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Motivated medical billing and coding specialist with over 4 years of experience in health operations management, billing, and coding. Expertise in ICD-9 and ICD-10, CPT, and HCPCS coding. Highly skilled in analyzing and validating patient information, diagnoses, and billing data. Demonstrated leadership skills that enable the processing of high volumes of patient information to achieve revenue generation goals.
- ICD-9 and ICD-10 coding
- HMOs and medicare
- Operations management
- Quality assurance and auditing
- CPT and HCPCS coding
- Medical billing
- Medical records management
- Patient confidentiality
- Oversee daily Billing Department functions, including medical coding, charge entry, claims, payment posting, and reimbursement management.
- Examine patients’ encounter forms to verify diagnosis codes and reconcile codes against services rendered.
- Accurately input procedure and diagnosis codes into billing software to generate invoices.
- Used electronic charge capture practices such as billing and account receivables (BAR) system and medical billing clearinghouse accounts to submit codes and invoices on time.
- Follow up on past due invoices and delinquent accounts to reduce number of unpaid and outstanding balances.
- Document patient data and medical records and perform routine medical record audits to comply with insurance company requirements.
- Uphold and reinforce compliance with hospital policies and federal regulations such as HIPAA.
- Provided administrative support to physicians and interpreted medical reports and data to assign ICD-9 and ICD-10 codes; entered diagnosis codes and patient information into billing software.
- Updated and managed diagnosis lists, coordinated routine documentation and coding audits, and executed qualitative analyses of discharged charges.
- Followed and maintained currency on coding, sequencing, and procedures’ best practices and updates.
- Reviewed and validated accuracy of charges, including dates of service, services provided, location, patient identification, and provider signature.
- Collected, posted, and managed patient account payments, and prepared and submitted claims forms to insurance companies and other third-party payers.
- Performed insurance verification, pre-certification, and pre-authorization.
- Entered procedure and diagnosis codes and requisite patient information into billing software to streamline invoicing and account management; added modifiers, verified diagnoses, and coded narrative diagnoses.
- Responded to staff and client inquiries regarding CPT and diagnosis codes.
Certificate: Billing and Coding Specialist, National Health Career Association – 2014
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