Medical Billing

Denise Garcia

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

Address: **** *.***** ******

City: Tampa

State: FL

Zip: 33617

Country: USA

Phone: 813-***-****

Skill Level: Experienced

Salary Range: $53,000

Primary Skills/Experience:

See Resume

Educational Background:

See Resume

Job History / Details:

Denise M. Garcia, (Cont.)

DENISE M. GARCIA, CPC

6111 East 112th Avenue * Temple Terrace, Florida 33617 * Cell 813-***-**** * **********@*******.***

PROFESSIONAL PROFILE

Accomplished specialist with professional integrity and a solid understanding of the medical billing and coding industry. Solutions-driven with refined communication skills and comprehensive problem solving abilities. Repeatedly promoted to leadership positions. Recognized for ability to excel as both a leader and key contributor. Demonstrates a positive, upbeat and can-do attitude.

SKILLS SUMMARY Demonstrated history of producing accurate, timely, compliant documentation meeting customer and management satisfaction. Keenly recognizes, investigates and resolves discrepancies leveraging extensive experience going through appropriate channels to facilitate medical claims review and appeal processes. Ability to operate with high degree of sensitivity and confidentiality. Strong decision making abilities and analytical thinking skills. Hands-on, deadline oriented self-starter, who handles pressure well and possesses excellent prioritization and time management abilities. Proven multitasker known for attention to detail, organization and professional knowledge.

QUALIFICATIONS

ICD-9 * CPT * E/M Coding * Procedural and Diagnosis Coding * Anesthesia * Operative/Progress Notes

Medical Records * Auditing * Patient Services * Accounts Receivable * Payment Posting * Modifiers

Workmans Compensation * Claims Review and Processing * HIPPA * Medical Terminology * CPR

Medical Transcription * Office Management * Office Systems Specialist * Training * Instruction

Insurance Verification * Computer Skills * Key 13560 KSPH * EPIC * Chartview * Citrix * 3M * PowerTrak * BR4 Medical Manager * Surgicource * IDX * MS Word, Excel, PowerPoint, Access * XP * Publisher

* Greenway Connect * EPIC EHR

PROFESSIONAL EXPERIENCE

Ultimate Medical Academy, Tampa, FL 2010-Present

Certified Professional Coder Lead Instructor Responsible to teach advanced coding on all chapters of the CPT and diagnosis coding. Instruct how to abstract operative/progress notes, fundamentals of E/M coding, inpatient and outpatient hospital coding. Maintain records of student attendance, student progress, and grade distributions. Participate in special staff development activities for faculty. Create collaborative structures for the classroom to enhance learning. Assume other responsibilities as assigned by the appropriate instructional administrator. Input student attendance in company database portal; ensure other instructors are update with reporting and adhering to company policies and compliance. Assist program director with student issues, student academic progress Assist in maintaining student retention - give reports to program director.

Peak Healthcare, San Diego, CA 2009-2010

Certified Professional Coder (Remote Coder)

Abstract physicians progress/procedure notes in the clinic setting by assigning the appropriate procedural and diagnosis codes for the following projects:

Emergency Department/Observations (Jan. 2010 Aug 2010) Observation care services, Subsequent hospital care visits, Observation/Inpatient care services, Observation care discharge services, Observation consults, Radiology, Procedures, ICD-9 codes.

Abstract Coding in the clinic setting (Aug. 2009 Jan 2010) Evaluation and Management, Emergency Department, Radiology/Laboratory, Pathology, Surgery (all sections within surgery), Vascular Injections, Medicine/Vaccines/Immunizations/Acupuncture, OB/GYN, Respiratory, Cardiology, Ophthalmology, Neurology Neuromuscular Procedures, Physical Therapy, Dermatology, Orthopaedic.

Coventry Health, Tampa, FL 2008-2010

Certified Professional Coder Reviewed Evaluation and Management that were electronically submitted through Powertrak and BR4 systems for the workmans compensation setting. Abstracted progress notes and evaluated the appropriate CPT code or denial of claim. Gave recommendations by adhering to the CPT Guidelines for determining the correct level to be billed. Reviewed consultations, hospital visits, emergency department, injection codes, prolonged visits, physical therapy, radiology, and medical team conferences. Verified that diagnosis codes matched and were in conjunction with procedure codes. Made certain that body parts matched physician billing.

