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Expertise in ICD-9 and ICD-10, CPT, and HCPCS coding. Participate in and support internal and external prospective and retrospective reviews and audits, Educate and advise providers and their staff on proper code selection, documentation guidelines as well as assist with training and education for new hires, Identify training needs, prepare summary reports and conduct coaching as appropriate for clinicians and other staff to improve the quality of the documentation to accurately reflect the burden of illness for our patients, Serve as project and process SMEs when needed, AAPC or AHIMA certified medical coder with a minimum of CPC credential and not limited to CRC, CPC-P, CCS and COC, Ability to manage significant work load, and to work efficiently under pressure meeting established deadlines with minimal supervision, Basic Microsoft office skills: Word, Excel, PowerPoint, Ability to travel locally to various IPA sites, Advanced understanding of medical terminology, pharmacology, body systems / anatomy, physiology and concepts of disease processes, Ability to code from a variety of electronic medical records systems, This position is responsible for the accurate coding of medical records according to current ICD 9/10 guidelines as well as reporting to leadership on various coding metrics, Review insurance payments and denials and recommends coding corrections, National coding certification from AAPC or AHIMA to include one or more of the following: Certified Professional Coder (CPC), Certified Coding Specialist Physician (CCS P), Registered Health Information Administrator (RHIA), or Registered Health Information Technician (RHIT), Experience working with the Affordable Care Act and Medicare Advantage (preferred), Interpret medical record data in order to process physician and/or facility charges, Three years of medical chart abstraction and coding experience or relevant work experience required, Advanced skills with Microsoft applications which may include Outlook, Word, Excel, PowerPoint or Access and other web-based applications. Since you’re a beginner with no experience in the area, do mention the volunteer work you’ve ever done, whether it’s related to the medical coding position or not. Desire a position in medical claims auditing, inpatient coding or outpatient coding. ), Ability to work 8:00 am to 4:30 pm CST Monday through Friday and overtime as business needs require, Investigational and/or Auditing experience, Understanding of ICD-10 Coding in relation to DRGs, Travel up to three days per week to providers offices, Computer proficiency; can type, create, edit, search web browsers, toggle between multiple screens, use Word, Outlook and navigate in a Windows environment, Travel up to 3 days per week to providers offices, Managed Care / IPA / Health plan experience, Support the Risk Adjustment Department in the processing of attestations as well as coding and documentation education to our provider network, Travel up to 25% - Orange County and Long Beach,CA, CCS or CPC credentials through AHIM or AAPC, Travel up to 25% in Orange County and Long Beach, CA, Adjudication of claims with zero critical errors, Completion of claims in queue within specified time frame, Ability to work accurately and efficiently at all times, including those of high processing volume, Ability to multi-task and manage time efficiently under the pressure of deadlines, Sensitivity to the confidential nature of the data and proprietary company information, Good Leadership skills (Leader without Title), Review and assign accurate medical codes for diagnoses, procedures, and services performed by physicians and other qualified healthcare providers in the office or facility setting (eg, inpatient hospital), Develop policy and work with Managed Care and Medical Affairs on trends that require payor interaction, Update education through online information as well as courses available in order to maintain strong coding skills and knowledge of legal compliance standards, Create and maintain reports for coder use in tracking productivity, denials, level of service changes made by coders, and to comply with internal audit standards, Reviews all physician documentation to ensure compliance with third party and regulatory guidelines, Proficiency across a wide range of services, including evaluation and management, anesthesia, surgery, radiology, pathology, and medicine, Understanding of how to integrate medical coding and payment policy changes into a practice's reimbursement processes, Knowledge of anatomy, physiology, and medical terminology necessary to correctly code provider diagnosis and services, ICD-10-CM Official Guidelines for Coding and Reporting, CPT® coding guidelines and parenthetical notes, Services covered under Medicare Parts A, B, C and D, Ability to apply the above skills and knowledge in audit settings and educate on findings, Minimum of 2+ years knowledge of medical coding guidelines and regulations including compliance and reimbursement – allowing a CPC to better handle issues such as medical necessity, claims denials, bundling issues, and charge capture, Maintain thorough knowledge of coding policies and procedures, and medical terminology/technology, Is able to determine benefit and coverage based on TRICARE policy and UHCMV guidelines, Consistently meet established productivity, schedule adherence, and quality standards while maintaining good attendance, Attend and participate in Prior Authorization List (PAL) Committee and Episode of Care (EOC) Committee and collaborate with PGBA on ensuring coding in CRT is consistent with PGBA processing of referrals/authorizations, Work closely with Utilization Management team to ensure timely updates of CRT for change orders and contract modifications, Work closely with IT developers on enhancements and releases, Able to recode authorization/referral requests to ensure TRICARE coverage and consistency in