CPC, CPMA - Looking for a remote medical coding/auditing position.

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Valerie Bates-Hoff, CPC, CPMA

Certified Professional Medical Coder/Auditor

Looking for a remote medical coding/auditing position.

Summary
CPC Certified Professional Coder, CPMA Certified Professional Medical Auditor (AAPC)
I am an experienced abstract medical coder ICD-10 proficient, currently pursuing CPC-H certification. I have expert knowledge of medical terminology, anatomy, physiology; and I have clinical experience as a medical assistant. I am also well trained in the coding/billing practices of Medicare and commercial payers. I have experience working for Emergency Medical Services which involves scene/inter facility ground and air (rotor/fixed wing) ambulance transports. I have written medical necessity & closer appropriate facility appeal letters to CMS and other insurance carriers with favorable outcomes. I am currently a remote medical coder responsible for capturing compliant HCC (hierarchical condition category) codes. I have previously worked as an HCC & E/M physician auditor as well as an auditor/trainer for the Department of Defense.

Work Experience

Remote Hierarchical Condition Category Coder
ArroHealth
Remote position
-
March 2015 to Present
• Responsible for capturing compliant HCC codes based on medical documentation and specific client guidelines to ensure proper assignment of ICD-9-CM and ICD-10-CM codes.

Medical Coding Auditor/Trainer
Diamond Solutions
San Diego, CA
-
July 2014 to November 2014
• Civilian Contractor through Diamond Solutions working for the Department of Defense at Naval Hospital Camp Pendleton.
• Audit Physician documentation within the patient medical record to ensure that Department of Defense, CPT, & ICD-9-CM guidelines are being properly followed.
• Meet with physicians/residents to discuss audit results in detail. Go over encounters & educate providers on current AMA CPT/ICD-9 & DOD coding guidelines.
• Responsible for complete and accurate code assignment of ICD-9-CM and CPT in accordance with DOD guidelines for ED encounters.
• Obtained Government Security Clearance.

Medical Coder / Auditor
Graybill Medical Group
-
Escondido, CA
February 2012 to July 2014
• Run reports generated through Revenue Max and Next Gen software.
• Audit physician documentation within the patient medical record to ensure all hierarchical condition categories (HCC), evaluation & management (E/M) codes have been captured compliantly.
• Meet with physicians to discuss audit findings in detail. Go over encounters/diagnosis detail report to show missed opportunities & educate providers on current AMA CPT/ICD-9 coding guidelines.
• Review medical records and assign appropriate CPT, HCPC's and ICD-9 codes for multi-specialty medical group.
• Responsible for accurate coding and abstracting of clinical information from medical records.
•Identify issues resulting in non-payment of claims due to internal and external issues.
• Responsible for accurately coding OB/GYN office Procedures, inpatient/outpatient surgeries & Cardiology Professional Services.

Certified Professional Coder
Golden Hour Data Systems
-
San Diego, CA
June 2010 to February 2012
Certified Professional Coder
• Analyze and abstract clinical transport records to assign the appropriate level of service, while using each ambulance companies state and county scope of
practice, to ensure the most compliant reimbursement.
• Accurately assigning ICD-9-CM codes and sequencing the diagnosis with the highest level of specificity, per the patient medical record to represent the
medical necessity of transport to the payer.
• Understanding billing practices and Medicare guidelines.
• Experienced in closer appropriate facility appeal process.

Business Service Representative
Sharp Rees-Stealy
April 2008 to June 2010
• The business service representative position is accountable for acquiring and processing correct patient demographic and insurance information, in a
conduct that aids the utmost economic compensation and encourages
customer service excellence.
• Constant interaction with physicians, nurses and patients regarding billing/
insurance questions and discrepancies.
• Direct communication with insurance companies to verify eligibility and benefits, to assure a profitable claim submission without designating patient
financial responsibility.
• Explaining detailed billing and insurance information to patients in detail to make sure they understand their plans stipulations.
Patient Service Representative
Sharp Rees-Stealy
-
San Diego, CA
April 2006 to May 2008
• Work directly with nurse and physician as scheduler/receptionist.
• Schedule appointments for patients (give prep information regarding procedures).
• Check-in patients for their appointments.
• Screen phone calls/take messages that relate directly to patient medical care.
• Verify insurance eligibility.
• Collect patient payments (copays/prior balances).
• Use strong customer service skills on a daily basis.
Medical Assistant
Sharp Rees-Stealy
-
San Diego, CA
May 2005 to April 2006
• Room Patients
• Take Vital signs
• Assist Physician in minor office procedures.
• Schedule hospital surgeries.
• Relay messages from physician to patient that deals directly with patient
medical care.
• Make medical documentation that directly affects patient care and physician
liability.
• Sterilize equipment.
Education
2009 UCSD Extension San Diego, CA
Medical Procedural Coding
Proficiency Certificate
Gained the knowledge of present information concerning CPT and ICD-9-CM procedural and diagnostic coding. Trained to be knowledgeable and proficient in anatomy and medical terminology using American Medical Association's Physician's Current Procedural Terminology. Trained for ICD-9-CM and CPT subject matter that equipped me for the American Academy of Procedural Coders (AAPC) accreditation examination.
 
2005 Maric College San Diego, CA
Medical Assisting
Learned to utilize all medical skills that allowed me to be a valuable employee in a medical office. Developed the essential understanding and ability needed for a profession in health care. The curriculum highlighted medical and laboratory proficiency, consisting of completing laboratory tests, charting, taking vital signs, and assisting in examinations and minor surgeries.

Certifications
CPC Certified Professional Coder (AAPC)
CPMA Certified Professional Medical Auditor (AAPC)
ICD10 Proficient
Medicare Billing Certificate Program for Part A Providers
 

rbandaru

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Request for latest Resume - AMShealth LLC

Hi ,

How are you doing. Some of our prospects need remote coders available for doing their coding.

Please send your latest resume that we can forward to them to see if they would be interested in your profile.

Looking to hear from you. Thank you for your time.

Please share your Latest resume at jsinclair@amshealth.com

Regards
Joseph Sinclair
Coding Solutions Specialist
www.amshealth.com
 
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