Wendi Swyhart
Coding and Charging Specialist
Nixa,MO
Summary
Detail-oriented Coding and Charge Specialist with 26 years at Mercy Hospital Springfield, achieving 97% accuracy in complex specialty coding. Expert in ICD-9, ICD-10, and CPT coding, adept at resolving billing issues and enhancing claims processing. Strong communicator with a commitment to maintaining HIPAA compliance and improving reimbursement accuracy.
Overview
26
26
years of professional experience
2
2
Certifications
Work History
Coding and Charge Specialist
Mercy Hospital Springfield
04.1999 - Current
Accurate medical coder performs all aspects of medical billing, including coding, charge entry, transmission, correction and resubmission. Brings 26 years of experience in working hand-in-hand with front office to validate proper information for claims processing. Detail-oriented and helpful professional with expertise in resolving billing issues and reviewing claim denials. ICD-9, ICD-10, CPT, and ASC coding expertise. Career spent assessing provider documentation to ensure appropriate codes have been assigned. Have a strong work ethic and can-do attitude. Knowledge in HIPAA regulations, and AMA and CMS coding rules.
Education
High School Diploma -
Kickapoo High School
Springfield, MO 65806No Degree -
Missouri State University
Springfield, MOSkills
- Coded outpatient encounters and complex specialty coding, maintaining 97% accuracy Reviewed medical record information to identify all appropriate coding Acted as liaison between business department, billers and third party payers in resolving billing and reimbursement accuracy Sought clarification from physicians and other hospital personnel for answers to needed coding interpretations prior to abstracting records Reviewed and abstracted relevant clinical data from electronic medical records to select appropriate code for procedures Coded medical observations and professional services delivered for each patient Carefully coded disease and injury diagnoses, acuity of care and procedures in inpatient setting Quickly responded to staff and client inquiries regarding CPT codes Verified proper coding, sequencing of diagnoses and accuracy of Outpatient procedures Reviewed account information to confirm patient and insurance information is accurate and complete
- Assigned additional diagnosis codes based on specific clinical findings (laboratory, radiology and, pathology reports as well as clinical studies) in support of existing diagnoses Interpreted medical reports to apply appropriate ICD-10, CPT and HCPCS codes Assigned procedure and diagnosis codes for insurance billing using EPIC Actively maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third party requirements regarding billing Applied coding rules established by American Medical Association and Centers for Medicare and Medicaid Services for assignment of procedural codes Communicated with healthcare personnel, including practitioners to promote accuracy Added modifiers as appropriate, coded narrative diagnoses and verified diagnoses Read through patient health data, including histories, physician diagnoses and treatments to gain understanding for coding purposes Maintained updated knowledge of coding requirements, which included continuing education and certification renewal Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements Submitted clean claims to insurance companies electronically to secure payments Investigated rejected and denied claims, correcting applicable coding Maintained strict confidentiality with adherence to HIPAA guidelines and regulations
- Proficient in EPIC/3M/CAC, Vitalware, some Excel
Certification
Hold CPC and CCS certifications
Timeline
Coding and Charge Specialist
Mercy Hospital Springfield
04.1999 - Current
High School Diploma -
Kickapoo High School
No Degree -
Missouri State University
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