Medical Customer Service
Resume:
Marla Panday, CPC, CPC-H
Delray Beach FL 33484
e/mail: ***********@*******.***
Objective:
Hospital Coding & Auditing, Medical Coder and billing analyst position
where my skills, abilities, and experience will contribute to the
efficiency, quality, and ongoing success of your organization.
Summary of Skills and Qualifications:
American Academy of Professional Coders (AAPC):
Certified Professional Coder (CPC) (Physician)
Certified Professional Coder - (CPC-H) (Hospital)
Health Care Reimbursement Specialist
Medical Coder: Cardiology CMS
guidelines
CPT and ICD-9 Urology Medical
Terminology
E&M's/ ED OB's PPO /HMO
Pathology Anesthesia Excel
Radiology Surgical Coding MS Word
Education and Training:
. University of London
. Certified Professional Coder thru AAPC
. Certified Outpatient Coder thru AAPC.
. Continuing Education: CPT coding, COB training, Medical terminology,
Cobra Appliances, Time Management, Employee Performance Evaluation
. Board Member of the Human Support Service
. St. Louis Community College at Forest Park; Spanish courses
. The Effective Supervisor, Interaction Skills for Success
Employment Experience:
TrueFACS Forensic Auditing Claims System -- 6/9/09 to present
Director of Inpatient and Outpatient Hospital bill Auditing staff;
implemented and approved appropriate CMS Billing & Compliance guidelines
for correct reimbursement and coding applications for both facility and
provider billings. Medical record coder and auditor.
Director of Reimbursement Analyst staff;
Determine hospital-specific cost for services rendered to inpatients and
outpatients based upon cost-reported overall and departmental cost-to-
charge ratios.
Team Health Specialized in ED coding. 3/09 to 6/2009
Millennium Practice Management Upper Saddle River, NJ 1/2007 to 3/2009
Specialized in Cardiology, Urology, E&M, Orthopedic, Gastro, Radiology,
Pathology
Per-Se Technologies St. Louis
3/2006 to 1/2007
Medical coder for E&M's, Pathology, Anesthesia, Surgical bills.
Connect Care St. Louis
2005 to 3/2006
Medical Coder, E & M's, Surgical; billing, payment poster.
RMRS St. Louis, MO 2002 - 2004
Negotiation for settlement of Hospitals and Physicians Bills. Medical
Billing, Medical Coding and Insurance Follow up
HNC Insurance Solutions St. Louis, MO 1998 - 2002
Complex Bill Review/Claims Processor
International Leather Goods Union St. Louis, MO 1991 - 1998
Office Manager - Negotiation for settlement for Hospitals and
Physicians Bills - Claims Processing.
Representative Accomplishments:
Medical Experience:
. Reviewed operative reports for correct coding for all surgical bills;
applying correct CPT and Diagnosis codes for E & M 's, Pathology,
Radiology, OB's, Anesthesia, Surgical, Cardiology, Urology,
Orthopedic, Gastro
. Reviewed, coded and approved all encounter forms and medical charts
for proper documentation by attending physicians and nurses according
to JCAHO/CMS requirements and guidelines.
. Ensured that all necessary documentation, notification and insurance
information are signed by patient and recorded in charts.
. Ensured that all current ICD-9-CM procedure and diagnosis codes were
properly applied to patients' problems or complaints.
. Ensured medical, hospital, surgical, optical, and dental claims were
processed and reimbursed in an accurate and timely manner to achieve
highest level of customer satisfaction.
Insurance Experience:
Negotiations for settlement for Hospitals and Physicians claims
. Oversight of Coordination of Benefits to promote cost-efficiency and
avoid duplicate payments
. Experienced in effective utilization of HMO networks and PPO's to
reduce costs
. Verified eligibility, investigated subordination agreements, analyzed
all medical and surgical bills to ensure accuracy, cost efficiency,
and quality customer service
. Supervised staff to achieve highest level of efficiency, accuracy,
productivity
. Managed office operations to achieve efficiency, productivity, and
highest level of service to membership and staff
. Conducted benefit presentations to membership at variety of work sites
and locations across the United States to facilitate clear
understanding of programs
Contact this candidate