Shannon12503
Guest
Shannon Edwards
1112 N. Marlyn Ave.
Baltimore, Maryland 21221
443-801-2566
shannonedwards12503@comcast.net
Objective:
To obtain a Medical Coding position that will allow me to
utilize my skill set to assist in meeting the goals and objectives of an
innovative and progressive organization.
PROFESSIONAL EXPERIENCE:
05/2011- Present
FPI at University of Maryland Medical Center
Certified Medical Coder- Neurosurgery
Reviews provider charges accuracy. This includes, but is not limited to: dates of service, procedures, level of care, locations, diagnosis (for medical necessity), patient identification and provider signature. Adds modifiers as appropriate, codes narrative diagnoses and verifies diagnoses for orders given.
Analyzes and interprets patient medical and surgical records to determine billable services.
Returns any incomplete charge tickets to the practice location for correction.
Interacts with providers and other medical professionals regarding billing and documentation policies, procedures and regulations. Obtains clarification of conflicting, ambiguous or non-specific documentation.
Reviews billing for optimal reimbursement while adhering to all insurer regulations regarding the prohibition of unbundling and other questionable practices.
Manages coding denial work queue to resolution.
Attends all mandated department trainings and staff meetings. Attends coding conferences, workshops and in-house educational sessions to receive updated coding information and changes in coding or regulations.
11/2010- 05/2011
Peak Health Solutions
Contractor on site at Kaiser Permanente/Coding Specialist (Full Time)
Review & code services that are potentially reimbursable, including Medicare, Medicaid, Workers' Comp & other third party payors by applying correct coding principles.
Review & code ambulatory surgical services & apply coding principles for correct coding.
Respond to questions from providers through inbasket messages, coding hotline or in person as needed.
Query providers for clarification of incomplete or ambiguous documentation as appropriate & monitor inbasket messages for timely responses.
Identifies workflow issues & works with supervisor to address changes in process.
Communicates & participates in local, regional & operational strategic meetings & initiatives involving coding & the revenue cycle enhancement process.
Participates in data quality & revenue cycle validation processes on a rotating basis.
Performs other duties as assigned or required.
-Job related Skills and affiliations:
Certified Professional Coder (CPC)
Member- American Academy of Professional Coders
Medical terminology, Anatomy and Physiology, Microsoft Word, Microsoft
Excel, Microsoft Outlook, Microsoft Power Point, Charge Entry
03/2008-09/2010
Home Paramount Pest Control
Pest Control Technician
Duties entail:
Conduct a thorough inspection and finish with a customized treatment plan
Provide professional services designed to eliminate pest problems, prevent
infestations and identify pest entry zones.
Conduct a comprehensive service report that includes product applications, pest
activity, and contributing conditions
9/2007-11/2010
American Coding Centers
Coding Consultant
Coding for services such as Anesthesia, Ambulatory Surgery, OB/GYN
Professional Services for Multi-specialties inpatient and outpatient Evaluation and Management Services
All Services are coded employing ICD-9-CM, CPT, HCPCS, and other coding resource materials as needed
Maintains & complies w/ policies & procedures for confidentiality of all patient records
Verifies all medical data from the record to complete a data abstract on each hospital encounter
SPECIALTIES
Certified through the AAPC in ICD-9, HCPCS, and CPT.
Experienced in KPHealth Connect, EPIC,IDX, HPF/McKesson
Proficient in Microsoft Word Xp Professional, Microsoft Office,
Microsoft Outlook, Microsoft Power Point, Microsoft Excel,
Microsoft Vista, IBM Lotus Notes, Novell Groupwise
Proficient in Medical terminology and Human Anatomy
GOALS
AAPC Certified ICD-10 by Spring of 2012
EDUCATION
Kenwood High School
Graduated 6/2002
3 years computer classes
2 years Spanish classes
Studied general courses
C.C.B.C. Essex
3/2004
Medical Office Administrative Assistant (Continuing education class)
• Patient registration/scheduling
• Charge entry, payment posting, accounts receivable follow-up, electronic claim submission
• HIPAA, health insurance guidelines
• Customer service
Coding Academy of America
5/2010
Studied for CPC national exam
Studied medical terminology
Studied human anatomy
REFRENCES
Available upon Request
1112 N. Marlyn Ave.
Baltimore, Maryland 21221
443-801-2566
shannonedwards12503@comcast.net
Objective:
To obtain a Medical Coding position that will allow me to
utilize my skill set to assist in meeting the goals and objectives of an
innovative and progressive organization.