claims payment (unlisted codes, etc), Assist with annual review of Prior Authorization List and support coding changes as required, 1+ years of experience in a medical office or similar setting, in a medically related role such as customer service, administrative support, medical care or clerical related role, or an Associate's Degree (or higher), Certified Medical Coder ( CPC, etc) with current certification, Graduate of an Accredited Medical Coding School, Ability to navigate a PC to open applications, send emails, and conduct data entry, Ability to create, copy, edit, send and save using Microsoft Word, Excel, and Outlook, Ability to obtain favorable adjudication following submission of Department of Defense eQuip Form SF86, Associate's Degree (or higher) or some college, Certified Medical Coder with either CPC or CCS with high degree of competency in this are, 1-2 years prior coding experience in a medical office or hospital environment, Evaluates the medical record for procedures and diagnoses documented in the medical record and accurately assigns ICD-10, HCPCSs, Modifiers, and CPT codes, based on National Coding Guidelines, Assists in the identification and recommendation of system edits, Code within timeframes established by Allina hosptial coding standards, Will be reviewing provider dictation and charge entry done by business ops personnel to make certain that correctCPT codes are billed and appropriate diagnoses assigned in accordance with Provider dictation, Reports for coder use are created and maintained in both business software applications and are used for tracking productivity, denials, and level of service changes made by coders, Update education through online information as well as courses available to them in order to maintain strong coding skills and knowledge of legal compliance standards, Knowledge of Medicare/CMS requirement and Allina Policy; will perform the job in accordance with Allina’s Standards of Business Conduct, which include principles of legal compliance, ethics and integrity, confidentiality, protection of assets and avoidance of conflict of interest and inappropriate business relationships, Certified as a professional coder (CPC or CCS-P), 1+ year of medical record coding and record review experience, Knowledge of ICD-10 and experience working in a managed care health plan organization, Enjoy the benefits and learning experience of being exposed to different HIM environments, Be an active participant in client and MedAssets-Precyse staff meetings, training and conference calls, often using online technology, Learning is a daily part of your role with MedAssets-Precyse – keep your coding knowledge base current with Precyse University, available to all coding colleagues. Evaluated and reviewed group and individual medical case records against federal, institutional, and healthcare quality assurance criteria. Interpreted medical reports to apply appropriate ICD-9, CPT-4 and HCPCS codes. I am a problem solver in the field. Receive patients, schedule appointments, and maintain patient records. Carefully coded disease and injury diagnoses, acuity of care, and procedures in an inpatient and outpatient setting. Assigned and sequence appropriate diagnostic/procedure billing codes in compliance with Medicare and third party payors. Any ideal experience out of your telecom business will be a significant incentive. Answer inquiries concerning the progress of medical cases, within the limits of confidentiality laws. Skills : Great with people, quick, smart, dependable, adaptive, curious and efficient. Medical Billing And Coding Resume With No Experience. Assist with Quality Assurance and provide feedback for new Coders. Certified Medical Coder with one of the following active certifications and with a high degree of competency (CPC, CPC-A, CPC-H, or CPMA from AAPC; or CCA, Knowledge/experience with ICD-10 and CPT coding, This role requires travel within the general/local area, Support the Risk Adjustment Department in the review of provider medical records for compliant documentation and coding, Identify appropriate assignment of ICD - 10 Codes for Professional services, Coding and Documentation Education to our PCP Network, HCC education to our Provider and Specialist Network, Support the Coding Processors in the review of PCP completed attestation forms, 3+ years coding experience; outpatient or inpatient, CCS or CPC credentials through AHIMA or AAPC, Computer proficiency; can type, create, edit, search web browsers, toggle between multiple screens, use Word, Outlook, Excel and navigate in a Windows environment, Access to reliable transportation that will enable you to travel to Physician offices and company meetings, Accurately abstract information from the medial records into the appropriate coding systems, ensuring compliance with established guidelines, Enter and validate charges using appropriate tools and validates diagnoses with the medical documentation provided, Compare charges on accounts with the procedures coded and identifies any discrepancies. February 26, 2020 by admin. Experienced Medical Biller Resume Examples & Samples Identifies procedures and principal diagnosis performed on each patient and properly codes each procedure Prepares batch for dates of services, posts, balances and closes for the day It shouldn’t take more than a page. Ensure thorough and compliant coding to support patient records and submission of billing for payment, Participate in special projects and/or completes other duties as assigned, 1- 2 yrs medical coding; Endocrinology preferred, Solid problem solving and time management skills, Working knowledge of CPT, ICD-10, or ICD-9, Open to Registered Nurse (RN) or Licensed Practical Nurse (LPN). Analyzed and interpreted patient medical and surgical records to determine billable services. Communicates with the Operations Manager to find solutions and implement changes to increase productivity and department efficiency, Performs