Shaiye S. Gutierrez, CPC
13646 Legacy Circle Apt A
Herndon, VA 20171
Cell: 703-380-5906

I am a motivated individual who would like to become a part of a healthcare team with room for personal learning and growth. Recently, I put my career on hold to celebrate the arrival of my first child. I am now ready to get back to my passion, which is my billing and coding career. I obtained my coding certification through AAPC in 2008. Through my professional history, I’ve obtained specialty experience in pediatrics, orthopedics, and anesthesia.

EMR; medical terminology; extensive knowledge of commercial health plans, Medicare, Medicaid, and Tricare; EDI and HIPAA compliance; medical documentation for substantiation of procedures; CCI edits and surgical/procedural bundling; bi-lingual Spanish intermediate

Professional Experience:
12/10-08/11 Evergreen Medical Billing Chantilly, VA
Certified Professional Coder
Temp-to-permanent position with the company before they decided to outsource their coding
Physician outpatient anesthesia and pain management coding for 2 hospital facilities;
120 records coded in a day with 96% accuracy.
Different cases including endoscopy, general surgery, and OB/GYN
Follow Medicare CCI edits and staying up to date with compliance issues

07/08- 05/10 Virginia Spine Institute Reston, VA
Certified Surgical Coder/Medical Billing Specialist
At one point, the only CPC in the practice
Code inpatient/outpatient procedures from the physicians dictated operative report
Utilize Correct Coding Edits established by CMS when inputting charges
Follow up with insurance companies (Medicare, Tricare, BC/BS) on submitted claims
Prepared formal appeal letters for denials of medical necessity, unnecessary bundling, etc.
Kept the billing department informed of any medical coding updates

07/07- 07/08 Capture Billing & Consulting South Riding, VA
Billing Specialist
Duties include entering charges for 10-Physician Pediatric Group using Medics Elite
Submitted claims electronically via Real Med and also by paper (CMS-1500)
Followed up on past due claims (over 90 days) with insurance via telephone or website
Posted payments according to EOB from insurance carriers
Set-up payment plans for patient accounts with balances
Created month-end claim reports

09/06- 03/07 AHC, Inc. Manassas, VA
Workers’ Compensation Claims Representative
Placed for externship during final semester in college
Duties included following up on past due medical bills for resolution and prompt payment
Contacting the patient, employer, and third party payers
Resubmission of medical bills on UB-92
Utilizing EOB/EOP to submit appeals if necessary
Utilized FACS database

07/31/06-01/27/07 Everest College McLean, VA
Medical Billing and Coding Specialist Diploma 4.0 GPA

Zipporah Brown Evergreen Medical Billing (202) 277-4733
Ruba Siddiqui Virginia Spine Institute (703) 881-6834