Medical Customer Service

William Goodrich CPC-A

**** ******* ****** *****

Henderson, NV 89014

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

Mobile: 702-***-****

PROFESSIONAL SUMMARY:

Certified Professional Coder with education and training in healthcare coding and billing,

anatomy and physiology, medical terminology pathophysiology and outpatient medical coding.

PROFESSIONAL EXPERIEINCE:

Medical Coder 2013

Las Vegas Paiute Tribe Health Center

• Determines accurate ICD-9 codes for E/M services, ob/gyn, radiology, internal medicine,

laboratory, behavioral health and dental.

• Reviews medical compliance and reimbursement policies, such as medical necessity and

correct coding issues to remain current

• Reviews all available documentation to support the correct use of the appropriate use of

CPT-4, ICD-9 and HCPCS Modifiers.

• Ensures that all claims meet Local Medical Review Policies and complies with edits

established by the Correct Coding Initiative.

• Query physicians when documentation does not support use of a particular code.

• Use available resources to investigate the use of unusual or unspecified codes

Volunteer 2013

Volunteers in Medicine of Southern Nevada:

• Primarily assist with the conversion of paper records into an EHR format using Soapware

software.

• Provide other office support as required.

Medical Biller and Coder 2013

Wellness Redemption and Rehabilitation Program

• Review patient files and assign appropriate ICD-9 Codes, CPT-4 Codes, and HCPCS

Codes including modifiers.

• Examine claims for Medicaid compliance and accuracy prior to submission.

• Coordinated initiation of the authorization process to ensure accurate coding when

submitting a request for authorization.

Medical Biller and Coder 2013 (cont.)

Wellness Redemption and Rehabilitation Program

• Submit bills to Medicaid using Nevada EVS, Allscripts and Payerpath software.

• Maintain HIPPA security procedures and confidentiality to protect patients.

• Submit, organize and track all insurance claims filed by the health care providers

• Follow-up until payment are received, manage collections activities, aging reports and

reconcile A/R reports.

• Investigate claims that have been rejected or denied and resubmit or appeal as

appropriate.

• Answer customer questions regarding claim status, explanation of benefits and eligibility.

Medical Records & Emergency Room Volunteer May 2011 – June 2012

St. Rose Dominican Hospital – Siena Campus, Henderson, NV

• Provided medical records archiving and direct support as needed in each respective

department to include maintaining supplies, records, and overall office organization to

ensure department efficiency

• Provided patient creature comforts, listened to patients worries and concerns.

• Answered questions (within scope) of treatment process

• Provided emergency room patient room preparations and transportation..

Skills & Certifications:

• Certified by the American Academy of Professional Coders (AAPC #01240408)

• ICD-9-CM, CPT and HCPCS Coding

• 10-key Proficient

• Microsoft Word, Excel, Office, Outlook and PowerPoint Proficient

• Customer Service

Education:

• Medical Coding Associate Program, Asher College, Las Vegas NV

• Bachelor of Science, Rutgers, State University of New Jersey, NJ

Contact this candidate