Medical Billing

Jessica Morales, CPC-A

**** **** **** **. ******, Texas 75217

Cell: 469-***-****

Email: ************@*****.***

Objective

Bilingual Medical Coder seeking a position that will allow my broad

knowledge of the ICD-9, CPT, and HCPCS in today's coding systems to be

used. I am a focused, self-motivated, and detailed oriented individual. I

possess highly developed skills in coding principles and guidelines. I am

proficient in the Microsoft Office with 50 wpm. I am seeking a position in

which I can utilize my advanced coding skills and look forward to long term

growth of opportunities.

Advanced Coding Skills

. ICD-10 Certified

. CPT Coding Guidelines

. ICD-9 Guidelines at the Sections, Subsection, and Category Level

. NCCI Edits / OIG

. Reimbursement Strategies

. HIPAA / OSHA Regulations

. Medicare and ABN

. HIPAA Regulations

. Law & Ethics

. Advanced Anatomy & Physiology

. Medical Terminology

. Pre-authorizations

. Familiarity with Third Party Payer Commercial Insurance

. Medicaid

. Benefits & Eligibility

. CPR Certified

. Phone Etiquette

Education / Affiliations

Kaplan College - Dallas, Texas

07/2012 - 04/2013

Medical Office Specialist

Skyline High School - Dallas, Texas

08/2008- 05/2012

High School Graduate

AAPC - American Association Professional Coders

AHIMA - American Health Information Management Association

AAPC - Coding Edge Magazine Subscriber

AHA - American Heart Association

Externship 200 Clock Hours

. Reviewed medical records for the determination and accurate assignment

of all documented diagnoses and procedures.

. Assigned and sequenced codes based on medical record documentation.

. Assigned appropriate discharge coding modifiers

. Abstracted and entered coded data and designated quality management

data for hospital statistical and reporting requirements.

. Communicated documentation improvement opportunities and coding issues

(i.e., discrepancies, physician queries, etc.) to the appropriate

personnel for follow up and resolution.

. Reviewed complex operative procedures for office surgeries.

. Coordinated and reconciled multiple surgical schedules to ensure

complete charge capture.

. Worked in conjunction with A/R team on follow up and resolution of

denials and rejections.

. Responsible for maintaining current knowledge of coding guidelines and

relevant federal regulations through the use of current CPT-4, HCPCS

II, and ICD-9/ICDD-10 materials, Federal Register, and other pertinent

materials.

Experience

Your Medsource, Inc. Carrollton, Texas

02/2013 - Present

. Accurately apply payments to patient accounts.

. Ensure claims are entered and submitted with 48 hours of receipt

. Post and reconcile insurance and patient payments. Research and

resolve incorrect payments, EOB

rejections, and other issues with outstanding accounts

. Audit accuracy of insurance claims. Verify correct ICD-9 and CPT codes

for a variety of specialties

. Set up new patient accounts

. Assign ICD-9 to physicians diagnosis and insure correct level of

service and various other CPT codes

. Set-up practice management software for submission of electronic

claims to clearinghouse. Work with

clearinghouse to resolve file compatibility issues

. Retrieve Electronic Remittance Advice (ERA's)

. Send secondary claims upon processing of primary insurance.

. Daily processing of Patient statements. Answer and resolve patient

billing inquiries

. Follow up on Insurance and patient aging. Re-submit insurance claims

as necessary. Knowledgeable

in timely filing restrictions

. Ensure office practices are in compliance with HIPAA regulations

References:

Delissa Ortega, CPC

Mobile: 469-***-****

. Former Medical Billing & Coding Instructor

Richard Su

Work: 972-***-****

. Former Manager

Kimberly Reil-Money

Mobile: 972-***-****

. Former Medical Billing & Coding Instructor

Contact this candidate