PROFESSIONAL EXPERIENCE:
05/2011- Present
FPI at University of Maryland Medical Center
Certified Medical Coder- Neurosurgery
Reviews provider charges accuracy. This includes, but is not limited to: dates of service, procedures, level of care, locations, diagnosis (for medical necessity), patient identification and provider signature. Adds modifiers as appropriate, codes narrative diagnoses and verifies diagnoses for orders given.
Analyzes and interprets patient medical and surgical records to determine billable services.
Returns any incomplete charge tickets to the practice location for correction.
Interacts with providers and other medical professionals regarding billing and documentation policies, procedures and regulations. Obtains clarification of conflicting, ambiguous or non-specific documentation.
Reviews billing for optimal reimbursement while adhering to all insurer regulations regarding the prohibition of unbundling and other questionable practices.
Manages coding denial work queue to resolution.
Attends all mandated department trainings and staff meetings. Attends coding conferences, workshops and in-house educational sessions to receive updated coding information and changes in coding or regulations.
11/2010- 05/2011
Peak Health Solutions
Contractor on site at Kaiser Permanente/Coding Specialist (Full Time)
Review & code services that are potentially reimbursable, including Medicare, Medicaid, Workers' Comp & other third party payors by applying correct coding principles.
Review & code ambulatory surgical services & apply coding principles for correct coding.
Respond to questions from providers through inbasket messages, coding hotline or in person as needed.
Query providers for clarification of incomplete or ambiguous documentation as appropriate & monitor inbasket messages for timely responses.
Identifies workflow issues & works with supervisor to address changes in process.
Communicates & participates in local, regional & operational strategic meetings & initiatives involving coding & the revenue cycle enhancement process.
Participates in data quality & revenue cycle validation processes on a rotating basis.
Performs other duties as assigned or required.
-Job related Skills and affiliations:
Certified Professional Coder (CPC)
Member- American Academy of Professional Coders
Medical terminology, Anatomy and Physiology, Microsoft Word, Microsoft
Excel, Microsoft Outlook, Microsoft Power Point, Charge Entry
03/2008-09/2010
Home Paramount Pest Control
Pest Control Technician
Duties entail:
Conduct a thorough inspection and finish with a customized treatment plan
Provide professional services designed to eliminate pest problems, prevent
infestations and identify pest entry zones.
Conduct a comprehensive service report that includes product applications, pest
activity, and contributing conditions
9/2007-11/2010
American Coding Centers
Coding Consultant
Coding for services such as Anesthesia, Ambulatory Surgery, OB/GYN
Professional Services for Multi-specialties inpatient and outpatient Evaluation and Management Services
All Services are coded employing ICD-9-CM, CPT, HCPCS, and other coding resource materials as needed
Maintains & complies w/ policies & procedures for confidentiality of all patient records
Verifies all medical data from the record to complete a data abstract on each hospital encounter
SPECIALTIES
Certified through the AAPC in ICD-9, HCPCS, and CPT.
Experienced in KPHealth Connect, EPIC,IDX, HPF/McKesson
Proficient in Microsoft Word Xp Professional, Microsoft Office,
Microsoft Outlook, Microsoft Power Point, Microsoft Excel,
Microsoft Vista, IBM Lotus Notes, Novell Groupwise
Proficient in Medical terminology and Human Anatomy
GOALS
AAPC Certified ICD-10 by Spring of 2012
EDUCATION
Kenwood High School
Graduated 6/2002
3 years computer classes
2 years Spanish classes
Studied general courses
C.C.B.C. Essex
3/2004
Medical Office Administrative Assistant (Continuing education class)
• Patient registration/scheduling
• Charge entry, payment posting, accounts receivable follow-up, electronic claim submission
• HIPAA, health insurance guidelines
• Customer service
Coding Academy of America
5/2010
Studied for CPC national exam
Studied medical terminology
Studied human anatomy
REFRENCES
Available upon Request