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Seeking a Medical Coding/Billing position in either a local or remote for clinic/hospital where I can utilize my extensive coding and billing knowledge, strong organizational abilities and customer service background.

Qualification Summary:

More than 20 years experience in the Medical Coding/Billing field. Certified Professional Coder (CPC) since 2001. AHIMA certified (RHIT) Registered Health Information Technician since 2007. Very knowledgeable in medical coding guidelines and coding techniques (ICD-9, CPT) Proficient in physician based coding and billing and outpatient coding. Skilled in HCC risk assessment ICD-9 coding and auditing. College level coursework included Anatomy & Physiology, Medical Terminology, Pharmacology and Health Information Management. Skilled at MS Office software including Microsoft WORD, EXCEL and POWERPOINT.

Clarkson College, Omaha NE
Associate of Science – Health Information Management Graduation Date: December 2006

Pacific College of Medical & Dental Careers, San Diego, CA
Dental Assisting Certificate~~1985

Coronado High School ~ Graduated 1983

Work Experience:

Remote HCC Coder 10/2010 – 01/29/2011
Maxim Health Information Solutions

I worked remotely performing HCC risk assessment ICD-9 coding/auditing per CMS and client specific guidelines. This project involved ICD-9 coding for outpatient visits for multiple provider types; including Cardiology, Nephrology, Endocrinology, Orthopedic Surgery, Neurology, Internal Medicine, Family Practice, Podiatry, Ophthalmology to name a few. Records were reviewed and abstracted for chronic conditions within given measurement years per client instruction. After codes were abstracted, the information was data entered into client website. I was required to sustain a 95% accuracy rate for this project and my work was audited by the client on a regular basis. I kept in daily contact with the client and the Maxim project manager for updates and instructions. I was also required to maintain and submit a daily Excel production log.

Remote HCC Coder 01/2010 – 08/2010
Peak Health Solutions
San Diego, CA
Performed ICD-9 HCC risk assessment coding/auditing/data abstraction on various client’s Outpatient medical records using HCC guidelines per CMS. Assisted with internal audits per request of manager. Performed medical record reviews on various types of software including PDM, Storan, and Cobius. Kept in close contact with project manager to make sure deadlines were met.

Medical Coding Specialist, Remote 09/2007 – 02/2010
Outcomes Health Information Solutions
Stanford, KY
Worked as a remote contract coder performing HCC ICD-9 risk assessment functions on various types of outpatient records including: internal medicine, Geriatrics, Cardiology, Rheumatology, Neurology etc. All audits were for Medical Advantage claims. Performed medical record reviews on all assigned charts for risk assessment abstraction. Completed data entry of patient’s ICD-9 CM service dates into the proprietary software application with necessary error and omission codes appended. Verified completeness and accuracy of my coding with current Outpatient coding guidelines. Completed all assigned coding within standard 48 hour turnaround. Maintained 95% accuracy rate in QA audits. Also maintained frequent communications with on site staff and attend required training via the
**Lapse in employment 2005 – 2007 due to fact I went back to school full time**

Reimbursement Specialist II/Coder 08/2003 – 05/2005
Yakima Regional Cardiac & Medical Center
Yakima, WA
I was responsible for CPT-4 and ICD-9CM coding on all anesthesia services (professional fee's) for a large group practice. Demographic entry for all new patients, payment posting, charge entry posting for all anesthesia services. AR follow up on outstanding charges. Assisted other staff members with coding and billing questions regarding anesthesia patients. Assisted patient's with billing concerns. I also coded for other staff members when they were sick, on vacation, etc.

Reimbursement Specialist I/Coder 09/1997 – 08/2003
Providence Yakima Medical Center
Yakima, WA
My main responsibility was as the billing and reimbursement specialist for all Worker's Compensation and Labor and Industries charges for a large hospital based physician billing group. Initiated a process to gather required medical records from the various offices in order to send claims to L&I and Workers Compensation for payment. Followed up on outstanding charges with heavy contact in Labor and Industries claim managers. I attained a 92% reimbursement on charges within my assigned payers (L&I and WC). On an annual basis, I updated the billing system new fees from the L&I provider schedule. Audited medical records for proper usage of ICD-9 and CPT codes - relaying discrepancies to various providers within our network. Labor and Industry guidelines explained to them as well. Assisted patients with billing issues related to Labor and Industries and Worker's Compensation claims. I performed daily electronic billing for the entire clinic network. Other duties included billing and reimbursement for Indian Health Services

Coder 07/1994 – 08/1997
Yakima Valley Radiology
Yakima, WA
My main duties were CPT-4 and ICD-9CM coding for diagnostic radiology services for a large physician practice. These radiology services included MRI, CAT scans and diagnostic radiology. I was assigned radiology professional fee coding duties for 3 local hospitals. Performed data entry of all assigned coded charges, assisted patients with billing questions, and was responsible for business forms inventory for entire facility. I performed daily backup of computer system.

Computer Billing Operator 07/1989 – 07/1994
Western Laboratories
Yakima, WA
CPT coding for laboratory and pathology procedures. Data entry for all payment types. Balanced day-end journals. Substituted for receptionist as needed. Performed electronic billing and posting DSHS payments. Assisted patients with billing problems. Gave verbal lab results to referring physician offices. Assisted with other general office duties.

References: Available upon request