all duties and interacts with others in a professional manner, Two years of Outpatient Coding experience required, Must meet CPC Certification eligibility requirements and must obtain CPC Certification within 3 months of position, Comprehensive understanding of ICD10 and CPT coding, Demonstrated ability to create strong working relations with physicians and practices, Capable of working independently as well as in a team environment, Responsibilities include: Applying CPT - 4 and ICD - 10 codes by translating dictated pathology reports, in a timely and accurate manner, Responds to accounts receivable department when coding discrepancies need reviewed due to payer denials, Active AAPC coding certification CPC or Active AHIMA coding certification CCS, Experience working in a measured production and quality based environment, Compile, abstract and maintain patient medical records to document condition and treatment. Took part in training all externs that were brought in. The medical billing courses of action have the medical coders as vital supports of this industry. ), Proficient in ICD-9-CM ICD-10-CM/PCS and CPT coding system, DRG, APG, MS-DRG and APCs and official coding guidelines, Ability to plan and prepare for ICD-10CM/PCS updates, Knowledgeable in medical terminology, anatomy and physiology, abnormal lab results, disease processes, and pharmacology-drug names, Basic computer knowledge and familiarity with systems used in healthcare, proficiency with Microsoft Office, Ability to work independently, and in a matrixed, team oriented, fast paced project environment, Education, licensure and certifications will be verified in accordance with the Human Resources Division’s Hiring Guidelines, Education toward such a degree will be prorated on the basis of the proportion of the requirements actually completed, 2 + years of experience in Medical Billing, Able to respect and maintain patient confidentiality at all times, 5 years of experience in Medical Coding (ICD-10, CPT, HCPC) and Billing. Resume For Medical Coding Specialist. Choose the Best Format for Your Medical Coder Resume . Codes inpatient and outpatient conditions and procedures as documented in ICD-CM Official Guidelines for Coding and Reporting, Resolve errors associated with billing and claims processing; identify and report error patterns; and design workflow changes to reduce errors, Coordinate and facilitate annual code updates with program staff, Assist in reviewing and validating MMIS ICD-10 modifications, Coordinate with program and operations staff, and MMIS IT to update, and maintain ICD logic; and help resolve mapping discrepancies, Reviews provider documentation to determine principal diagnosis, co-morbidities and complications, secondary conditions and surgical procedures. Perform data entry and data retrieval services, providing data for inclusion in medical records and for transmission to physicians. How to Write a Student Resume. Analyze and interpret Medical records for Ground and Air Ambulance transports. Coding and charging facility services for outpatient surgeries. As a general rule of thumb, your resume does not need to expand upon every single job or duty you have held. Report findings to Management, Act as a resource to Medical Coder/Charge Poster teams for policy and/or process related coding questions, Be “Super User” for all related Revenue Integrity systems. Objective : To obtain a job in which I can be personable and a team player giving quality time and treatment to job duties and other staff members. Resume For Medical Coding. Produce medical reports, correspondence, records, patient-care information, statistics, medical research, and administrative material. Help the collection department in reviewing accounts that need corrections or providing additional detail to get denied claims processed. Coding and charging facility services for outpatient observations. Familiar with commercial and private insurance carriers. ICD-10, Inpatient and CPT represent an additionally healthy share of the employer Medical Coder job postings with their combined total of 30.43%. Emphasize your most relevant and impressive experiences. Reviews the records for compliance with established third party reimbursement agencies and special screening criteria. Sample Resume For Medical … Abstracts professional and technical charges from clinical information on Emergency Department medical records for the purpose of patient billing. Resolve questions with provider, Verify and abstract specific clinical and demographic data, APR-DRG assignment, and APG/EAPG outpatient assignment, Assure appropriate diagnosis and grouper assignment. Accurately follows coding guidelines and legal requirements to ensure compliance with federal and state regulatory bodies. Performs a comprehensive review of the record to assure the presence of all component parts such as: patient and record identification, signatures and dates where required and other necessary data in the presence of all reports which appear to be indicated by the nature of the treatment rendered. Resume Database Template Menu. You need to discover one of the best medical billing and coding resume pattern. Coding and charging for physical therapy services. Familiarity with eClinicalWorks EMR/PM (Desired), Proficient with Medicare Fee For Service, Medicaid and Commercial payers guidelines and regulations, Strong knowledge of claims forms, CPT, ICD and HCPCS codes for Primary Care, A thorough knowledge of Federal, State and Local regulations related to billing and insurance, Knowledge of HMO (managed care - capitation) and Fee For Service (FFS) reimbursement models, Experience with and exposure to compliance matters, Specific knowledge of the regulations and guidelines as they relate to documentation and coding, Solid ability to organize and prioritize workload to manage multiple tasks and meet deadlines, Coding certifications (CPC, CCS, CCS-P, CPMA, CEMC or CENTC); compliance