Medical Insurance

Amy Mayle

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

Grafton, WV 26354

******************@*****.***/ 304-***-****

Objective:

Remote Medical Coder

Summary of Qualifications:

Over ten years experience as a medical coding professional in a variety of clinical

•

settings.

• CMRS Certificate

• Will be sitting for CCS exam

• Perform audit coding of disease and injury diagnoses, acuity of care, and procedures

• References used for coding include the current International Classification of Diseases

(ICD), Clinical Modification; American Medical Association Physicians' Current

Procedural Terminology (CPT); Health Care Common Procedure Coding System

(HCPCS); Physicians' Desk Reference

• Knowledge of medical terminology, anatomy and physiology

• Broad medical experience also includes billing, reimbursement, HIPPA rules, insurance

verification, scheduling, and report creation

• Key strengths: communication, leadership and interpersonal skills; multi-tasking and

overall resourcefulness

Experience:

D&M Medical Services, West Virginia 2004-2012, Remote Medical Coder

• Accurately assign ICD-9-CM and/or CPT-4 code(s) and sequence diagnosis and

procedures per patient medical record

• Assure the assignment of complete, accurate, timely and consistent codes by the medical

coding unit

• Reconcile clinical notes, patient encounter form, health information for compliance with

HIPPA rules and JCAHO standards.

• Provide coding and documentation advice to the coding unit, clinical and professional

staff.

• Analyze billing to improve coding data accuracy for Medicare compliance

reimbursement

• Ensure coded data accurately reflects service provided, based on documentation,

guarding against fraud and abuse

• Coding and Charge Entry for Insurance and Patient Billing

• Code records by following prescribed coding standards such as ICD-9 and CPT

• Coded inpatient charts at a rate of 20+ charts/day coding proficiency and 98-100%

accuracy

Reviewed, analyzed and managed coding of diagnostic and treatment procedures

•

contained in inpatient and outpatient medical records

AMBS, West Virginia, 2002-2004, Medical Billing Specialist

• Assigns codes on all diagnoses, procedures, professional service, and supplies with the

most accurate and descriptive ICD-9-CM, CPT-4, Evaluation and Management and

HCPCS codes for all patient encounters for reimbursement

• Coded outpatient charts at a rate of 100 + charts/day coding proficiency and 98-100 %

accuracy

• Bill insurance claims automated or manual using HCFA 1500 and UB-92form (UB04)

• Verify insurance eligibility, follow-up on all insurance denials

• Audit claims for accuracy, completeness. Correct CPT and ICD10 coding errors

• Submit reimbursement claims to insurance companies and government entities

• Collect patient payments and maintain billing records

• Retrieve/file charts, medical records

• Answer incoming telephone calls, file reports, manage mail

• Manage release of information requests

• ICD-9 &CPT-4 Coding as directed

• Maintains inventory

Education:

Ashford University, Bachelors Degree in Health Informatics

Grafton High School, Grafton WV, High School Diploma received

References:

Available upon request

Contact this candidate