Medical Billing & Coder

Cynthia Kaiffie

Arcadia, California ************@*****.*** 626-***-****

Professional Summary

Detailed and results-oriented professional uses analytical skills to examine patient encounter forms, EOBs, CMS 1500s and UB-04s, verify diagnosis codes and reconcile against services rendered. Has a solid understanding of medical terminology and anatomy, medical reports and patient data, and adept at medical records management. Additional Skills

8 years management

Ability to build and maintain solid

relationships and resolve conflict

Surgery & Modifiers

Payments & Adjustments

Medical Records Management

ICD 10-CM/PCS, CPT & HCPCS

3M Encoder & CMS Reimbursement

Microsoft Excel, Word, PowerPoint

QuadraMed Suite MPI

Nuance Quantim Encoders

CIOX Health ROI

Education

Kaplan University April 2016

Medical Billing & Coding Certificate

Medical Terminology

Human Anatomy & Physiology I, II

Diseases of the Human Body

Medical Coding I, II

Medical Insurance & Billing

Reimbursement Methodologies

Revenue Cycle Management

Practicum

Translated medical reports and data, and assigned ICD-10 codes

Reviewed and validated accuracy of charges, including dates of service, services provided, location, patient identification and provider signature

Verified insurance, pre-certification, and pre-authorization

Charge entry, reconciling ICD-10 codes against rendered services

Familiar with HMOs, PPOs, Medicaid, Medicare, Tricare and Workman’s Compensation

Thorough understanding of Revenue Cycle Management (RCM)

Maintained compliance policies and HIPPA regulations while processing California State Northridge University, Northridge CA September 1982 Bachelors of Science, Business – Fashion Design & Marketing Work Experience

Marshalls, Monrovia, California October 2015 – present Floor Merchandiser

Establish and execute merchandising plans and priorities:

Design and layout of marketing displays throughout the store

Manage flow of merchandise from backroom to sales floor

Maintenance of all merchandising standards (sizing, categorizing, signing, damages, recovery)

Handle cashier duties

Lori’s Gifts, Duarte, CA February 2009 – January 2015 Store Manager

Increased store profitability by:

Meeting and exceeding sales goals

Analyzed P&L statements, sales and activity reports, and other performance data to determine inefficiencies and executed improvement processes in advertisement, promotion, productivity and efficiently staffing personnel which increased sales, store productivity and profit

Balanced POS with a 98% accuracy rate, handled cash and processed daily bank deposits

Maintained California Labor Law compliance

Lori’s Gifts, Duarte, CA (continued)

Interviewed, hired, trained and supervised employees on daily routines:

Provided counseling, coaching, mentoring and disciplined associates as warranted

Motivated sales associates to meet and exceed sales goals through incentives and contests

Up keep of facilities, sales floor cleanness and organization

Daily check in and pricing of new goods

Promotions and store events

Delegated responsibilities to assistant managers

Designing of store layouts and marketing displays throughout the store

Daily merchandising the sales floor daily with new products

Creating a welcoming environment and fun buying experience

Providing outstanding customer service and product upselling

Maintaining a positive and professional environment The Broadway (Formerly-Hale Stores), Los Angeles, CA July 1983 – September 1989 Buyer (42 stores)

Enhanced profits by acquiring suitable goods at competitive prices through sensible planning and careful purchasing

Formulated policies and negotiated contracts and credit lines for providers, suppliers and/or vendors

Reviewed, evaluated, and approved specifications for issuing awarding bids

Overseer of the Purchasing department’s budget

Determined product availability and sales forecasts for all seasons

Produced market conditions and cost of merchandising reports

Developed advertising promotions

Tested new product development

Designed junior dresses, women shoes and accessories lines with vendors

Established and developed solid provider, supplier and vendor relationships

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