CPC-A Experienced in Billing & Coding Orthopedics, PA & OH Workers Compensation

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CPC-A Experienced in Billing & Coding Orthopedics, PA & OH Workers Compensation


Background Summary

Compassionate, reliable individual who has completed Pittsburgh Technical Institute’s accredited Medical Coding and Billing program, with specialized training in terminology, practice management software, and HIPAA. Recognized for academic achievement as Outstanding Student of the Fall and Winter Quarters at Pittsburgh Technical Institute, in addition to graduating from Butler County Community College, summa cum laude, with an Associate in Arts in English. Certification as an apprentice professional coder received September 2014 from the American Academy of Professional Coders.


Pittsburgh Technical Institute, Oakdale, PA
¬Certificate, Medical Coding, July 2014
¬GPA: 3.72
¬Billing Skills
¬Computerized insurance and patient billing and collections, CMS-1500 and UB-04 completion, revenue cycle processes, third party and government payer regulations, payment applications
¬Coding Skills
¬ICD-9-CM Vols. 1-3, CPT-4, and HCPCS coding using an encoder and manuals, chart abstracting and auditing, diagnosis and procedure coding guidelines, anatomy and physiology of body systems, disease processes, medical terminology
¬Registration Skills
¬Customer service, appointment scheduling, patient registration processes, insurance verification, electronic and manual medical records, ABN and MSP forms, HIPAA compliance regulations and forms
¬Medisoft practice management software,
¬Neehr Perfect EHR, SpeedECoder encoder
¬Butler County Community College, Butler, PA
¬Associate in Arts in English, May 2009
¬GPA: 3.86
¬English Courses
¬Speech; grammar; research; modern drama; Old and Middle English, Renaissance, Neo-Classical, 19th and 20th century English, and Pre-Colonial, Romantic, Realistic, and Modern American literature.
¬Additional Courses
¬Health science; intermediate algebra; general psychology; physical fitness; sociology; introduction to art; introduction to painting; drawing; philosophy; early United States history; principles of geology; environmental science; and Microsoft Word, Excel, and PowerPoint.

Related Experience

Sharon Regional Physician Services Sharon, PA February 2015 to Present
Medical Biller and Coder

Orthopedic Office February 2015 to December 2015
Bill encounters for office visits, including x-rays and pain control injections when performed; conduct follow-ups with managed care organizations and attorneys for Pennsylvania and Ohio Bureau of Workers Compensation patients via phone calls and faxes, and submit C-9s and Medco-14s to OBWC; handle insurance denials and appeals, and submit documentation to the administrator for write-off approvals; back-up for front desk, checking patients out, collecting copays and making follow-up appointments; back-up for obtaining surgery and procedure authorizations; answer phone calls and schedule office visits, handle billing questions, take messages, or transfer calls to appropriate staff; manage cash deposits and weekly batch; inventory and order office supplies; scan documentation into electronic medical records; and verify health insurance coverage via phone, Navinet, PROMISe, or Passport.

Billing Office December 2015 to present
Bill encounters for orthopedic and cardiology office visits, including electrocardiograms, x-rays and pain control injections when performed; code and bill inpatient/outpatient surgeries and inpatient consultations for orthopedic surgeons; handle insurance denials and appeals, and submit documentation to the administrator for write-off approvals; handle billing questions; verify health insurance coverage via phone, Navinet, PROMISe, or Passport; backup biller for general surgery; coordinate with orthopedic office staff regarding Workers Compensation patients; handle various urgent high dollar claims when assigned by billing manager.

Athena and Cerner

Zagger Family Practice Butler, PA July 2012 to April 2013

Front Desk Receptionist
¬Answered telephone and directed calls to appropriate staff when necessary; scheduled and confirmed patient office, diagnostic, and specialist consultation appointments; greeted visitors, ascertained purpose of visit, and directed them to appropriate staff; operated office equipment such as voice mail messaging systems, fax machine, and software applications to schedule patients and maintain medical records; completed insurance or other claim forms; interviewed patients to complete documents, case histories, or forms, such as intake or insurance forms; transmitted correspondence or medical records by mail; performed bookkeeping duties such as credits, collections, and banking; recorded patients' medical history and information such as test results in medical records; authorized drug refills and provided prescription information to pharmacies; explained treatment procedures, medications, diets, or physicians' instructions to patients; collected laboratory specimens to send for testing; and contacted medical facilities or departments to schedule patients for tests or admission.

Allegheny Valley School Slippery Rock, PA February 1997 to May 2006

Program Aide
¬Assisted adults with mental retardation and various other handicaps in learning daily living and job skills; provided personal care; assisted in recreational and physical therapy; documented individuals' progress and behavior management plans daily; worked with psychology and psychiatry departments in order to understand and apply adjustments to behavioral and medication plans.

Work Experience

Michaels Arts and Crafts

Support Specialist Butler, PA August 2013 to February 2015
Counting and processing daily intake, including bank deposits; balancing cash on hand; minor, miscellaneous bookkeeping duties; reporting discrepancies to corporate office when necessary; price change activations; processing deliveries and online orders; verifying product quantities on hand; verifying store use items; confirming framing sales.

Replenishment Crew Butler, PA April 2010 to May 2012
Unloading, sorting, and stocking merchandise from trucks; setting planograms and displays; signing weekly sales advertisements; up-stocking shelves; assisting new employees; customer service; back-up framer and cashier.

Framer Butler, PA February 2008 to April 2010
Assisted customers in choosing frames and matting for artwork or photos; took measurements and entered dimensions into specialized framing computer program; placed orders via computer; framed artwork and photos; contacted customers by telephone; back-up cashier; stocked framing department; performed store recovery; customer service.

Activities / Achievements

• ¬Dean’s List, Butler County Community College, 2006-2007
• President’s List, Butler County Community College, 2007-2009
• Marjorie White Scholarship, Butler County Community College, 2007
• Outstanding Student Award, Medical Coding and Billing Program, Pittsburgh Technical Institute, Fall 2013 and Winter 2014 Quarters
• Published in Facets Magazine, Butler County Community College, 2007, 2010, and 2013
• Article and advice column writer for The Cube Newspaper, Butler County Community College, 2006 to 2007
• Tutor for below-average and mentally ill students in grammar, composition, and literary comprehension for English and Art History courses, Butler County Community College, 2006 to 2007