THOMAS J. ADAMS, CPC
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 Workman’s 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.