396 Duane St Hornell, NY 14843
607.661.7421 [email protected]
Professional Fee Coder HIM Professional Medical Billing Specialist
Certified professional coder with over a decade of professional work in the health information management field and diverse experience in coding across multiple specialties including inpatient, outpatient, OB/GYN, pediatrics, internal and family medicine. Seeking a challenging position with a well-established organization with opportunities for continued professional growth.
PROFESSIONAL EXPERIENCE
University of Rochester Center for Primary Care Rochester, NY
Informational Analyst II/Professional Fee Coder 2016 Present
Assign and code professional and facility procedures, services and diagnoses for claims processing.
Capture, review and abstract patient medical records to ensure accurate patient statements; review medical records for coding and documentation compliance.
Audit provider documentation to assure compliance with National Coding Standards, including ICD-10, CPT, CMS & ASA.
Provide subject matter expertise and guidance to staff regarding existing documentation, coding, queries, and audit requirements; research and communicate changes/updates/trends and identify opportunities for education & improvement.
Administer charges for claim submission, coordinate missing charge reports, and process work claims edits.
Resolve coding and charge disputes; participate in the appeal process.
Provide education to physicians and staff/clients regarding coding and billing topics as needed.
Pinnacle Family Medicine Hornell, NY Coder/ Primary Medical Biller 2009 – 2016
Performed primary billing duties; worked with all major and commercial insurance companies.
Managed claim submission and follow-up, scrubbed claims for optimum acceptance rate.
Responded to rejections and denials; filed appeals.
Reviewed medical records, utilizing ICD-10, CPT, and HCPCS for professional services.
Managed Workmans Compensation and no-fault claims.
Conducted audits and coding reviews to ensure all documentation was complete and accurate.
St. James Mercy Hospital Hornell, NY
Patient Financial Representative 2005 2009
Daily data entry and posting of billing and patient charges.
Provided service to patients regarding queries and concerns; worked closely with insurers to provide follow-up as needed.
Facilitated and negotiated resolution of patient accounts and billing disputes.
Managed electronic Medicaid billing.
Input and secure handling of confidential health information and financial data.