SUMMARY

SKILLS

EXPERIENCE

BRIDGET O. SMALLS, CPC

*** ****** *****, ******* *, NJ 07753 H: 732-***-**** C: 732-***-**** ac2fa9@r.postjobfree.com

To obtain a great position to utilize all of my past experience as well as my medical coding certification. I have had a lot of experience on the Insurance side of the business and I also have had a great deal of experience in multi specialty coding and further taught all of the above for over 15 years. I am very competent in coding guidelines and a I know my way around both Medicare and Medicaid LCD's. I have taught both ICD10 CM and PCS. My management experience is extensive and I also know my way around Insurance companies medical policy.

I have been on several teams that have implemented a great deal of improvement initiatives at Insurance Companies, Healthcare facilities and also learning institutions. I was a diplomat creating internal and external relationships among my peers. Compliance is number one for all things Insurance and Coding.

Managed care contract

knowledge

Electronic Medical Record (EMR)

software

Extensive anatomy/physiology

knowledge

Knowledge of HMOs, Medicare

and Medicaid

Maintains strict confidentiality

Trained in ASC Coding

Qualified pain management

coder

Worked closely with IT to resolve

all kinds of edits

Quality and Compliance

Implement SOP for most

employers

processed large amount of claims

while resolving edits

implementation of new software

resolving all types of issues

ICD-10 coding

Extensive anatomy/physiology

knowledge

Certified coding instructor

07/2016 to 10/2017 Medical Billing, Coding & Documentation Specialist Trainer United States Air Force DOD/Mindleaf Technologies - Wrightstown, NJ Assigned additional diagnosis codes based on specific clinical findings

(laboratory, radiology and, pathology reports as well as clinical studies) in support of existing diagnoses.

Reviewed diagnostic and procedural terminology for consistency with acceptable medical nomenclature. Ensured compliance with medical/legal requirements, JCAHO standards and Army regulations. Consistently ensured proper coding, sequencing of diagnoses and procedures. Acted as a liaison between the business department, billers and third party payers in resolving billing and reimbursement accuracy Demonstrated knowledge of HIPAA Privacy and Security Regulations by appropriately handling patient information. Demonstrated analytical and problem-solving ability by addressing barriers to receiving and validating accurate HCC information.

Carefully reviewed medical records for accuracy and completion as required by insurance companies.

Trained everyone in the MTF on proper coding and documentation per the MHS guideline through auditing of records in AHLTA

01/2010 to 07/2016 Program Director/Clinical Coordinator Sanford Brown Institute - Iselin, NJ

Directed the daily operations for the medical billing and coding program, also developed strong relationships with Insurance Companies and provider offices for potential clinical externships sites which lead to employment for the students Monitored operational tasks and suggested and created improvements Taught extensive Insurance applications, CPT4 coding ICD10 CM and PCS medical terminology and also A & P

Supervised 4 instructors and scheduled all classes day and night 04/2008 to 01/2011 Medical Billing Insurance Representative Practical Billing Solutions - Red Bank, NJ

Carefully reviewed medical records for accuracy and completion as required by insurance companies.

Recorded and filed patient data and medical records. Demonstrated analytical and problem-solving ability by addressing barriers to receiving and validating accurate HCC information. Extensive communication with Insurance carriers insuring that their medical policy was followed and fee schedules matched the providers contract 02/2003 to 09/2007 Medical Billing Specialist/Manager Visiting Physician Services - Eatontown, NJ

Performed full-cycle medical billing in a fast-paced company Efficiently performed insurance verification and pre-certification and pre-authorization functions.

Coded and prepared all claims to be sent to all Insurance Companies Performed quality control of the data entry system to verify that claims and payments were posted correctly.

02/2002 to 05/2002 Temporary Case Manager

Nurse Finders - Edison, NJ

HIPPA implementation team project manager

Worked with IT department and special projects manager closely Demonstrated analytical and problem-solving ability by addressing barriers 08/2000 to 02/2002 Medical Biller And Coder

J & S Stark Agency - Shrewsbury, NJ

Assigned additional diagnosis codes based on specific clinical findings

(laboratory, radiology and, pathology reports as well as clinical studies) in support of existing diagnoses.

Carefully reviewed medical records for accuracy and completion as required by insurance companies.

Thoroughly investigated past due invoices and minimized number of unpaid accounts.

Recorded and filed patient data and medical records. EDUCATION AND TRAINING

ACTIVITIES AND HONORS

12/1999 to 08/2000 Medical Billing Clerk

Cardiology Medical Group - Edison, NJ

Completed registration quickly and cordially for all new patients. Scheduled patient appointments.

Retrieved physician correspondence from dictation service and made edits when necessary.

12/1997 to 05/1999 Member Service Representative

Prudential Healthcare - Cranbury, NJ

Attended anti-fraud trainings, conferences, client SIU trainings and industry seminars.

Interviewed claimants, medical specialists and employers to determine pertinent claim information.

Reduced loss ratios through fair and prompt processing of claims. Investigated any potentially fraudulent claims with a focus on thoroughness, quality and cost control.

Mentored all new members of the claim staff.

08/1995 to 12/1997 Team Service Representative

Blue Cross and Blue Shield of New Jersey - Newark, NJ Junior member on Medical Policy team

Made sure all SOP were implemented and followed.

Made sure all claim edits were addressed and corrected Processed claims

2001 Certificate: MBC/Insurance Specialist

Brookdale Community College - Lincroft, NJ

Certified Professional Coder 01427599

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