Thank you,
Teri Peniston, CPC
Teri Peniston
CPC
AAPC License 01436954
[email protected]
(760) 707-4662
Summary
Dependable, hardworking professional
Bilingual in English and Spanish
Positive interactions with clients and staff
Detailed and analytical approach
Training in Office Procedures
ICD-10, DSM-IV, CPT coding
Adhere to HIPAA standards
Experience
Claims Compliance Analyst
September 2017 present
Research and resolve claims issues
Adjust any improper denials
Verify member eligibility and provider coverage
Ensure that ICD-10 and CPT codes are valid
Coordinate benefits
Prepare audits of provider-selected claims
Assist with special projects as needed
Claims Examiner III at American Specialty Health
December 2013 September 2017
Processed medical claims for chiropractic, acupuncture and physical therapy
Interpreted Explanation of Benefits and coordinated primary/secondary insurance
Consistently met quantitative and qualitative production standards
Verified personal health information and eligibility requirements
Sales Associate at Ross Stores, Inc.
June 2011 – August 2014
Cashier: Handled cash/credit card transactions
Fitting Room Attendant: Enforced loss prevention procedures
Sales Floor: Merchandised items, organized store
Case Manager at Palomar Counseling Services
September 2006 – April 2008
Provided short-term therapy to children, youth and families, including intakes and psychosocial assessments and psycho-educational groups. Completed medical documentation, with appropriate DSM-IV diagnoses and CPT/HCPCS codes, with monthly and annual updates
Provided community resources to families
Educated parents in behavioral interventions
Conducted psycho-educational groups for teen recovery program
Skills & Expertise
Knowledge of medical terminology
Familiarity with several commercial insurance companies and Medicare
Experience interpreting CMS-1500 forms
CPT and ICD-10 coding
Coordination of benefits
Customer Service
Computer applications: Word, Excel, Outlook, 10-key
Education
Mira Costa College
Certificate in Insurance Coding and Billing, Medical Administrative Professional, 2010 – 2012
San Diego State University-California State University
Master’s degree, Social Work, 2004 2006
AAPC
Practicode July 2017 May 2018