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CMS’ proposed actions are intended to increase price transparency, access to care, patient safety, positive healthcare outcomes, and health equity. On July 19, 2021, the Centers for Medicare & Medicaid Services (CMS) announced new proposed actions to address the health equity gap, decrease mounting healthcare costs, and increase medical accessibility and patient quality of care. […]
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CMS released the 2017 OPPS proposed rule on July 5 without much fanfare. On July 14, the Federal Register version was posted, and upon initial review, it seems rather short at 186 pages.
As a newly certified professional coder (CPC-A) with 1 year of practical experience, I am confident that with my broad knowledge in medical coding and transitional skills gained through my years of work experience, I would be a positive fit for an entry-level medical coding or billing position or at the very least, an externship program where it would be a win/win for all!
I have worked extensively in both fast paced and deadline-oriented areas, and have always strived to ensure the job was successfully completed and on time. I would appreciate the opportunity to discuss first hand my qualifications and dedication. Please feel free to contact me via phone or email as reflected on my resume.
Thank you in advance for your time and consideration.
Thank you for your time,
Christi Pryor,CPC:D
Natalie Grimmer
17 Coral Lane
Levittown PA 19055
Cell Phone: 267-304-7173
Email: [email protected]
Experience
November 2013 to Present- Capital Health Institute for Neurosciences
Pennington, N.J.
Billing Specialist
.Oversee the daily submission of claims sent to the insurance companies for busy Neuroscience practice, including review of proper coding
. Work denied claims for coding and medical necessity issues
. Working knowledge of CPT and ICD10 codes
.Log physician and surgeon inpatient consults into Patient Keeper
.Keep current on doctors credentialing status
July 2012 to November 2014 Performance Spine & Sports Medicine
Newtown, PA
Billing and Claims Representative
.Responsible for all aspects of Accounts Receivable follow up for multiple carriers on an out of network level for a multispecialty provider
.Verification and submission of new claims via Zirmed
.Submit reconsiderations and appeals in a timely manner to ensure payment
.Apply deductibles and payments
March 2010 to July 2012 Northeast Management
Huntingdon Valley, PA
Accounts Receivable Representative
. Responsible for all aspects of A/R follow up for Byberry MRI and Diagnostic Center, Tricounty Pain Care and Tricounty Anesthesia Associates, Valley Pain Center and MR Pain Management
. Responsible for resolving outstanding workers compensation and auto claims through contact with attorneys, insurance companies and claimants in a timely manner
. Working knowledge of CPT and ICD 9 codes as well as HCFA claim forms
November 2008 to March 2010 Perioperative Services, LLC
Newark, DE
Audit and Resolution Representative
.A/R follow up on all Blue Cross Blue Shield accounts for Dynamic Therapy Services including Blue Card, Highmark and Personal Choice.
. Working knowledge of payor contracts to ensure accurate and timely billing and payment
. Knowledge of CPT and ICD-9 codes as well as HCFA forms
.Knowledge of payment posting and insurance/patient refund processes
October 2007 to October 2008 Pro Physical Therapy
Newark, DE
Collections specialist
. A/R collection activities for multiple insurance carriers including Workers Compensation and Auto claims.
. Responsible for resolving outstanding workers compensation and auto claims through contact with attorneys, insurance companies and claimants in a timely manner
. Working knowledge of HCFA forms as well as CPT and ICD-9 Codes
January 2005 to October 2007 Pharmerica Pharmacy
Newark, DE
Billing Coordinator
.Ensure accurate billing for multiple long term care and assisted living facilities on a monthly and weekly basis.
.Work discrepancy reports for billing errors and maintain spreadsheets for corporate accounts
.Utilizing the AS400 system for updating resident accounts, along with censuss and face sheets that the facilities send to the business office.
July 1999 to September 2004 Benefit Concepts
Warminster, PA
Medical Claims Repricer
.Accurate repricing of physician and hospital bills for multiple PPOs using the FACTS and RIMS systems as well as the internet based programs
.Troubleshoot any inaccuracies timely
.Knowledge of CPT and ICD-9 codes
.Working knowledge of HCFA and UB92 forms
Education: Bucks County Community College 1993-1994 Newtown, PA
Bishop Conwell High school 1989-1993 Levittown, PA
Certificates: Diploma
Memberships: Active member and student of the AAPC (American Academy of Professional Coders)
Currently working towards CPC Certification
References: Upon Request
Salary Expectation: $ 53-55,000 Annually
WORK EXPERIENCE
Recruiting Specialist (Remote position) 2015 – present
(Large Healthcare Recruitment Company) –
Recruit for allied health, nursing, finance, operations and IT employees for 800+ bed health network, encompassing three hospitals and affiliates. Source and prescreen candidates, facilitate phone interviews and provide appropriate timely feedback to all parties. Maintain daily / weekly analytics and recruiting performance metrics for leadership and client.
Associated Neurologists, Vestibular & Balance Center 2012 – 2014
Front Desk Assistant
High volume Physical and Occupational Rehabilitation practice, specializing in treating vestibular, neurological and orthopedic conditions. Responsibilities include scheduling appointments, obtaining and verifying new patient demographic and insurance information, obtaining authorizations for treatment, and explaining medical benefit and financial responsibilities to patients. Ensure correct coding of diagnosis, procedures and testing services rendered. Bill for physical therapy, acupuncture, neurological testing and ancillary self-pay services (i.e. therapeutic massage, movement classes, fitness memberships, individualized personal training), collect and apply patient payments to accounts. Liaise with patients, physician offices, third party administrators, and private and government payers to obtain required authorizations for treatment and for payment collection and claim appeals.
Western Connecticut Health Network 2010 – 2012
New Milford Hospital – Emergency Department Coder. Analyze Emergency Department records and assign admit / discharge diagnosis (ICD-9) and procedure (CPT) codes for services rendered during emergency department encounters. Assign appropriate professional and facility codes and fees based on documentation provided and query treating physicians as necessary. Enter, audit and finalize charges.
Danbury Hospital – Patient Access Liaison. Responsibilities include scheduling outpatient advanced radiology procedures in a high volume patient call center, obtaining and verifying patient demographic and insurance information and explaining appointment preparation and financial responsibilities to patients. Liaise with physician offices, third party administrators and payers to obtain required authorizations prior to scheduled appointments.
Began health care career transition by completing a Medical Billing and Coding Certificate Program at Danbury Hospital 2009-2010, encompassing medical terminology, anatomy and physiology and CPT and ICD-9 coding. Worked as part time Pharmacy Technician at CVS July- December 2009 while in school.
Staffing Consultant (Remote Contract Position thru Search Wizards) 2007 – 2009
Microsoft
Partner with Redmond staffing consultants and hiring managers for full-cycle recruitment for all levels of employees in the Central Marketing Group. Identify and prescreen candidates, facilitate phone interviews and provide appropriate and timely feedback to all parties. Document candidate activity in the ATS, and maintain weekly volume statistics and recruiting performance metrics.
EDUCATION, TRAING AND PROFESSIONAL MEMBERSHIPS
AAPC – National and Local Chapter (2009-present)
CPC Certified November, 2010; ICD – 10 Proficient
Microsoft Office (Word, Excel, Outlook) LinkedIn, Taleo, Sorian Scheduling, Document Imaging, Athena, Meditech, 3M Encoder, Allscripts, GPMS
BA Economics State University of New York at Stony Brook, New York