Tiffany Brown
SACRAMENTO,CA
Summary
AAPC- Certified Professional Coder with extensive Fee for Service (FFS) and FQHC experience. CPC-certified coder with 15 years of revenue cycle experience.
Overview
11
11
years of professional experience
1
1
Certification
Work History
Clinic Coder
The Everett Clinic- Optum/United Healthcare
06.2023 - Current
- Correctly coded and billed medical claims for various hospital and nursing facilities.
- Maintained high coding standards by adhering to industry best practices and staying current with emerging technologies.
- Utilized electronic medical record systems to store, retrieve and process patient data.
- Used strong analytical and problem-solving skills to develop effective solutions for challenging situations.
- Communicated effectively with staff, patients, and insurance companies by email and telephone.
Certified Coding Specialist
Elica Health Centers
12.2018 - 05.2022
- Assigned accurate medical codes for diagnoses, procedures, and services performed
- Investigated medical claims for correct coding standards per (CMS) and (HRSA) guidelines
- Resolved various claim edits, charge corrections and incorrect payment credits
- Trained staff in coding subject matter.
Senior Healthcare Analyst
Health Net
02.2015 - 12.2018
- Determined level of reimbursement based on established criteria: contracts, plans, and employer groups
- Researched and adjusted requests for overpayment, underpayment, refund, and contract issues and ensured compliance with departmental and company policies and procedures
- Conducted cost containment analysis.
Denials Analyst
Dignity Health Medical Foundation
07.2013 - 12.2014
- Researched insurance payer contracts for corrected reimbursement rates
- Applied contractual adjustments to outstanding claims
- Assisted providers with appropriate billing and authorization procedures
- Prepared and submitted medical claims to insurance payers for reimbursement
- Reviewed, corrected, and appealed denied medical claims
- Posted patient payments, corrected patient insurance coverage information and verified patient insurance coverage.
Education
B.S. in Health Information Technology -
02.2024
Technical Diploma in Medical Administration - Coding Education
01.2011
Skills
- Medical Billing
- CPT coding
- ICD-10 coding
- Hospital coding experience
- Auditing
- Anatomy/Physiology Knowledge
- Managed Care, Commercial, Medicare, Medicaid experience
- Certified Coding Specialist - Physician - Based (CCS-P)
- Regulatory guidelines
- Medical billing code accuracy
- EMR Systems
- Certified Medical Coder
Ehr Systems
- Epic
- 3M
- Athena Health
- Optum 360
- Cerner
- IDX
- Meditech
- Allscripts
Certification
- CPC - Certified Professional Coder
Timeline
Clinic Coder - The Everett Clinic- Optum/United Healthcare
06.2023 - Current
Certified Coding Specialist - Elica Health Centers
12.2018 - 05.2022
Senior Healthcare Analyst - Health Net
02.2015 - 12.2018
Denials Analyst - Dignity Health Medical Foundation
07.2013 - 12.2014
Thomas Edison University - B.S. in Health Information Technology,
Madison Technical Institute - Technical Diploma in Medical Administration, Coding Education
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