Medical coder
Resume:
Yan Guo
Lawrenceville, GA 30043
*********@*******.***
OBJECTIVE
To obtain a position as a Medical Coder and/or Biller where I can utilize
my skills and training, with an opportunity for growth.
SKILLS
. Heart saver CPR
. Excellent communication skills to interact effectively and
professionally with all levels of the organization
. Highly dependable with solid work ethic and consistently displays
the highest levels of integrity
. Bilingual (English & Chinese)
. Excellent in softwares: Allscripts, Specialty Practice Manager,
MediSoft, Medical Manager, Centricity, Brightree DME and Microsoft
Offices
. Excellent experience with McKesson HPF, Cerner, PayerPath
EDUCATION
Certification Medical Billing and Coding. GPA 4.00
SANFORD BROWN COLLEGE-ATLANTA, GA
Courses Taken:
ICD-9 Coding & CPT-4 Coding, Medical Terminology, Anatomy & Physiology,
Medical Insurance
Associate Degree of Microsoft Office User Specialist. GPA 3.75
INTERACTIVE COLLEGE OF TECHNOLOGY, CHAMBLEE, GA
Associate Degree of Economical Information Management & Computer
CHONG QING POST& TELECOMMUNICATIONS UNIVERSITY, CHONG QING, CHINA
EXPERIENCE
Atlanta Colon & Rectal Surgery, PA
Billing Center at Saint Joseph Hospital
Atlanta, GA 10/2012---present
Coding and Billing Associate
. Maintain Coding Certification
. Code/Pre-audit inpatient/outpatient E/M services and
inpatient/outpatient procedures for 5 physicians
. File primary/secondary/tertiary insurance claims
. Send out electronically and paper claims and fix failed claims
. Work on payer rejected claim report, follow up appeal and EOB
denials
. Processing of insurance mail and take proper action such as
process refund, submit medical records, etc.
. 30/60/90 Day Delinquent Insurance Claim List, research and
appeal/process outstanding claim
. Excellent experience with Modifier 22, 57, 25 appeals
. Post payments and adjustments
. Complete Surgical Coding and Billing Queries
. Perform medical records audit per patients and insurance
carriers' requests
. Provide coverage for the Billing department as applicable
Medical Aid Supply House
Duluth, GA 12/2009---09/2012
Coding, Billing and Patient Service Representative
. Distribute and document the prescriptions/CMN received from
physician's office appropriately
. Receives incoming orders for DME items accordingly and
contacting appropriate field personnel
. Collect necessary medical documents from physician office per
insurance's guideline
. Submit PRE-AUTH or PRE-CERT to insurance carriers and obtain PA
in time manner
. Check insurance eligibility and similar item history, explain
benefits to patient as needed
. Assign ICD-9/CPT/HCPCS code for each item according to medical
records
. Process billing and submit claim and follow up the
reimbursement status for each claim, submit paper appeals
. Work with following insurances daily: Medicare, Georgia
Medicaid, BCBS, UnitedHealthCare, Cigna,
Humana, Tricare, Worker'sComp, PeachState, CareCentrix, Universal
Health Care, Care Improvement.
. Post payments, adjustment and write-off activity to paper chart
and DME billing software BRIGHTREE
. Review EOBs and explain EOB to patient if necessary
. Currently handle 600+ claims every month
MedQuest
Southeastern Business Services Center/AR Department
Alpharetta, GA 11/2011---12/2011
Externship
. Assist BlueCross BlueShield team to file auto claims in the states
of Georgia, South Carolina, Arizona, Alabama, Florida and
Tennessee.
. File claims to primary and secondary carrier, use Centricity
software to sort documents, verify ICD-9 and CPT codes are matching
current radiology reports, review EOBs per patients request, post
claim steps and payment receiving, mail claims to each insurance
. Handle attorney request for EDI department for 6 states, generate
itemized health records for patients according to HIPAA, fax to
attorney office and post the account status to Centricity
CERTIFICATION
Certified Professional Coder since August 2012
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