Shanise Williams
Queens,NY
Summary
Efficient professional in healthcare documentation boasts high productivity and the capability to complete tasks swiftly while maintaining accuracy. Skilled in medical coding, electronic health records management, and data analysis. Excel in organizational, communication, and problem-solving skills, ensuring seamless workflow and compliance with healthcare regulations.
Overview
16
16
years of professional experience
1
1
Certification
Work History
Claims Medical Certified Professional Coder
Healthcare Risk Advisors
Manhattan, NY
03.2023 - Current
- Provided feedback while checking for appropriate coding, catching errors, and making revisions found in submitted claims.
- Maintained accurate records of all claim activities for audit purposes.
- Inputted data into the system, maintaining the accuracy of coding information and reported services.
- Stayed current on HIPAA regulations, claims processing, and medical terminology.
- Organized information by using spreadsheets, databases or word processing applications.
- Participated in training sessions designed to educate staff on importance of effective risk management principles.
- Recommended appropriate action steps based on results of analytical research into specific areas of risk exposure.
- Reviewed police reports, medical treatment records, medical bills and physical property damage to determine extent of liability.
- Assign ICD-9-CM, ICD-10-CM, and ICD-10-PCS to claims.
- Provided guidance on complex clinical scenarios requiring special attention when assigning codes.
- Resolved discrepancies between coded information and medical record documentation.
- Analyzed data from multiple sources to identify patterns that may indicate incorrect coding.
- Collaborated with internal departments to ensure the timely submission of clean claims.
- Interpreted physician orders, notes, lab results, radiology reports. for appropriate code assignment.
- Applied coding rules established by American Medical Association and Centers for Medicare and Medicaid Services for assignment of procedural codes.
- Read through patient health data, histories, physician diagnoses and treatments to gain understanding for coding purposes.
- Maintained updated knowledge of coding requirements, which included continuing education and certification renewal.
- Assigned additional diagnosis codes based on specific clinical findings (laboratory, radiology and, pathology reports as well as clinical studies) in support of existing diagnoses.
- Verified proper coding, sequencing of diagnoses, and accuracy of procedures.
- Participated in coding team meetings to discuss challenges and best practices.
- Interpreted medical reports to apply appropriate ICD-9, ICD-10, CPT-4, and HCPCS codes.
- Managed coding for multiple specialties, ensuring specific codes are accurately applied.
Medical Biller and Coder Externship
Island Musculoskeletal Care
Hewlett, NY
10.2023 - 01.2024
- Performed daily audits on all bills submitted for accuracy and completeness.
- Maintained up-to-date knowledge of coding regulations and changes in reimbursement policies.
- Interpreted physician orders, notes, lab results, radiology reports. for appropriate code assignment.
- Reviewed medical records and identified diagnosis codes, procedures, services and supplies for coding.
- Verified accuracy of patient information and insurance data in billing system.
- Tracked details such as authorizations, pre-certifications or referrals required prior to service delivery.
- Worked closely with physicians to obtain additional clinical information when needed for accurate coding assignments.
- Read through patient health data, histories, physician diagnoses and treatments to gain understanding for coding purposes.
- Added modifiers as appropriate, coded narrative diagnoses and verified diagnoses.
- Entered coded data into electronic health record (EHR) systems.
- Submitted claims to insurance companies electronically or by mail.
- Ensured timely filing of all claims within established guidelines.
Receptionist Administrator
Access Staffing
Melville, NY
08.2016 - 10.2023
- Welcomed visitors and customers by greeting and answering or directing inquiries.
- Maintained office supply inventory and placed orders to meet demand.
- Facilitated smooth communication between staff and senior management through diligent message delivery.
- Resolved customer complaints or answered customers' questions.
- Researched and prepared reports required by management or governmental agencies.
- Recommended solutions related to staffing issues and proposed procedural changes to managers.
- Issued work schedules, duty assignments and deadlines for office or administrative staff.
- Computed balances, totals or commissions to support accounting team.
Account Payable Clerk
A Holly Patterson Extended Care
Uniondale, NY
07.2011 - 07.2016
- Analyzed purchase orders, contracts, invoices, check requests and other documents related to the accounts payable cycle.
- Processed invoices and payments in accordance with company policies and procedures.
- Prepared checks for payment of vendor invoices on a timely basis.
- Maintained accounts payable files and records in an organized manner.
- Provided support during internal and external audits as necessary.
- Managed vendor relationships through prompt communication of payment information.
- Identified areas where operational efficiencies can be improved in the accounts payable process.
- Collaborated with vendors, suppliers and staff members across departments to resolve any issues that arose.
- Verified accuracy of coding on invoices prior to processing payments.
- Applied mathematical skills to calculate totals, check figures, and correct problems with physical and digital files.
- Checked postings and documents for correctness, accuracy and proper coding.
- Matched orders with invoices and recorded required information.
Medical Records Clerk
Nassau University Medical Center
East Meadow, NY
06.2009 - 07.2011
- Reviewed medical records for completeness and accuracy according to established guidelines.
- Responded to inquiries from patients, physicians and other healthcare providers regarding medical records.
- Maintained a secure filing system for confidential documents.
- Processed incoming medical records requests.
- Retrieved patient medical records in response to requests from authorized personnel.
- Assisted in developing processes for maintaining current information in patient's files.
- Prepared reports summarizing patient information as requested by physicians or other healthcare providers.
- Identified discrepancies between physical documentation and electronic health records.
- Updated patient files with new medical information as needed.
- Processed and invoiced records requests from patients, providers and third parties.
- Tracked and processed release of information requests.
- Maintained complete confidentiality in accordance with HIPPA/ organization and legal requirements.
- Purged outdated files.
- Pulled patient charts for upcoming appointments.
Education
High School Diploma -
Hempstead High School
Hempstead, NY08-1993
Skills
- Surgical coding experience
- Continuing education commitment
- Anatomy and physiology
- ICD-9CM ICD-10CM ICD-10 PCS CPT
- Certified Professional Coder CEU
- Claims processing efficiency
- Medical terminology
- Electronic health records navigation
- Documentation review expertise
- HIPAA compliance
- Investigative
- Critical thinking
- Analytical reasoning
- Evidence collection
- Medical record analysis
- Policy investigations
- Accident scene investigations
- Examine reports
- Claim form analysis
- Case reporting
- Analytical thinking
Certification
Certified Professional Coder AAPC
Timeline
Medical Biller and Coder Externship
Island Musculoskeletal Care
10.2023 - 01.2024
Claims Medical Certified Professional Coder
Healthcare Risk Advisors
03.2023 - Current
Receptionist Administrator
Access Staffing
08.2016 - 10.2023
Account Payable Clerk
A Holly Patterson Extended Care
07.2011 - 07.2016
Medical Records Clerk
Nassau University Medical Center
06.2009 - 07.2011
Certified Professional Coder AAPC
High School Diploma -
Hempstead High School
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