Medical Insurance

SAMANTHA GREEN

*** ******** ****** **********, ** 29532

843-***-****; *****************@*****.***

EDUCATION

Certified Professional Coder March 2009

Received certification after passing AAPC Coding Test in February 2009

West Florence High School June 1993

Graduated with honors

Participated in the Teacher’s Cadet Program

EXPERIENCE

Pathology Service Associate January 2010 – April 2016

McKesson Corporation – Florence, SC

Coded surgical and gynecological pathology claims

Coded HPV genotypes claims

Code molecular I-9 and I-10 claims

Reviewed and assessed medical codes for diagnoses, procedures and services performed by

healthcare providers

Ensured coding met billing compliance guidelines with AMA, Medicaid, and Medicare

Participated in audits, and educating of physicians and medical staff to make sure coding

guidelines were being followed

Handled claim denials from insurance companies

Assigned diagnoses and procedures to patients based on physician notes

Collaborated with coders in multiple offices and countries to solve pathology diagnoses issues

Billing Analyst October 2008 – November 2009

Colonial Family Practice – Sumter, SC

Handled claim denials from insurance companies

Reviewed billing and medical documentation for hospital services

Processed insurance claims and self pay charges

Ensured coding met billing compliance guidelines with AMA, Medicaid, and Medicare

Analyzed physician notes and patient treatment for insurance claims

Analyzed billed procedures and claims for inconsistencies

Billing Analyst March 2007 – October 2008

Physicians Practice Solutions – Florence, SC

Completed BlueCross BlueShield EOBs

Analyzed medical records for numerous doctor offices

Processed refunds for Commercial Insurance Company, BlueCross Blue Shield

and patients

Handled communications with patients and insurance companies to solve billing issues

Balanced payment and charges from self-pay patients and insurance companies

Monitored billing and collections to ensure physicians followed billing regulations

Insurance Claims Analyst August 1996 – January 2007

BlueCross Blue Shield - Florence, SC

Processed claims for military personnel and their dependents

Analyzed claim form deferrals

Corrected coding errors found on patient medical claims

Drafted ALGA form letters for providers and beneficiaries

Acted as a liaison between providers and beneficiaries to settle medical claim disputes

Worked professional and inpatient claims

SKILLS

ICD-9

ICD-10

CPT Coding

HCPCS Coding

Coding software (MDIV, Freedom Imaging Systems, IDX)

Analytics

HIPAA guidelines and regulations

Excel

Healthcare research

Financial & Statistical Analysis

Chart Auditing

Anatomy and physiology

Healthcare compliance

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