TPeniston61
Networker
I am looking for an coding opportunity in the San Diego area. I have worked for 5 years for a specialty health company as a third-party biller to insurance agencies across the United States. During my time at this company, I have progressed from Claims Examiner I to level III and am now a claims analyst. Dependability and thoroughness are my greatest strengths. I am able to analyze detailed information and easily make appropriate decisions. I work to avoid denials due to incorrect eligibility information and coding errors. I have a current CPC certification, working to remove the A, apprentice level, through a year-long Practicode program, which requires you to code a variety of scenarios directly from medical records. Though I have not worked in a specific coding position, I believe that I have the ability to quickly assimilate new information and apply what I know. I am constantly learning, I regularly attend AAPC meetings, I adhere to HIPAA standards, and I keep up-to-date with changes to ICD-10 and CPT coding guidelines. Please review my attached resume. I look forward to hearing from you.
Thank you,
Teri Peniston, CPC
Teri Peniston
CPC
AAPC License 01436954
citywatch@att.net
(760) 707-4662
Summary
• Dependable, hardworking professional
• Bilingual in English and Spanish
• Positive interactions with clients and staff
• Detailed and analytical approach
• Training in Office Procedures
• ICD-10, DSM-IV, CPT coding
• Adhere to HIPAA standards
Experience
Claims Compliance Analyst
September 2017 – present
Research and resolve claims issues
Adjust any improper denials
Verify member eligibility and provider coverage
Ensure that ICD-10 and CPT codes are valid
Coordinate benefits
Prepare audits of provider-selected claims
Assist with special projects as needed
Claims Examiner III at American Specialty Health
December 2013 –September 2017
Processed medical claims for chiropractic, acupuncture and physical therapy
Interpreted Explanation of Benefits and coordinated primary/secondary insurance
Consistently met quantitative and qualitative production standards
Verified personal health information and eligibility requirements
Sales Associate at Ross Stores, Inc.
June 2011 - August 2014
Cashier: Handled cash/credit card transactions
Fitting Room Attendant: Enforced loss prevention procedures
Sales Floor: Merchandised items, organized store
Case Manager at Palomar Counseling Services
September 2006 - April 2008
Provided short-term therapy to children, youth and families, including intakes and psychosocial assessments and psycho-educational groups. Completed medical documentation, with appropriate DSM-IV diagnoses and CPT/HCPCS codes, with monthly and annual updates
Provided community resources to families
Educated parents in behavioral interventions
Conducted psycho-educational groups for teen recovery program
Skills & Expertise
• Knowledge of medical terminology
• Familiarity with several commercial insurance companies and Medicare
• Experience interpreting CMS-1500 forms
• CPT and ICD-10 coding
• Coordination of benefits
• Customer Service
• Computer applications: Word, Excel, Outlook, 10-key
Education
Mira Costa College
Certificate in Insurance Coding and Billing, Medical Administrative Professional, 2010 - 2012
San Diego State University-California State University
Master's degree, Social Work, 2004 – 2006
AAPC
Practicode July 2017 – May 2018
Thank you,
Teri Peniston, CPC
Teri Peniston
CPC
AAPC License 01436954
citywatch@att.net
(760) 707-4662
Summary
• Dependable, hardworking professional
• Bilingual in English and Spanish
• Positive interactions with clients and staff
• Detailed and analytical approach
• Training in Office Procedures
• ICD-10, DSM-IV, CPT coding
• Adhere to HIPAA standards
Experience
Claims Compliance Analyst
September 2017 – present
Research and resolve claims issues
Adjust any improper denials
Verify member eligibility and provider coverage
Ensure that ICD-10 and CPT codes are valid
Coordinate benefits
Prepare audits of provider-selected claims
Assist with special projects as needed
Claims Examiner III at American Specialty Health
December 2013 –September 2017
Processed medical claims for chiropractic, acupuncture and physical therapy
Interpreted Explanation of Benefits and coordinated primary/secondary insurance
Consistently met quantitative and qualitative production standards
Verified personal health information and eligibility requirements
Sales Associate at Ross Stores, Inc.
June 2011 - August 2014
Cashier: Handled cash/credit card transactions
Fitting Room Attendant: Enforced loss prevention procedures
Sales Floor: Merchandised items, organized store
Case Manager at Palomar Counseling Services
September 2006 - April 2008
Provided short-term therapy to children, youth and families, including intakes and psychosocial assessments and psycho-educational groups. Completed medical documentation, with appropriate DSM-IV diagnoses and CPT/HCPCS codes, with monthly and annual updates
Provided community resources to families
Educated parents in behavioral interventions
Conducted psycho-educational groups for teen recovery program
Skills & Expertise
• Knowledge of medical terminology
• Familiarity with several commercial insurance companies and Medicare
• Experience interpreting CMS-1500 forms
• CPT and ICD-10 coding
• Coordination of benefits
• Customer Service
• Computer applications: Word, Excel, Outlook, 10-key
Education
Mira Costa College
Certificate in Insurance Coding and Billing, Medical Administrative Professional, 2010 - 2012
San Diego State University-California State University
Master's degree, Social Work, 2004 – 2006
AAPC
Practicode July 2017 – May 2018