Medical Coder Internal Medicine
Resume:
Chidi Ibe, CPC, CRC, CBCS
Richmond, TX
SUMMARY:
Years of Experience: OP Profee and Facility Coding – 12+ years
Specialties: Emergency Department, Urgent Care, Orthopedics, Family Medicine, OBGYN, Pediatrics, Hospitalists, Incision and Drainage, Radiology (CT scans, MRI, ultrasound, etc.), Pathology, Dermatology, Hematology/Oncology, Neurology, Wound Care, Cardiology, Urology, Ancillary, GI, ENT, Podiatry, Rehab, Vaccinations, Internal Medicine, E/M Leveling (profee and facility), Inj/Inf, Modifiers, CPT, ICD-10, Denials, NCCI/LCD/NCD, Claim Edits, SDS, Observations, HCC
Systems: 3M Encoder, Optum EncoderPro, EPIC, Medisoft, Soarian (briefly), IDX, Cerner, Lynx, RealMed, NextGen, Apxtender, & Microsoft Office Products, Encoder computer assisted coding
Proficient in retrieving, reviewing, scanning, and uploading Medical Information from EMR and paper charts.
Able to perform Charge review, Insurance verification, claim submission and Claim follow-up.
Extremely knowledgeable in Medical Billing and Coding guidelines such as (ICD-9 CM, ICD-10 CM, CPT, APC, DRG and HCPCS).
Excellent knowledge of Anatomy & Physiology, Advanced Medical Terminology, Psychology, and Pharmacology.
Effective communication and interpersonal skills.
Completed HIPAA training and Proficient in HIPAA laws.
Knowledge and experience in Medicare, Medicaid, HMO’s, PPOs, and most insurance EOBs.
PROFESSIONAL EXPERIENCE:
May 2023 – October 2023
Brundage Group (UF)
Remote Medical Coder
• Providing coding services, including Charge entry/abstractor, Hospital Inpatient, Surgery, Ancillary, Hospital Ambulatory and Claim reviews.
• Providing coding services, including Claims Edit, ER.
• Outpatient, ED (Emergency Dept.), Pro fee
• Assign appropriate modifiers, CPT, and follow Correct Coding Initiative guidelines.
June 2017 – May 2023
Insight Global
Remote Medical Coder
Providing coding services, including Hospital Inpatient, Charge entry/abstractor, Radiology (EKG - Cardiology), Ancillary, Ambulatory and Claim reviews.
Experience with DRG payor methodologies: MS-DRG, APR-DRGs, ICD-10-CM & PCS coding guidelines and conventions, PSIs, HACs, and HCCs, and Medicare IPPS
Claims Edit & Denials, Telemedicine and Outpatient Pro fee, Podiatry and Pain Management
Coding-related denials and post-billed denials for coding accuracy and appealing them based upon coding expertise and coding judgment, Hospital and/or Medical Group revenue operations
Experience with DRG assignment coding, ICD-10 PCS coding
Assign appropriate modifiers, CPT, and follow Correct Coding Initiative guidelines.
Review coding and abstracting on all patient types assigned for review including ambulatory surgery, ER, clinic, diagnostics and evaluation and management levels to assure 95% coder accuracy.
Nov 2016 – June 2017
Medpartners
Remote Medical Coder
Providing coding services, including Charge entry/abstractor, Hospital Radiology (EKG - Cardiology), Ancillary, Hospital Ambulatory and Claim reviews.
Outpatient Chemotherapy infusion, Claims Edit, ER, Telemedicine.
Prepayment Review coding, Claim edits & Denials
Assign appropriate modifiers, CPT, and follow Correct Coding Initiative guidelines.
Resolve denials based on ICD-10-CM diagnosis codes, and CPT- 4 procedural codes for outpatient, inpatient claims, and other coding reasons
Process charge corrections based on medical record reviews, contracts, regulations as directed by the client
Feb 2015 – Oct 2016
Peak Health
Remote Medical Coder
Independently Audit, Prescreen and abstract ICD 9-CM, and ICD 10 codes from Outpatient charts using EMR system.
Responsible for providing coding and services, including ER Charge entry, Radiology, OB/GYN, Pathology, Ancillary, Assign appropriate modifiers for E/M, HCPCS, Ortho/Pain, OP Claim reviews.
Abstract codes from Internal Medicine, Hospitalist, Hematology & Oncology, Dermatology, Family Practice and Cardiology charts.
Participate in company training programs.
Analyze and interprets documentation from medical records and completes accurate Coding of Hospital – based diagnosis and procedures, Pro fee coding of diagnosis and procedures, Charge Review, E/M assignment and Charge router.
Communicates with Provider for missing documentation or questions regarding documentation.
June 2014 – Jan 2015
Cigna HealthSpring (Addison Group)
Remote Risk Adjustment Coder
Responsible for providing Coding and Auditing services. This includes the analysis and translation of medical and clinical diagnoses, procedures, injuries, or illnesses into designated numerical codes.
Carry out Pro fee coding and, HCC coding to the highest specificity based on the provider documentation.
Independently performed Care Provider Site Reviews, Chart Keeping Standards Reviews, HEDIS Hybrid Chart Abstractions, Medicare Risk Adjustment, and Care Provider Monitoring Reviews.
March 2011 – June 2014
Outcomes Healthcare solutions
Remote Medical Coder
Performing Diagnosis code abstractions from EMR and paper charts of care providers, facilities, medical records, and other associated medical-field materials, personnel, and documents.
Independently performed Care Provider Site Reviews, Chart Keeping Standards.
Review HEDIS Hybrid Chart Abstractions, HCC, Medicare Risk Adjustment, and Care Provider Monitoring Reviews.
Assign appropriate modifiers and follow Correct Coding Initiative guidelines.
EDUCATION:
Western Governors University
Masters: Business, May 2019
May 2013 Houston Community College Advanced Medical Coding
May 2013 Houston Community College Electronic Health Records
February 2013 National Healthcare Association Certified Billing and Coding Specialist
January 2013 Houston Community College Health Information Management
September 2012 Houston Community College HIPAA Certificate
December 2001 MBM Computer School, Abuja Certification in Information Technology
June 2000 Imo State University, Owerri B.A (French Language)
CERTIFICATIONS:
Certified Professional Coder (CPC), AAPC
Certified Risk Adjustment Coder (CRC), AAPC
Certified Billing and Coding Specialist (CBCS), NHA
Certified Inpatient Coder (CIC), AAPC
ICD-10 Certified
SKILLS:
Reliable and excellent multi-tasking skills
Attention to details
Excellent Analytical and Organizational Skills
Maintains strict confidentiality (HIPAA)
Team player with positive mind
Fluent in written and verbal communication in English and French.
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