Coding Specialist with 24 years providing administrative and patient support in hospital and medical office settings. Advanced knowledge of private insurance processes and codes. Polished professional manages multiple tasks, utilizes electronic medical record systems, and provides excellent customer service to patients and staff. Adheres to medical records policies and procedures to comply with HIPAA regulations. Track record of effectively troubleshooting issues and maintaining patient confidentiality. Disciplined individual skilled in collecting and verifying patient demographic and insurance information and preparing and maintaining medical records. Proficient in using medical terminology and classifying diagnostic procedures, treatments and medications. Dedicated to providing highest quality care to patients. Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.

Overview

24
24
years of professional experience

Work History

Medical Billing and Coding Lead

Clinix Health Services of Colorado
Centennial, Co
09.1999 - Current
  • Ability to work with multiple practice management and EHR systems to ensure proper billing and coding
  • Managed billing department for multi diverse practice
  • Maintain accuracy while inputting CPT and ICD-10 codes for insurance billing
  • Analyzing financial and performance reports to work on problem areas and organize staff for major projects
  • Quick and efficient follow up to insurance companies to maintain low rejection report of 1.2 percent and increase collections on consistent basis with AR of 32 days and below
  • Maintained knowledge for navigating payer websites to determine claim status, and submit medical records
  • Performed accounts receivable duties including invoicing, researching denials, discrepancies, and reconciliations
  • Communicated with customers to identify and resolve outstanding payments
  • Referrals to Specialist
  • Management Training
  • Front Desk and Scheduling
  • Properly coding services, procedures, diagnoses, and treatments
  • Preparing and sending invoices or claims for payment
  • Correcting rejected claims
  • Tracking payments
  • Following up with patients outstanding bills
  • Ensures professional and friendly customer service to both internal and external customers
  • Demonstrates knowledge of insurance coverage and benefits
  • Is focused on systematic improvement and monitoring of Revenue Cycle Management
  • Special Projects for Upper Management
  • Leadership
  • Promoted to supervisory roll with ability to lead multiple teams to exceptional success.
  • Assigned appropriate medical codes with 85 percent accuracy rate
  • 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
  • Communicated with insurance companies to research and resolved coding discrepancies
  • Reviewed, analyzed, and managed coding of diagnostic and treatment procedures contained in outpatient medical records
  • Interacted with physicians and other healthcare staff to ask questions regarding patient services
  • Reviewed patient charts to better understand health histories, diagnoses, and treatments
  • Monitored changes in coding regulations to provide recommendations for compliance
  • Utilized active listening, interpersonal, and telephone etiquette skills when communicating with others
  • Performed on-site coding audits to determine accuracy and compliance with coding guidelines
  • Verified signatures and checked medical charts for accuracy and completion
  • Maintained accuracy, completeness, and security for medical records and health information
  • Verified accuracy of patient information in medical records
  • Scanned and uploaded medical records into electronic medical records system
  • Updated patient financial information to guarantee accuracy
  • Assigned appropriate medical codes with 90 percent accuracy rate

Education

Skills

  • Emily Griffith Technical College
  • November 1995
  • Denver, Colorado
  • KEY SKILLS
  • Account reconciliation
  • Coding
  • Customer service
  • 10- key proficient
  • Microsoft word, excel, powerpoint, outlook
  • EHR systems
  • Allscripts
  • Payment processing

Additional Information

  • AWARDS , Employee of the year 2022

Timeline

Medical Billing and Coding Lead

Clinix Health Services of Colorado
09.1999 - Current

Sandra Pope