Remote CPC
Resume:
Laura Zelenyak CPC
Johnson City, NY 13790
*******@*****.***
Career Objective
I have obtained 20 years of experience with Medical Billing as a Medical Auditor and Certified Professional Coder. I want to work as an advancing medical coding professional in a challenging and intriguing working atmosphere remotely with the utilization of adept coding expertise and proficiency, auditing office visits, while still obtaining Certified Educational Units for my credentials.
Experience
Advize Health LLC June 1, 2016- March 8, 2017
201 East Kennedy Blvd, Ste 1130
Tampa, FL 33602
CPC and Auditor
Audits E/M codes, chart auditing to abstract HCPCS, CPT, ICD-9/10 codes. Provides education on coding, billing, and medical necessity.
Obtained and utilized Certification in HCC Auditing.
Performs extensive coding and billing research on each specialty group audited to ensure up-to-date guidelines and rules are followed.
Provides feed back to the Quality Analyst within Advize. For example, if I see an ongoing problem with dictation or abuse of a template, so that our Quality Analysts can educate the physicians on proper documentation.
Performed audits for government and commercial payers focusing on: Evaluation and Management, Surgical, and DME coding and billing.
Completed pre- and post- submission review of claims to ensure the documentation supported the procedures billed.
Performed and managed various special projects to determine if services were supported as billed based on the submitted documentation. This included medical necessity reviews to determine reasonableness of proposed and ongoing treatment plans.
Performed utilization/medical necessity and clinical documentation reviews on various provider specialty procedures for both inpatient and outpatient services.
Specializing in medical guidelines with the latest knowledge and resurge for Neurosurgical Surgeries from fusions (post lateral, anterior, Interbody and 360 Fusions), Laminectomy, Arthrodesis, verteplasties at all levels of spine.
Also, including, all Craniotomies and Craniotomies including Shunts, Burr Holes and cyber knife, Carpal Tunnel Surgeries,
E&M auditing for Neurology, Pain Management and Interventional Neuro-Radiology, Sleep Studies programs; hospital based and home study and Intraoperative Neurophysiological Monitoring and including Pain Management injections from Facet, Epidural, Acupuncture and Morphine Pumps
United Health Services August 8, 2016- Present
Johnson City, NY 13790
Neurosurgical Specialty and Surgical Coder
Southern NY Neurosurgical Group merged with United Health Services on August 8, 2016. When I started working full time with Advize for Auditing in June of 2016, I had then agreed to work remotely per diem with United Health Services to help them with all their Neurosurgical and Pain Management coding.
Southern NY Neurosurgical Group
Johnson City NY 13790
Certified Professional Coder April 2007 – August 8, 2016
In charge of coding for Neurosurgeries, Pain Management office visits and injections and E&M and injections for Neurology Practice
Code for Neurosurgical Surgeries from fusions (post lateral, anterior, Interbody and 360 Fusions), Laminectomy, Arthrodesis, verteplasties at all levels of spine.
Code for all Craniotomies and Craniotomies including Shunts, Burr Holes and cyberknife
Code for Carpal Tunnel Surgeries
E&M auditing for Neurology, Pain Management and Interventional Neuro-Radiology
Coding for all Sleep Studies programs; hospital based and home study
Code for all Interoperative Neurophysiological Monitoring
Coding Pain Management injections from Facet, Epidural, Acupuncture and Morphine Pumps
In charge of authorization, precertification, coding and charging of all Neurosurgeries
Post Medicare check and work Account Receivable. Also, prepare appeal letters and any correspondence needed in a grievance
Handle all Electronic Billings and Paper as well as statements. Acknowledgements including separate billing of Medicare Secondary Payer
In charge of ordering and monitoring all office supplies going in and out of office
Expert in Excel, creating formulas and spreadsheets to help the physician monitor their charges and payments monthly.
ICD10 Certified
Orthopedic Associates
Binghamton NY 13903
Medical Biller March 2004 - April 2007
Blue Cross Blue Shield, Aetna, Fidelis & CDPHP
In charge of meeting with all insurance representatives regarding their insurance.
Handled all phone calls coming in from patients that had a question on their bill or insurance payment
President of Sunshine fund, creating special events, fundraisers and working with charities to help keep morale up within employs and doing something good for less fortunate
Nabil K. Kiridly MD, Plastic Surgeon
Smithtown NY 11787
Billing Manager April 2002 - April 2004
Handled all accounts payable and receivable
Meet with all patients to set up payment plans and discuss finically responsibilities, as we were only participating in Medicare. All others were Out of Pocket
Managed office Staff of 5 employees
Southern Pain Management Center
Vestal NY 13850
Medical Biller June 1998 - April 2002
Computer Skills
Microsoft Word, Excel and PowerPoint. Med3000, NextGen, NeuroMed, SharePoint, EM Coder and 3M Coding.
Qualifications
Certified Professional Coder (AAPC)
Education
Bryant and Stratton College
Syracuse NY
Certified Medical Coder. Graduated 2012
Vestal High School
Vestal NY
High School Diploma 1996
References
Upon Request
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