BRANDY L. MILLER-BROWN

email: ad1jbk@r.postjobfree.com

AAPC certified coder: CPC and CRC

phone: 605-***-**** (MTN time)

I am a US citizen and am authorized to work in the US.

WORK EXPERIENCE:

MEDICAL BILLING CLAIMS SPECILIST From: 06/30/2023-08/15/2023

Black Hills Regional Eye Institute Supervisor: Jean Olein

On-site in Office @ 2800 Third St. Rapid City, SD 57701

Starting wage: $21.00 per hour 605-***-****

Job Duties:

Perform posting charges

Perform completion of claims to payers

Conduct duties in a professional and timely fashion

Submit billing data to the appropriate insurance providers

Process claims

Resolve denial instances

Achieve maximum reimbursement for services provided

Deploy, maintain, and report on various programs

Effective communication skills

Basic computer skills, such as sending emails, typing, and using spreadsheets

Interact with clients and patients

Creative problem-solving skills

Work independently

Collaborate well with others

Knowledge of Medicare, Medicaid, and third-party reimbursement methodologies

Knowledge of local, state, and federal healthcare regulations.

I can demonstrate critical thinking skills to manage day to day basic operations, manage my own work queues and the ability to seek assistance from my team with respect.

MEDICAL CLAIMS PATIENT ACCOUNTS SPECILIST From: 10/01/2022-02/01/2023

Black Hills Surgery Hospital and Same Day Surgery Center Supervisor: Kristy Bowie

Remote Worker @ home office addresses 1868 Lombardy Dr. Rapid City, SD 57701

Starting wage: $22.00 per hour 605-***-****

Job Duties:

Focus on continuous process improvement

Ability to make good judgments in demanding situations

Ability to react to frequent changes in duties and volume of work

Effective communication skills

Extensive writing capabilities / efficiencies

Ability to listen empathetically

Ability to write professional appeal letters

Ability to organize details logically and accurately

Ability to construct an effective argument related to the medical necessity for hospital services. Ability to effectively communicate in writing.

Ability to communicate with multiple levels in the organization (e.g., managers, physicians, clinical and support staff)

Ability to maintain a strong relationship with various clinical and non-clinical team members to positively affect financial outcomes

Ability to manage multiple tasks with ease and efficiency

Self-starter with a willingness to try current ideas

Ability to work independently and be result oriented

Positive, can-do attitude coupled with a sense of urgency

Effective interpersonal skills, including the ability to promote teamwork

Strong problem-solving skills

Ability to ensure an elevated level of customer satisfaction including employees, patients, visitors, faculty, referring physicians and external stakeholders

Ability to use various computer applications including EPIC

Provided excellent PC operating skills (keyboard, mouse) and use of MS Office. I have a broad knowledge of health care business office practices and principles. I have a degree in Business Management and can-do basic math skills and knowledge of general accounting principles. I strive in knowledge of business office policies and procedure. I will maintain confidentiality of sensitive information adhering to HIPPA guidelines and rules of PHI.

UNITED HEALTH GROUP RETROSPECTIVE MEDICAL CODER (Remote worker)

The Judge Group - El Segundo, CA & Wayne, PA 19087 From: 07/01/2021-11/01/2021

Supervisor: Ashley and UHG project management. Phone: 1-610-***-****

Starting wage: $26.50 per hour

Job Duties:

Reviewed outpatient medical record information on both a retroactive and prospective basis to identify, assess, monitoring, and document claims and encounter coding information as it pertains to risk adjustment.

Ensure that the diagnosis codes for each chronic or major medical condition have been captured and submitted within the permitted timeframe.

Assess adequacy of documentation of claims and query outpatient provider claims to obtain additional medical record documentation or to clarify documentation to ensure accurate and appropriate coding.

Audit provider documentation ICD-9 or 10 codes to ensure adherence with CMS Risk Adjustment guidelines.

Participated in departmental and physician network performance improvement initiatives.

Safeguards medical records and preserves the confidentiality of personal health information through the observance of physician network policies pertinent to the release of medical record information, record retention, and HIPAA privacy and security.

OUTPATIENT MEDICAL PROFEE AND FACILITY CODER AND AUDITOR USAF

Distinctive Home and Health Care/ Contractor for government awarded hired firm.

2006 Tulson Lane Suite A100, Bowie, MD 20721 From: 01/01/2021-06/01/2021

Supervisor: Anna Walker/ Nichole Spark phone: 301-***-**** ext#200

Starting wage: 24.50 per hour CAC access-On USAF base

Job Duties:

I can apply the advanced knowledge of the current coding classification systems such as ICD 10, CPT, and HCPCS for the subspecialty being assigned examples would be (outpatient, inpatient, outpatient, outpatient and inpatient combined).

Adhering to accepted coding practices, guidelines and conventions when choosing the most appropriate diagnosis, operation, procedure, ancillary, or Evaluation and Management code to ensure ethical, accurate, and complete coding.

