Shamira Ross
Las Vegas,NV
Summary
Detail-oriented Medical Biller and Coder with proven skills in ICD-10 coding, claims processing, and denial management. Committed to ensuring compliance with HIPAA regulations and optimizing revenue cycle management.
Overview
9
9
years of professional experience
Work History
Medical Biller and Coder
Kaiser Permanente
Los Angeles, CA
04.2022 - 10.2025
- Processed and submitted medical claims using advanced billing software to ensure accurate reimbursements.
- Reviewed patient records for coding accuracy, minimizing errors in insurance billing submissions.
- Collaborated with healthcare providers to resolve discrepancies in coding and billing information.
- Analyzed billing reports to identify trends and implement improvements in revenue cycle management.
Medical Biller
Cedar Sinai Medical Center
Beverly Hills, CA
02.2020 - 06.2021
- Processed and submitted medical claims to ensure timely reimbursement and compliance with regulations.
- Reviewed patient records and billing data for accuracy, resolving discrepancies promptly.
- Collaborated with healthcare providers to verify insurance coverage and obtain necessary authorizations.
- Utilized electronic health record (EHR) systems for efficient billing operations and documentation management.
- Verified insurance of patients to determine eligibility.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Filed and updated patient information and medical records.
Medical Coder
Providence Health & Services
Santa Monica, CA
10.2016 - 12.2018
- Analyzed and assigned accurate medical codes for diverse procedures and diagnoses.
- Ensured compliance with coding regulations and guidelines, minimizing errors in documentation.
- Collaborated with healthcare providers to resolve coding discrepancies and optimize billing processes.
- Streamlined coding workflows, improving efficiency of claims processing and reimbursement cycles.
- Minimized errors by providing ongoing feedback to clinical staff regarding proper documentation practices.
- Reduced claim denials by maintaining thorough knowledge of payer-specific requirements and guidelines.
- Monitored changes in coding regulations to provide recommendations for compliance.
- Conducted internal audits to identify areas for improvement in coding accuracy and compliance.
- Generated reports to identify coding trends and discrepancies.
- Reduced turnaround time for appeals by preparing comprehensive supporting documentation for denied claims.
Education
Medical Billing And Coding
American Career College
CA06-2009
Skills
- HIPAA compliance
- Payment posting
- Insurance verification
- ICD-10 proficiency
- CMS-1500 form completion
- Patient account management
- Medicare and medicaid billing
- Claim submission
- Medical coding expertise
- Diagnostic coding
- Appeals processing
- Procedural coding
- Commercial insurance billing
- Workers' compensation billing
- UB-04 form completion
- Denial management
- CPT coding
- Revenue cycle management
- Disability claims process
- Medical billing procedures
- Claims processing
Timeline
Medical Biller and Coder
Kaiser Permanente
04.2022 - 10.2025
Medical Biller
Cedar Sinai Medical Center
02.2020 - 06.2021
Medical Coder
Providence Health & Services
10.2016 - 12.2018
Medical Billing And Coding
American Career College