Professional Summary:

CPC with over * yrs experience within in healthcare industry. Currently audits ICD-9 and CPT coding on inbound Claims to ensure they are correct and to ensure timely reimbursement. I have a thorough knowledge of medical coding guidelines and coding techniques (ICD-9, CPT-4 and HCPCS) as well as of Anatomy, Physiology and Advanced Medical Terminology. Possess excellent communication and group interaction skills.

Technical Summary

Cerner, Amicus, Allscripts, CCS, Windows 2003 and XP: Word, Excel, Outlook, Essentris, AHLTA, CHCS

Education Summary:

B2B Medical Coding Solutions

American Academy of Professional Coders (AAPC) - (CPC) Certified Professional Coder: Dec 2010

Luther Burbank High School – Graduated: June 1999

Professional Work Experiences

Out Patient Medical Coder Magnificus Inc. (David Grant Medical Center) 10-2013- July 2015

Enter CPT codes and ICD-9 codes into database system accurately

Review and read ER Charts- Doctor Notes from (Essentris) and assigned appropriate CPT codes and ICD-9 codes

Enter CPT codes and ICD-9 codes into AHLTA/CHCS

Enter Inpatient Rounds

Out Patient Medical Coder Doma Technologies (David Grant Medical Center) 01-2013- 11-2013

Enter CPT codes and ICD-9 codes into database system accurately

Review and read ER Charts- Doctor Notes from (Essentris) and assigned appropriate CPT codes and ICD-9 codes

Enter CPT codes and ICD-9 codes into AHLTA/CHCS

Clerk CHW (Dignity Healthcare) 10-2009 – 12-2011(Resigned)

Audits ICD-9 and CPT coding on inbound Claims to ensure they are correct and to ensure timely reimbursement. If error exists, responsible for researching and sending Claim to the Coding Department for edits.

Review and organize claims that are received electronically

Process referrals and authorization form into database (IDX- Reflection for Regis Graphic Session)

Post Rejections for Appeal Acknowledgements and Appeal Approved received via correspondence

Pull and print medical records for Workers Compensation Claims from database (Cerner, Amicus, and Allscripts)

Claims Clerk I Superior Staffing (HP-Hewlett-Packard Co) EDS. Aug. 2008 – Mar. 2009 (temporary)

Entered confidential data into database system(Medical & Medicare)

Enter CPT codes and ICD-9 codes into database system accurately

Scan through EOBs for unpaid claims

Assisted others as needed

Intake Representative Health Net, Inc Nov 2004 – Jun. 2007 (Resigned)

Entered CPT codes and ICD-9 codes into database system accurately

Researched diagnosis and procedure for correct ICD-9 and CPT

Processed HMO and PPO insurance, referrals and authorization forms into Care Coordination system (CCS)

Medical transcription

Office Clerk Kyle Reporting, Inc., Jan. 2004 – Apr. 2004 (temporary)

Responsible for filing confidential documents, photocopied and scanned documents

Answered incoming calls

Coordinated with other departments to assist with projects

Reliable for general office administrative responsibilities

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