Monitoring ever-changing regulatory and policy requirements affection coded information for the full spectrum of services provided. Reviewing encounters and/ record documentation to identify inconsistencies, ambiguities, or discrepancies that may cause inaccurate coding, medico-legal repercussions or impacts quality of patients care.

I can accurately perform a full scope of outpatient coding including ambulatory surgical cases, diagnostic studies and procedures, and outpatient encounters, and inpatient professional facility coding, including discharges surgical cases, diagnostic studies and procedures, and inpatient professional services within the medical group or for any received referrals of community care.

Managed all coding reviews of 21 ancillary clinics and Covid clinic subspecialties with interpersonal relations working closely resolving conflicts dealing with individuals at all organizational levels. Researching coding conventions and guidelines for each subspeciality.

I communicated with interpersonal to provide research and to help solve complex questions related to coding conventions and guidelines in an accurate and timely manner via verbal and written/email communication supporting staff of coding conventions for improving results from AFMS audit reviews. Focusing on conflict resolutions to improve accuracy percentages.

I conducted daily evaluations of providers coding and making recommendations for change following DHA/MTF quality assurance. Guiding them to an increased level of 80-100%.

I formatted and presented individual auditing results to staff. On a monthly basis identifying audit results providing guidance to improve. accuracy of DQ reviews increasing from 40% to 100% monthly.

I have the knowledge to format, create and present the coding education power points and training ed sheets that are used for coding education to ensure ethical, accurate, and complete coding for staff meetings with my skills interpreting and adapting health information guidelines that are not completely applicable to the work and pointing out gaps in specificity and encouraging the staff to use judgment in completing assignments in compliance with MDM documentation guidelines. Presenting information at monthly/weekly meetings.

While performing focused audits of initial and annual coding compliance training and reporting of potential violations to individuals at all organizational levels.

Tracking and aided with write back errors, CAPERS, or coding of clinical errors of coding cause of missed documentation transmitting and extracting required information from GENESIS, AHLTA, or CHCS and entering the corrected NCCI edits into 3M encoder coding system.

Promptly coding of all billable encounters to 100% accuracy rate and monitoring/coding 60% of all daily unbillable accounts to ensure records were coded properly, signed, and significant data is recorded, and corrections are made to validate the data transmittal through different government computer systems.

Software used: AHLTA, CHCS, MHS GENESIS, DEERS, CIS, CCE, QAS, 3M ENCODER, EPIC

OUTPATIENT MEDICAL PROFEE AND FACILITY CODER AND AUDITOR USAF

Sterling Medical Corp. / Contractor for government awarded hired firm.

411 Oak Street Cincinnati, OH 45219 From: 09/01/2019-12/01/2020

Supervisor: Jenny Clark phone: 513-***-****

Starting wage: 24.50 per hour CAC access-On USAF base

Job Duties:

I can apply the advanced knowledge of the current coding classification systems such as ICD 10, CPT, and HCPCS for the subspecialty being assigned examples would be (outpatient, inpatient, outpatient, outpatient and inpatient combined).

Adhering to accepted coding practices, guidelines and conventions when choosing the most appropriate diagnosis, operation, procedure, ancillary, or Evaluation and Management code to ensure ethical, accurate, and complete coding.

Monitoring ever-changing regulatory and policy requirements affection coded information for the full spectrum of services provided. Reviewing encounters and/ record documentation to identify inconsistencies, ambiguities, or discrepancies that may cause inaccurate coding, medico-legal repercussions or impacts quality of patients care.

I can accurately perform a full scope of outpatient coding including ambulatory surgical cases, diagnostic studies and procedures, and outpatient encounters, and inpatient professional facility coding, including discharges surgical cases, diagnostic studies and procedures, and inpatient professional services within the medical group or for any received referrals of community care.

Managed all coding reviews of 21 ancillary clinics and Covid clinic subspecialties with interpersonal relations working closely resolving conflicts dealing with individuals at all organizational levels. Researching coding conventions and guidelines for each subspeciality.

I communicated with interpersonal to provide research and to help solve complex questions related to coding conventions and guidelines in an accurate and timely manner via verbal and written/email communication supporting staff of coding conventions for improving results from AFMS audit reviews. Focusing on conflict resolutions to improve accuracy percentages.

I conducted daily evaluations of providers coding and making recommendations for change following DHA/MTF quality assurance. Guiding them to an increased level of 80-100%.

I formatted and presented individual auditing results to staff. On a monthly basis identifying audit results providing guidance to improve. accuracy of DQ reviews increasing from 40% to 100% monthly.

I have the knowledge to format, create and present the coding education power points and training ed sheets that are used for coding education to ensure ethical, accurate, and complete coding for staff meetings with my skills interpreting and adapting health information guidelines that are not completely applicable to the work and pointing out gaps in specificity and encouraging the staff to use judgment in completing assignments in compliance with MDM documentation guidelines. Presenting information at monthly/weekly meetings.

While performing focused audits of initial and annual coding compliance training and reporting of potential violations to individuals at all organizational levels.

Tracking and aided with write back errors, CAPERS, or coding of clinical errors of coding cause of missed documentation transmitting and extracting required information from GENESIS, AHLTA, or CHCS and entering the corrected NCCI edits into 3M encoder coding system.

