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Download your Free copy of my "Medical Coding From Home Ebook" at the top right corner of this page 2018 CPC Practice Exam Answer Key 150 Questions With Full Rationale (HCPCS, ICD-9-CM, ICD-10, CPT Codes) Click here for more sample CPC practice exam questions with Full Rationale Answers Click here for more sample CPC practice exam questions and answers with full rationaleSeeking a rewarding, full time position as a remote associate.
Caring and compassionate medical professional, with a proven determination to consistently excel at all assigned duties, seeking to turn medical professional skills into continuation of a rewarding career with a dynamic organization.
WORK EXPERIENCE
Billing Follow-Up Associate
Government Adventist Health Physicians Network
Hanford, CA – October 2015 to Present
Responsible for daily processing of the patient account following discharge in order to submit a timely and accurate bill. ◦ Reviews all information for accuracy, completeness and compliance. ◦ Prepared and submit clean claims to various insurance companies either electronically or by paper ◦ Work with other departments of the hospital in conjunction with the PFS Billing Supervisor to improve the quality of information directly related to submitting a compliant bill. ◦ Resolves credit balances by requesting refunds to the Accountants by region to refund patients and/or insurances ◦ Answered questions from patients, clerical staff and insurance companies ◦ Identified and resolved patient billing complaints. ◦ Processed payments from insurance companies and prepares a daily deposit. ◦ Communicates any/all potential concerns clearly and timely to department management, offering suggestions to resolve &/or avoid any negative impacts. ◦ In cooperation with the PFS Leadership team, coordinates and ensures adherence to hospital financial and department policies. Promotes positive relationships with patients, coworkers, physicians and the community. Portrays a positive image for the hospital and PFS department Participated in educational activities and attended monthly staff meetings. Maintained strictest confidentiality Adheres to all HIPAA guidelines/regulations.
Lead Authorization Coordinator
Foundation For Medical Care/Key Medical Group – Visalia, CA – October 2005 to September 2015
Verify eligibility and benefits through the health plans web portal. Identify and provide accurate CPT/ICD-9/ICD-10 codes during authorization check and/or authorization request. Maintain all authorizations/notifications related faxes from physicians, and/or health plans. Received incoming documentation from providers in order to support the appeals process if a claim is denied. Communicates professionally and timely to the patient, physician, and clinical staff regarding authorization status or authorization delays. Processed 100 plus referrals in one business day. Handles difficult situations in a professional demeanor Trained new employees to on process ◦ Request for authorization ◦ Check claim status ◦ Follow up on claim denial/ appeal/grievance ◦ Verify Eligibility Status Operate multi-line phone systems with ease
Accounting Clerk Accountemps – Visalia, CA
August 2004 to September 2004
Processed and reported on debit/credit transactions and total accounts on excel documents and databases, and using specialized accounting software. Operate 10-key calculators, typewriters, and copy machines to perform calculations and produce documents. Comply with federal, state, and company policies, procedures, and regulations. Perform financial calculations such as amounts due, interest charges, balances, discounts, equity, and principal. Perform general office duties such as filing, answering telephones, and handling routine correspondence, etc.
Customer Care Representative/Department Secretary-Appeals Grievance
San Diego, CA – February 2003 to August 2004 Operate office equipment, such as voice mail messaging systems Worked daily with MS word processing, spreadsheet, or other software applications to prepare reports, invoices, financial statements, letters, case histories, or medical records. Answer telephones and directed calls to appropriate staff. Schedule and confirm patient appointments, surgeries, medical consultations, pharmacy authorization. Transmit medical records by mail, e-mail, or fax. Provide claim status to patients. providers, and hospitals. Process referrals by incoming fax.
EDUCATION
Certification in Medical Billing and Coding Ultimate Medical Academy – Tampa, FL 2014 to 2015
Patient Care Assistant Technician Maric College – San Diego, CA 2001 to 2002
Hanford High School – Hanford, CA 1995
Medical Billing and Coding-Associates Degree Grantham University – Lanexa, Kansas 2016
ADDITIONAL INFORMATION SKILLS
CPT coding courses, HCPCS, Analytical and Critical Thinking, ICD-10 CM, ICD-9 CM, Payment Poster, EZ-CAP, Cerecons, IDX, Medical Billing and Coding, Customer Service, Multi-Line Phone System, Problem Solving, 10-key, Microsoft Word, Excel, Outlook, PowerPoint, Spreadsheet 50 WPM, Power Chart, SSI, MS4/AS400, RCI, Medical Terminology, Collections
Any clarification on this would be helpful as I am lost and do not feel what I am being told is necessarily true.
Thank you,
Nicole Stettner, CPC
Coding Analyst
What I totally don’t understand is the rationale behind the answer. It states, "To start narrowing your choices down, the hand and foot were closed with adhesive strips. The Section Guidelines in the CPT® manual for Repair (Closure) states: Wound closure utilizing adhesive strips as the sole repair material should be coded using the appropriate E/M code. Eliminating multiple choice answers A and B. The lacerations on the face are intermediate repairs, because debridement and glass debris was removed. The guidelines in the CPT® codebook for Repair (Closure) states: Single-layer closure of heavily contaminated wounds that have required extensive cleaning or removal of particulate matter also constitutes intermediate repair. Eliminating multiple choice answer C. The intermediate repair of the lacerations to the face totaled 6 cm (12053). The right arm and left leg had cuts measuring 5 cm each which totaled 10 cm requiring intermediate repair (12034)."
The problem I have with this answer is that ALL of the answers have the same E/M code in the same place – so how can you use the rationale stated above (Guidelines… B)?