
Experienced nursing professional with excellent skills in patient assessments, managed care, and delivering high-quality nursing care
To determine the appropriateness of patient charges and Charge Description Master (CDM) assigned HCPCS/CPTs by reviewing the medical record, facility protocol and other applicable documentation
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analyzes and resolves billing edits that are holding patient claims from billing by reviewing medical records and other applicable documentation
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Makes necessary adjustments to patient account charges based on regulatory and payor guidelines
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Determine the appropriateness of patient charges by verifying billing data for accuracy and completeness and by following regulatory requirements to resolve edits or exceptions
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Apply modifiers when appropriate or make necessary adjustments to patient account charges and/or balances