Medical Customer Service

Michelle Proulx

** ******** ***** **** **, Merrimack, NH 03054 H: 603-***-**** C: 603-***-**** ********.**@*****.***

A highly self motivated professional with a proven track record of 9 years experience in auditing claim error and corrections. A natural organizational ability to maximize productivity while keeping all departments working together to reach a common goal. Designed and implemented new procedures and policies to cut cost and payroll hours through efficiency, thus safeguarding the company and its assets. A quick decision maker with the strength to make the most difficult decisions to positively affect the company. A fearless leader who inspires others to take pride in their work and to do what it takes to get the job done.

Professional Qualifications

Adobe & Microsoft Suites HIPPA compliance Medical terminology expert

ICD-10 coding specialist HCPCS Coding Guidelines Proficient with HCPCS coding guidelines

Training employees Client/Customer Service Conflict Resolution expert

A/R verification CPT specialist Audit and claims specialist

Exceptional organizational skills Vast knowledge of all insurance carriers

PROFESSIONAL EXPERIENCE

Conifer Health Solutions September 2015 – April 2017

Coding Team Lead

Monitor team members' participation to ensure the training they are being provided is being put into use, and also to see if any additional training is needed

Manage the flow of day-to-day operations

Performed weekly performance audits.

Reviewed denied claims identified errors and corrected claims.

Ensured compliance with current Healthcare regulations and guidelines

Provided high level verbal and written customer communication

Answer billing and coding questions to both internally and externally

Elliot Hospital June 2008 – September 2015

Team Lead / Coding Specialist II

•Guide workflow and/or assigns tasks to other clinical staff

•Comply with all Health System policies and procedures

•Assist management staff with supervisory activities to assist the expanded care team. Participates with creations and implemented of departmental goals, processes and procedures.

•Precisely completed appropriate claims paperwork, documentation and system entry.

•Correctly coded and billed medical claims for various hospital and nursing facilities.

•Carefully researched newly identified diagnoses and/or medical procedures to expand skills and knowledge.

•Meticulously identified and rectified inconsistencies, deficiencies and discrepancies in medical documentation.

•Maintained knowledge of coding requirements, through continuing education and certification renewal.

•Entered orders into the EMR system efficiently and without errors.

•Assigned appropriate medical codes with a 98.3% percent accuracy rate.

Granite State Podiatry June 2008 – September 2015

Medical coder

Granite State Podiatry is where I completed my internship requirement for Sea Coast Career Schools. My duties while participating in this program included:

Precisely completed appropriate claims paperwork, documentation and system entry.

Correctly coded and billed medical claims for various hospital and nursing facilities.

Professionally and courteously verified appointment times with patients.

Assisted in the maintenance of medical charts and/or electronic medical record (filing, Op Reports, test results, home care forms).

Verified patients' eligibility and claims status with insurance agencies.

EDUCATION

Seacoast Career Schools

Coding and billing specialist

Rivier University

Associate of Applied Science

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