Megha Patel, CCS, CPC, HCC Certified
Buena Park, CA - 90620
Home: 714-***-****
Cell: 714-***-****
Email:********@*******.***
Objective:
. Seeking to obtain a challenging position in a career oriented
clinic/hospital/Medical/Insurance/ Professional Bill Review companies.
. Utilizing my office and computer skills as well as assist in efficient
productive company operations.
. Highly motivated and goal oriented who displays quick learning and
self starting abilities, Proficient in problem identification,
evaluation and resolution.
. I can work as an effective Team player who works well under pressure,
independently and within a cohesive group.
Qualification Summary:
. Certified Coding Specialist (CCS, AHIMA Approved)
. Certified Medical Coder (5+ Years' experience) (CPC, AAPC approved)
. HCC Certified (Hierarchical Condition Categories) (AAPC Approved)
. Certified Medical Biller
. Proficient in Medical Insurance Coding, Medical Terminology And
Medical Billing
. Excellent knowledge of ICD-9 coding, Medcheck, 3MEncoder, OMFS
Guidelines, AAOS and Medicare Guidelines (NCCI Edits and MUE Edits),
Medisoft, GE IDX Software, SMS Invision, A2K/FMS/Signature, AMA CPT
coding,CM1500 forms, UB92 forms, UB04 Forms
. Data Entry 8000-9000 KS, Typing speed 40 Word per minute.
. Strong knowledge of MS Word, Excel, Outlook, Power Point and MS
Access.
. Dependable, Reliable, Hardworking, motivated, energetic, dedicated and
professional
. Strong ability to multi-task, organized, disciplined and detail
oriented
Education:
Certified Coding Specialist (CCS-AHIMA)
AHIMA
2014
Certified Professional coder (CPC-AAPC)
AAPC
2013
AAPC Approved:
Completed Certification course on Risk Adjustment coding (HCC Coding) 2014
Presently enrolled in ICD-10-CM Proficiency Online Course
Cypress College, CA 2008-2010
Successfully completed Certification of Medical Coding Program (Health
Information Coding Certificate)
Successfully completed Certification of Medical Billing Program (Medical
Insurance Billing Specialist Certificate)
Experience:
Corvel Corporation, 1100 W. Town and Country Road, Suite 400, Orange, CA
92868
01/2010- Present
Professional Review Specialist/Orthopedic Coder
. Review and audit medical bills (Worker Comp. (surgery)) to ensure that
they are appropriate and adhere to the State Official Medical Fee
Schedule (OMFS) (PFS 2014), customer Guidelines and PPO Discount.
. Review Facility bills and verify DRG validation to ensure that they
are appropriate and adhere to the AMA CPT Manual.
. Verify and validate Surgery bills per AAOS/Medicare Guidelines on
insurance provider behalf. Consult reference materials in the auditing
process.
. Ensure that system data accurately reflects submitted billing
information and make any necessary corrections as needed.
UCI Medical Center, 200 S. Manchester, Ste 300, Orange, CA 92868
04/2009 - 07/2009
Senior Medical Biller
. Responsible for checking patient's insurance eligibility to respective
insurance such as Medicare, Medi-cal, MSI, Blue Cross, Blue Shield,
CalOptima, CCS etc.
. Checked all returned mailed either from bad address or address change
and perform task to cleanup address or forward mails to CBB collection
agency for further proceeding.
. Received payment from walk in patient and give them guidance and
advice as needed.
. Checked patient voice message on answering machine and do the follow
up.
Dr.David H Payne M.D., 1902 Royalty Drive, Suite 260, Pomona, CA 91767
01/2009-04/2009
Medical Biller
. Billing for worker comp. and all commercial carrier, following up on
unpaid or denying claims for their status
. Look up ICD-9 and CPT Codes in the intern to verify if a code has been
changed and entered deposited and updated patients demographics using
the Prime Clinic system.
. Retrieve billing records for copy services and law firms.
. Set up on line electronic Medicare and Medi-cal claim process.
. Occasionally handling front desk. (e.g. Schedule patient appointment,
answering patient telephone etc.)
Dr.Ashok Amin M.D., 1711 West Romneya Ave. Anaheim, CA 92801
08/2008 - 01/2009
Medical Biller
. Billing for medical and all commercial carrier, following up on unpaid
or denying claims for their status
. Heavy data entry tasking, answering the phones and files, faxing and
copying documents.
. Look up ICD-9 and CPT Codes in the intern to verify if a code has been
changed and entered deposited and updated patients demographics using
the Medisoft system.
. Submitting insurance claims, complete claim form for Medicare,
Medicaid, PPO, HMO etc.
Molina Health Care Group (ASAP Staffing), 1 Golden Shore, Long Beach, CA
90802
08/2008 - 08/2008
Medical Records Clerk
. Responsible for Arranging and managing medical records.
. Process, verify and scan the medical records.
. Heavy data entry to the software of the medical records.
. Responsible for other duties related to medical clerk.
Children Hospital (Office Team), 1811 N. Western Avenue, Los Angeles, CA
90027
04/2008 - 08/2008
Medical Records Clerk III
Process daily correspondence to ensure that all explanation of benefits are
scanned and uploaded into on-line computer information exchange system.
. Retrieve billing records for copy services and law firms.
. Prepare and arrange lock boxes to scan and upload in the computer
system for efficient access to collector retrieval.
. Purges unnecessary paper from file room and all patient discharge
documents.
. Create electronic records, entering data of all medical paper work
into on-line system.
. Photocopy hard copy records as authorized, responsible for mail room
duties.
. Use word for correspondence and excel for mini accounting works.
.
References: Available upon request.