Tina Ennis
Manitowoc,WI
Summary
Accomplished CPC offering 14 years experience , accurately entering information for insurance and billing purposes. Highly skilled at memorizing frequently used codes for speedy completion of work. Demonstrated professionalism when communicating with patients, insurance companies, and healthcare staff.
Experience in pro-fee coding: in-patient, out-patient, behavioral health, & multi-specialties. Detail orientated and knowledgeable on coding guidelines and changes with background in Medicare, Medicaid, and third-party billing.
Overview
17
17
years of professional experience
1
1
Certification
Work History
CERTIFIED CODER
MEDIX, Memorial Hospital And Health Care Center
08.2023 - Current
- Reviewed out-patient medical documents of diagnosis and procedures and assigned ICD-10, CPT, and HCPCS according to coding guidelines
- Analyzed reports for accuracy on patient information, recorded date of service or procedure and verified location and physician name and signature
- Consulted with physicians on documentation that was incomplete, inaccurate or required further diagnosis specification
- 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 outpatient records and interpreted documentation to identify diagnoses and procedures
- Interacted with physicians and other healthcare staff to ask questions regarding patient services
- Maintained updated knowledge of coding requirements, through continuing education and certification renewal
- Verified, coded and added modifiers to diagnoses
- Reviewed patient charts to better understand health histories, diagnoses, and treatments.
CODER II/RADIOLOGY
Medical College Of Wisconsin
02.2023 - 06.2023
- 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
- Correctly coded and billed medical claims for various hospital and nursing facilities.
- Verified signatures and checked medical charts for accuracy and completion.
- Reviewed outpatient records and interpreted documentation to identify diagnoses and procedures.
- Used classification manuals to gain additional knowledge of disease and diagnoses processes.
CERTIFIED PROFESSIONAL CODER
Agnesian Health Care/SSM, FDLRC
12.2012 - 02.2023
- Prepare and code electronic clinic charges for data entry according to medical guidelines and medical regulations to ensure payment is of the maximum allowed.
- Reviewed account information to confirm patient and insurance information is accurate and complete.
- Applied coding rules established by American Medical Association and Centers for Medicare and Medicaid Services for assignment of procedural codes
- Collaborated with billing team to confirm no additional diagnosis codes available for LCD and NCD coverage
- Maintained updated knowledge of coding requirements, which included continuing education and certification renewal
- Responded to coding questions from callers and other internal departments
- Added modifiers as appropriate, coded narrative diagnoses and verified diagnoses
- 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 and abstracted all medical data to assign appropriate codes for hospital inpatient records
- Reviewed clinical data from medical records to assign ICD, CPT and HCPCS codes
- Trained and mentored junior coders to support growth and development ad apply high-quality coding practices.
PATIENT ACCOUNT SPECIALIST
Agnesian Healthcare
11.2009 - 11.2012
- Answers calls and explain methods of filing/resolution of claims to patients
- Enters payment and discount information as necessary and reviews payment and denials for proper reimbursement.
- Evaluates accounts and prepares adjustments to refund payments and correct discrepancies as necessary.
- Maintains working knowledge of AHC managed care contracts, Medicare, Medical Assistance, Workman's Compensation guidelines, discount rules and insurance billing.
- Manages on-line work list and reports to insure timely and accurate filing and resolution of claims.
- Updates patient demographic information into computer as necessary
- Works with outside vendors on claim disputes to ensure proper reimbursement per contract and/or industry guidelines.
CUSTOMER SERVICE REPRESENTATIVE
Aurora Medical Group
11.2009 - 11.2012
- Evaluates accounts and prepares adjustments to refund payments and correct discrepancies as necessary, Vision, Ob Gyn, Family Medicine, Behavioral Health, Pediatrics, Registration
- Schedule/reschedule patient appointments in GE
- Complete referrals /enter referral in to GE
- Maintains working knowledge of AHC managed care contracts, Medicare
- Medical Assistance, Workman's Compensation guidelines, discount rules and insurance billing
- Manages on-line work list and reports to insure timely and accurate filing and resolution of claims
- Updates patient demographic information into computer as necessary
- Works with outside vendors on claim disputes to ensure proper reimbursement per contract and/or industry guidelines
- Enter messages into Cerner
- Capture patient demographics
- Answer multiple phone lines
- Collect co-pays
- Enter patient insurance information
- Obtain authorizations
- Check status of patient's accounts
- Post co-payments to patients accounts/print/write recipes
- Check Aurora Health Care's Refill line/ Check the My Aurora website, direct all messages to appropriate nurse/CSR
RECEPTIONIST
Raether Chiropractic
06.2007 - 10.2008
- Answer multiple lines to schedule or reschedule patients
- Collect co-pays and enter entries into patient accounts
- Enter diagnoses into practice management software (Eclipse)
- Verify insurance coverage and eligibility of patients
- Maintain patient files
- Produce day sheets, balance/close out drawer
- Implement HIPAA privacy
Education
Medical Insurance Billing -
Moraine Park Technical College
Fond Du Lac, WI06.2007
Medical Office Specialist -
Moraine Park Technical College
Fond Du Lac, WI06.2007
Skills
- Adaptability and Flexibility
- Specialty-Specific Coding
- Behavioral Health Coding
- Appeals Process Handling
- Denial Management Strategies
- Team Collaboration Abilities
- Evaluation and Management Coding
- Proficiency in McKesson, Cerner, & Epic
- Coding Error Resolution
- Inpatient Coding
Certification
- CPC - Certified Professional Coder
Timeline
CERTIFIED CODER
MEDIX, Memorial Hospital And Health Care Center
08.2023 - Current
CODER II/RADIOLOGY
Medical College Of Wisconsin
02.2023 - 06.2023
CERTIFIED PROFESSIONAL CODER
Agnesian Health Care/SSM, FDLRC
12.2012 - 02.2023
PATIENT ACCOUNT SPECIALIST
Agnesian Healthcare
11.2009 - 11.2012
CUSTOMER SERVICE REPRESENTATIVE
Aurora Medical Group
11.2009 - 11.2012
RECEPTIONIST
Raether Chiropractic
06.2007 - 10.2008
Medical Insurance Billing -
Moraine Park Technical College
Medical Office Specialist -
Moraine Park Technical College
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