Erin Spada, CPC Email:emspada@yahoo.com
3360 James Way Tel: (720) 988-8043
Westminster, CO 80030
Objective
To obtain a job in the medical field that will be both challenging and rewarding, preferably using the medical coding/auditing skills I have acquired, but not necessarily limiting myself to that specific field.
Experience
Surgical Specialists of Colorado, PC Wheat Ridge, CO
Medical Coder/Biller 11/2008 to present
General surgery, Vascular and Trauma coding and billing for an 21 surgeon practice. Helped train and educate the physicians, as well as created job aids and guides for physicians and staff including a monthly coding newsletter. Work insurance and patient accounts receivable, post payments and work collection accounts daily. Responsible for routine audit of claims for coding and billing errors.
March Vision Care, Inc. Culver City, CA
Claims/Operations Supervisor 5/1/2006 to 8/2008
Supervised the Claims, Customer Service, and Operations staff, which included; claims audit and coding practices, monitored incoming and outgoing phone calls, tracked daily mailroom activities, and kept claims at 100% compliance for 2 years in a row. Wrote reports for claims extractions, and EOP production, as well as auditing reports through Crystal, and R&R report writer programs. Worked closely with the IT department, and helped remediate the base system for claims processing and customer service issue tracking.
Meridian Healthcare Mgmnt Woodland Hills, CA
Pricing Coordinator 9/2005 to 4/1/2006
Maintained provider pricing database tables based upon contract information and client guidelines to ensure claims were processed accurately. Interpreted provider contracts to determine the required pricing configuration rules. Acted as a liaison in researching, resolving and documenting complex claims and customer service issues related to pricing. Monitored and tracked all pricing database reference table updates. This included: CPT, HCPCS, ICD-9, revenue codes, RBRVS schedules, Medicare Fee Based Schedules and Medicaid Schedules. Assisted and performed other tasks as delegated such as running reports, and attending Operations Meetings.
Hoag Hospital Newport Beach, CA
Utilization Management Assistant 3/2003-9/2005
Directly responsible for all aspects of the operational needs of the Utilization Management Department of Greater Newport Physicians. Collaborated with nurses and hospital case managers in the patient referral process. Audited and authorized patient?s referrals, as well as translated physician notes into ICD-9 and CPT codes. Assisted physicians and insurance companies, as needed, with complex issues related to benefits. Communicated benefits and eligibility information to physicians and Healthcare facilities.
Member Services Supervisor 4/2000-4/2003
Answered phones in a heavy call center environment. Supervised department, and handled difficult calls when requested. Helped providers and patients with HMO insurance questions, referral and claim status, status of new physicians within the group. Nominated to be part of an expanded team for implementing a new computer system for the hospital subsidiaries. Worked closely with other departments, problem solving, and organizing/leading staff meetings department.
Medical Records Clerk 4/1999-4/2000
Responsible for organizing and delivering patient charts. Filings, typing, excel, member insurance research. Fill positions around the office, such as, front office, reception, and answering phone for the department.
Education
2004 AAPC/Coding Depot Mission Viejo, CA
Coding Certificate Medical
Received Medical Coding Certification
1998-Current Orange Coast College Costa Mesa, CA
Some College Courses
Worked on Associates degree for Medical Management
1998 Edison High School Huntington Beach, CA
High School Diploma General
Participated in Model United Nations, Cheerleading, Student Senate, and took honor classes.
3360 James Way Tel: (720) 988-8043
Westminster, CO 80030
Objective
To obtain a job in the medical field that will be both challenging and rewarding, preferably using the medical coding/auditing skills I have acquired, but not necessarily limiting myself to that specific field.
Experience
Surgical Specialists of Colorado, PC Wheat Ridge, CO
Medical Coder/Biller 11/2008 to present
General surgery, Vascular and Trauma coding and billing for an 21 surgeon practice. Helped train and educate the physicians, as well as created job aids and guides for physicians and staff including a monthly coding newsletter. Work insurance and patient accounts receivable, post payments and work collection accounts daily. Responsible for routine audit of claims for coding and billing errors.
March Vision Care, Inc. Culver City, CA
Claims/Operations Supervisor 5/1/2006 to 8/2008
Supervised the Claims, Customer Service, and Operations staff, which included; claims audit and coding practices, monitored incoming and outgoing phone calls, tracked daily mailroom activities, and kept claims at 100% compliance for 2 years in a row. Wrote reports for claims extractions, and EOP production, as well as auditing reports through Crystal, and R&R report writer programs. Worked closely with the IT department, and helped remediate the base system for claims processing and customer service issue tracking.
Meridian Healthcare Mgmnt Woodland Hills, CA
Pricing Coordinator 9/2005 to 4/1/2006
Maintained provider pricing database tables based upon contract information and client guidelines to ensure claims were processed accurately. Interpreted provider contracts to determine the required pricing configuration rules. Acted as a liaison in researching, resolving and documenting complex claims and customer service issues related to pricing. Monitored and tracked all pricing database reference table updates. This included: CPT, HCPCS, ICD-9, revenue codes, RBRVS schedules, Medicare Fee Based Schedules and Medicaid Schedules. Assisted and performed other tasks as delegated such as running reports, and attending Operations Meetings.
Hoag Hospital Newport Beach, CA
Utilization Management Assistant 3/2003-9/2005
Directly responsible for all aspects of the operational needs of the Utilization Management Department of Greater Newport Physicians. Collaborated with nurses and hospital case managers in the patient referral process. Audited and authorized patient?s referrals, as well as translated physician notes into ICD-9 and CPT codes. Assisted physicians and insurance companies, as needed, with complex issues related to benefits. Communicated benefits and eligibility information to physicians and Healthcare facilities.
Member Services Supervisor 4/2000-4/2003
Answered phones in a heavy call center environment. Supervised department, and handled difficult calls when requested. Helped providers and patients with HMO insurance questions, referral and claim status, status of new physicians within the group. Nominated to be part of an expanded team for implementing a new computer system for the hospital subsidiaries. Worked closely with other departments, problem solving, and organizing/leading staff meetings department.
Medical Records Clerk 4/1999-4/2000
Responsible for organizing and delivering patient charts. Filings, typing, excel, member insurance research. Fill positions around the office, such as, front office, reception, and answering phone for the department.
Education
2004 AAPC/Coding Depot Mission Viejo, CA
Coding Certificate Medical
Received Medical Coding Certification
1998-Current Orange Coast College Costa Mesa, CA
Some College Courses
Worked on Associates degree for Medical Management
1998 Edison High School Huntington Beach, CA
High School Diploma General
Participated in Model United Nations, Cheerleading, Student Senate, and took honor classes.