Florida Orthopaedic Institute Surgery Center, Temple Terrace, FL 2007-2008

Certified Professional Coder Handled abstract coding for pain patients and patients having orthopaedic surgery. Ensured correct CPT and ICD-9 codes and proper modifier codes were assigned.

Medical Records Coordinator Handled break down of charts in correct order. Obtained the operative notes and physician signatures. Made certain the operative notes were concise and accurate to coding and that they were complete and ready for billing. Handled training of support personnel. Tracked patient charts daily in preparation for coding and billing. Screened healthcare records to verify they were complete and contained all required data. Maintained confidentiality of medical records and supervised the release of medical information. Ensured retrieval and storage of records were compliant with legal requirements. Made certain records were accessible to authorized health care practitioners anytime facility was open to patients and that records were filed for easy retrieval. Provided backup billing support as needed.

Florida Gulf-to-Bay Anesthesiology, Tampa, FL 2006-2007

Certified Medical Coder Anesthesia Coding Reviewed physicians procedure notes and applied the appropriate procedural and diagnosis codes including abstract coding for the following medical facilities:

Critical Care for Tampa General Hospital, Surgicare for St. Marys Hospital, Florida Orthopaedic Institute-Surgery Center, Largo Medical, St. Pete Medical, Southbay Memorial Hospital, Riverwalk Medical, Pasco Medical, Tampa General Hospital (Anesthesia for all prodedures) and Physicians Health Center in Naples, Florida.

Florida Orthopaedic Institute Surgery Center, Temple Terrace, FL 2005-2006

Patient Services/Collection Specialist Checked in patients, ensured proper forms were completed, collected co-payments and answered questions regarding insurance. Pursued outstanding late accounts with patients in accordance with facility policy and procedures. Updated accounts receivable aging accounts, monitored aging report, updated insurance data and assisted front desk personnel as needed.

Custom Staffing, Tampa, FL 2005

Medical Bill Claims Reviewer Reviewed and process 60-90 medical bills daily for rehabilitation and health insurance facilities. Entered all bills and determined proper allowance based on State provisions and established guidelines.

Concentra Integrated Services, Tampa, FL 2004-2005

Medical Bill Review Auditor Reviewed medical bills for Workers Compensation and resolved errors. Used PowerTrak to manually price procedure codes that had not been processed correctly in system. Knowledge of physical therapy, chiropractic care, surgeries, anesthesia, home health care and prescription drugs. Processed and resolved invalid exception codes, reviewed CPT and ICD-9 codes for linkage, and managed employee sensitive claims. Entered all bills and determined proper allowance, ensured accurate modifiers, and sent payment recommendations to insurance carrier. Handled 150-200 bills daily; assisted in job training and developed documentation for training.

ADDITIONAL PROFESSIONAL EXPERIENCE

Great American Paper, Inc., Tampa, FL Executive Administrative Assistant 2002-2004

Brandon Regional Hospital, Brandon, FL Radiology Assistant 2002-2003

TeleRadiology Association, Tampa, FL Radiology Assistant 2001-2002

EDUCATION

Hillsborough Community College, Tampa, FL

Medical Billing and Coding, 2005 (GPA 3.50)

Internship: H. Lee Moffitt Cancer Center in Tampa, Florida from May 2005 to July 2005 in the DIO Coding Support Department.

A.A. Liberal Arts, 1973

ASSOCIATIONS

Member of the American Academy of Professional Coders (AAPC)

Member Secretary for Southeast Florida Chapter (AAPC)

COMMUNITY INVOLVEMENT 2012 Secretary position for AAPC Florida Southeast Chapter (newly developed chapter in Tampa). AAPC Acted as Secretary for Tampa Bay Professional Coders and assisted with negotiations to have local chapter regional conference to be held in November 2010. H. Lee Moffitt Cancer Center Offered time and talent in DIO Coding Support Department as the medical coder for Oncology physicians (research of Melanoma).

AWARDS

Teach Beyond Z education achievement award for collaborative structuring at 2011 UMA Education Summit.

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