Megha Patel, CCS, CPC, HCC Certified

** ******* ****,

Buena Park, CA - 90620

Home: 714-***-****

Cell: 714-***-****

Email:acgsnr@r.postjobfree.com

Objective:

. Seeking to obtain a challenging position in a career oriented

clinic/hospital/Medical/Insurance/ Professional Bill Review companies.

. Utilizing my office and computer skills as well as assist in efficient

productive company operations.

. Highly motivated and goal oriented who displays quick learning and

self starting abilities, Proficient in problem identification,

evaluation and resolution.

. I can work as an effective Team player who works well under pressure,

independently and within a cohesive group.

Qualification Summary:

. Certified Coding Specialist (CCS, AHIMA Approved)

. Certified Medical Coder (5+ Years' experience) (CPC, AAPC approved)

. HCC Certified (Hierarchical Condition Categories) (AAPC Approved)

. Certified Medical Biller

. Proficient in Medical Insurance Coding, Medical Terminology And

Medical Billing

. Excellent knowledge of ICD-9 coding, Medcheck, 3MEncoder, OMFS

Guidelines, AAOS and Medicare Guidelines (NCCI Edits and MUE Edits),

Medisoft, GE IDX Software, SMS Invision, A2K/FMS/Signature, AMA CPT

coding,CM1500 forms, UB92 forms, UB04 Forms

. Data Entry 8000-9000 KS, Typing speed 40 Word per minute.

. Strong knowledge of MS Word, Excel, Outlook, Power Point and MS

Access.

. Dependable, Reliable, Hardworking, motivated, energetic, dedicated and

professional

. Strong ability to multi-task, organized, disciplined and detail

oriented

Education:

Certified Coding Specialist (CCS-AHIMA)

AHIMA

2014

Certified Professional coder (CPC-AAPC)

AAPC

2013

AAPC Approved:

Completed Certification course on Risk Adjustment coding (HCC Coding) 2014

Presently enrolled in ICD-10-CM Proficiency Online Course

Cypress College, CA 2008-2010

Successfully completed Certification of Medical Coding Program (Health

Information Coding Certificate)

Successfully completed Certification of Medical Billing Program (Medical

Insurance Billing Specialist Certificate)

Experience:

Corvel Corporation, 1100 W. Town and Country Road, Suite 400, Orange, CA

92868

01/2010- Present

Professional Review Specialist/Orthopedic Coder

. Review and audit medical bills (Worker Comp. (surgery)) to ensure that

they are appropriate and adhere to the State Official Medical Fee

Schedule (OMFS) (PFS 2014), customer Guidelines and PPO Discount.

. Review Facility bills and verify DRG validation to ensure that they

are appropriate and adhere to the AMA CPT Manual.

. Verify and validate Surgery bills per AAOS/Medicare Guidelines on

insurance provider behalf. Consult reference materials in the auditing

process.

. Ensure that system data accurately reflects submitted billing

information and make any necessary corrections as needed.

UCI Medical Center, 200 S. Manchester, Ste 300, Orange, CA 92868

04/2009 - 07/2009

Senior Medical Biller

. Responsible for checking patient's insurance eligibility to respective

insurance such as Medicare, Medi-cal, MSI, Blue Cross, Blue Shield,

CalOptima, CCS etc.

. Checked all returned mailed either from bad address or address change

and perform task to cleanup address or forward mails to CBB collection

agency for further proceeding.

. Received payment from walk in patient and give them guidance and

advice as needed.

. Checked patient voice message on answering machine and do the follow

up.

Dr.David H Payne M.D., 1902 Royalty Drive, Suite 260, Pomona, CA 91767

01/2009-04/2009

Medical Biller

. Billing for worker comp. and all commercial carrier, following up on

unpaid or denying claims for their status

. Look up ICD-9 and CPT Codes in the intern to verify if a code has been

changed and entered deposited and updated patients demographics using

the Prime Clinic system.

. Retrieve billing records for copy services and law firms.

. Set up on line electronic Medicare and Medi-cal claim process.

. Occasionally handling front desk. (e.g. Schedule patient appointment,

answering patient telephone etc.)

Dr.Ashok Amin M.D., 1711 West Romneya Ave. Anaheim, CA 92801

08/2008 - 01/2009

Medical Biller

. Billing for medical and all commercial carrier, following up on unpaid

or denying claims for their status

. Heavy data entry tasking, answering the phones and files, faxing and

copying documents.

. Look up ICD-9 and CPT Codes in the intern to verify if a code has been

changed and entered deposited and updated patients demographics using

the Medisoft system.

. Submitting insurance claims, complete claim form for Medicare,

Medicaid, PPO, HMO etc.

Molina Health Care Group (ASAP Staffing), 1 Golden Shore, Long Beach, CA

90802

08/2008 - 08/2008

Medical Records Clerk

. Responsible for Arranging and managing medical records.

. Process, verify and scan the medical records.

. Heavy data entry to the software of the medical records.

. Responsible for other duties related to medical clerk.

Children Hospital (Office Team), 1811 N. Western Avenue, Los Angeles, CA

90027

04/2008 - 08/2008

Medical Records Clerk III

Process daily correspondence to ensure that all explanation of benefits are

scanned and uploaded into on-line computer information exchange system.

. Retrieve billing records for copy services and law firms.

. Prepare and arrange lock boxes to scan and upload in the computer

system for efficient access to collector retrieval.

. Purges unnecessary paper from file room and all patient discharge

documents.

. Create electronic records, entering data of all medical paper work

into on-line system.

. Photocopy hard copy records as authorized, responsible for mail room

duties.

. Use word for correspondence and excel for mini accounting works.

.

References: Available upon request.

Contact this candidate