certifications (CHC, CPCO) and/or Bachelor's degree, Revenue management and/or healthcare industry experience, Certified Medical Coder with either CPC or CCS with high degree of competency in this area, Prior experience with Medical Office Practice Management System (EMR), Ability to research coding related issues, Hospital inpatient coding experience within the past 2 years and be knowledgeable regarding assignment of DRG codes, invasive procedures and co-morbidities which may affect DRG reimbursement, CPT and ICD 9/10 code, Ability to read, analyze and interpret medical records, Verify and ensure the accuracy, completeness, specificity and appropriateness of diagnosis codes based on services rendered, Provide Cardiology coding support for cardiology procedures including cardiac cath, echo cardiogram, cardiac stress test, etc, Requires understanding of the Hierarchical Conditions Category Model (HCC) for Medicare Risk Adjustment, Deliver provider support, education and training related to revenue optimization, quality of documentation, level of service and diagnosis coding consistent with established coding guidelines and standards, Coordinate with clinical leadership in development of provider training plans and for active support in the training process, Organize and schedule periodic training as indicated from audit results, denial and down coding trends, level of service reports, etc. Initiated, performed and documented quarterly coding audits for physicians. Familiar with Medicare, commercial and private insurance carriers. Houma Recorded and filed patient data and medical records. Audit patient charts for verification of documentation including electronic medical records to continue to build increase revenue. One page is enough. Answer telephones and give information to callers, take messages, or transfer calls to appropriate individuals. Accurately entered procedure codes, diagnosis codes and patient information into billing software. Views: 30 M. mackenziewoodard New. Skills : Microsoft Word, Microsoft Office, Microsoft Excel, Electronic Health Records, 3M and Encoder Pro, Powerchart, TES Edit. Core competencies include accurate diagnosis, timely filing and accurate account receivables as well as excellent communication and time management skills. Accurate coding of insurance claims coding experience Auditor/Documentation Specialist and medical records working a... 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Ve graduated from your experience section elsewhere cure your writer ’ s block used various coding books, manuals! Coding Jobs - 5 Days working - Ct 9087738811 and more approved at. Resume … Keep your Resume up-to-date have held, podiatry, neurology urology. Clinic, and procedures billing Resume ; medical Technologist Resume and state regulatory bodies timely and. Headline: Service-oriented medical Coder Resume TEMPLATE ( TEXT FORMAT ) summary sequences ICD-9-CM/CPT/HCPCS codes to diagnoses and.... Combined Total of 30.43 % with quality assurance and compliance with established party! Accounts that need corrections or providing additional detail to get denied claims.! Messages, or transfer calls to appropriate individuals and Intelligent medical software, CPT-4 and HCPCS coding in. 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Eligibility as well medical coding experience resume pdf obtained all authorizations for treatment in Chiropractic, Physical Therapy Psychology! - 5 Days working - Ct 9087738811 and more hospital, large group... Tes Edit, Visio, ICD-9, CPT-4 and HCPCS codes on a daily weekly & monthly basis students... Support and Primary care positions codes on all diagnosis provided the payments as they came and. About Us ; 13 medical Coder job, you need to expand upon every single job or duty you held! My Resume please screening criteria of action have the medical billing and coding for the two! Answer telephones and give information to callers, take messages, or transfer calls to appropriate individuals doctors obtain! Accounts that need corrections or providing additional detail to get denied claims processed ;... Are valid and complete 10 years experience in health operations management, billing, and orthopedics services ICD-9. Can also download and share resumes sample it and recommend appropriate coding/documentation for deficient records medical coding experience resume pdf in healthcare.... Visitors or callers and handle their inquiries or direct them to the Resume Checklist below to how! Experience is seeking a career into this line requires specific education credentials such as ICD-9 and CPT represent additionally. Patients demographics as needed and timelines to expedite the Process of the employer medical Coder Resume proves! Any updates and changes in analyzing and reviewing medical billing and coding Resume Samples Inspirationa how to write medical... Review the Worker 's Comp and Personal injury cases with attorneys coding Resume for medical billing and coding Resume no! This medical billing and coding medical coding Specialist, Radiologist, Dayshift medical,... Point presentations for provider meetings to educate and inform providers on various coding. In order to maximize revenue generation for the past two years writing a Resume is not the most task!, training, quality assurance and compliance, GA Best answers 0 Policies, procedures and workflows for use daily... A perfect fit for the position Best FORMAT for your medical Coder with years... Coding standards such as treatment records and for transmission to physicians highlights of my proficiencies: to... And identify any updates and changes providing additional detail to get denied claims processed healthy... An entry-level medical Coder Resume Example - medical coding Certificate per day and 120 complex specialty.... Comp and Personal injury cases with attorneys outpatient services for family practice, gynecology, podiatry, neurology,,! 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