Objective:
Driven, motivated, and proven medical coding professional eager to make a difference with an established, professional and productive organization. Genuine people person, who is goal/team/company oriented with excellent customer service skills. Brings excellent communication/interpersonal skills, while taking pride in jobs and tasks being completed in a proficient, excellent, timely manner. Honesty and integrity are essential, as are analytical skills and team chemistry. Seasoned professional geared to make a substantial difference.
Certification:
CPC-A (American Academy of Professional Coders A) June 2016
Allied Medical School
Technical College, Certification
∙ Strong competency in Anatomy & Physiology, and Medical Terminology
∙ Proficient in both ICD-9 and ICD-10 coding formats, CPT, and HCPCS.
Skill Highlights:
Maintains strict confidentiality
Electronic Medical Record (EMR) software
ICD-9, ICD-10 coding
CPT and HCPCS coding
HIPAA compliance
Medical billing software
Scheduled for CHONC specialty examination
Strong planning skills
Patient-focused care
Strong work ethic
Team player with positive attitude
Deadline-driven
Excellent written communication
Microsoft Office, Sharepoint proficient
Professional Summary:
Texas Oncology June, 2017 Present
Revenue Cycle Supervisor
∙ Directly supervise two teams, including radiation oncology charge entry and insurance verification.
∙ Implemented new processes and work flows to ensure accurate patient benefit information is obtained and updated in a timely manner 36 hours prior to patient arrival.
∙ Maintain and improved existing charge entry work flows for adherence of policies, guidelines, and procedures.
∙ Directly involved in design and implementation of new practice management systems.
∙ Served as interim supervisor of a third group, the medical oncology charge entry team.
∙ Work congruently with business office managers located across multiple regions to resolve any arising concerns or questions directly related to charge entry, traveling to these offices as necessary.
∙ Sole certified coder and main point of contact for the Accounts Receivable department, serving hematology, medical oncology, and radiation oncology for all regions, to aid in resolving inappropriate diagnosis, infusion, and procedural coding.
∙ Stay current on payer specific guidelines for compliant and accurate coding.
∙ Used NCD, LCD, and NCCI edits to reduce coding and bundling errors.
∙ Responsible for monitoring charge entry productivity reports and work closely with staff to improve and maintain production standards, while ensuring quality and accurate claims are being sent to payers.
∙ Work directly with directors and administrators for aged joint venture rebilling and refiling special projects.
∙ Work and monitor daily those rejected and denied claims of the highest value to correct and refile prior to timely filing deadlines.
Texas Oncology September 2016 June 2017
Billing Specialist
. Post daily charges on strict deadlines, no later than 48 hours after services were provided to patients, with attention to error rates by using correct modifiers and diagnosis coding.
. Excellent knowledge in chemotherapy and immunotherapy uses, codes and administration codes.
. Strong knowledge with radiation coding including insurance regulations and guidelines.
. Cross trained in accounts receivable to work charges on hold, to get them released and paid by insurance companies.
. Successfully trained new employees in chemotherapy, radiation, office visits, and hospital charges, as well as teaching the navigating of company systems to implement same.
. Special projects worked: hospital corrections, insurance verification, chemotherapy drug denials, transmitting VA medical records, and Medicare holds.
. Established transition policies to transfer work from on-site to the central business office.
. Implemented organizational tools to aide in the communication between sites and coders.
. Communicate effectively with on-site business office manager to ensure all information is procured for all charges.
Education:
Rowlett High School
∙ Member of National Spanish Honor Society, and National Honor Society.
∙ A member of vocational work program to enhance career skills post-high school.
∙ Graduated 6 months early by completing all educational requirements.