Promptly coding of all billable encounters to 100% accuracy rate and monitoring/coding 60% of all daily unbillable accounts to ensure records were coded properly, signed, and significant data is recorded, and corrections are made to validate the data transmittal through different government computer systems.

Software used: AHLTA, CHCS, MHS GENESIS, DEERS, CIS, CCE, QAS, 3M ENCODER, EPIC

MEDICAL BILLING CLAIMS SPECILIST From: 04/01/2017-03/01/2018

Rapid City OB/GYN Physicians Private Practice Clinic Supervisor: Cari Simonson

On-site in Office @ 2800 Third St. Rapid City, SD 57701

Starting wage: $19.00 per hour Phone: 605-***-****

Job Duties:

I perform all the daily medical billing & coding/revenue cycle specialist claim filings. Solving daily clearing house denial of improper NCCI edits, modifiers associated with claim denials, UB-04 & CMS1500 claim forms being rejected by the clearing house during pre-scrubbing.

Coding patients for practice management of OBGYN encounters using ICD-10, CPT, E&M, and HCPCS codes.

Managed submission of medical claims, ensuring proper claim coding with compliance of CPT and ICD-10 guidelines via paper claims that need to be submitted to secondary insurances.

Communicating with internal and external customers via verbal and written communication, and

performs follow-up on claims when necessary, and appeals claims when denied.

Processing of claims to Medicare, Medicaid, or government-assisted programs and most of the current to date insurance carriers in the open market and workers compensation programs.

I improved the use of the electronic billing/EHR medical records system with in the intra office management to upload and process fee-schedules with management for better billing practices.

Willing to be accessible to other departments upon demand for inquiries regarding reimbursement with diagnostic services and studies, discharges from inpatient services.

I can demonstrate critical thinking skills to manage day to day basic operations or the ability to seek assistance when needed from internal sources or insurance websites or patients.

Managed my own work queues and created the billing cycle claims that are created by the

physicians in the office. I work steadily, efficiently and will show constant vigilance to the details of the work.

I can utilize all office equipment including personal computer and application software, printer, FAX, copier, multi-line telephone system.

Knowledge of all insurance and/or government claims submittal and appeal processes.

I can use appropriate reference materials when needed. I can multi-task when/if needed.

Software used: e-Clinical, NextGen, Windows Excel, EPIC, Optum, Noridian, SD HHS systems.

MEDICAL CLAIMS PATIENT ACCOUNTS SPECILIST From: 01/01/2016-03/01/2017

Regional Health Care and Hospital Supervisor: Mona Klatt

On-site office worker @ 4100 11th Street Rapid City, SD 57701

Starting wage: $12.50 per hour Phone: 605-***-****

Job Duties:

Ability to make good judgments in demanding situations

Ability to react to frequent changes in duties and volume of work

Effective communication skills

Extensive writing capabilities / efficiencies

Ability to listen empathetically

Ability to write professional appeal letters

Ability to organize details logically and accurately

Ability to construct an effective argument related to the medical necessity for a hospital service. Ability to effectively communicate in writing.

Ability to communicate with multiple levels in the organization (e.g., managers, physicians, clinical and support staff)

Ability to maintain a strong relationship with various clinical and non-clinical team members to positively affect financial outcomes

Ability to manage multiple tasks with ease and efficiency

Self-starter with a willingness to try innovative ideas

Ability to work independently and be result oriented

Positive, can-do attitude coupled with a sense of urgency

Effective interpersonal skills, including the ability to promote teamwork

Strong problem-solving skills

Ability to ensure an important level of customer satisfaction including employees, patients, visitors, faculty, referring physicians and external stakeholders

Ability to use various computer applications including EPIC

Provided excellent PC operating skills (keyboard, mouse) and use of MS Office. I have a broad knowledge of health care business office practices and principles. I have a degree in Business Management and can-do basic math skills and knowledge of general accounting principles. I strive in knowledge of business office policies and procedure. I will maintain confidentiality of sensitive information adhering to HIPPA guidelines and rules of PHI.

Software used: Legacy DOS systems, NextGen, Optum, Noridian, BCBS, Noridian, EPIC

INDEPENDENT SALES AGENT OF LIFE AND HEALTH INSURANCE POLICYS

REGISTERED REPRESENTATIVE OF A BROKER/DEALER SECURIETIES AGENT

Ozark National Life Insurance Company and N.I.S. Financial Advisor's - Kansas City, MO

Independent work searching for potential clients in the state of South Dakota.

January 1998 to December 2002

EDUCATION

Bachelor's degree in business management

National American University-online campus - Rapid City, SD From: 2017 to 2019

AS degree in H I M and Medical Coding From: 2013 to 2016

Western Dakota Technical College - Rapid City, SD

Skills

• Epic

• Communication skills

• ICD-10

• Hospital experience

• Auditing

• CPT coding

• Business management

• Medical coding

• Medical billing

• Medicare

• HCPCS

• Quality assurance

• Medical records

• Organizational skills

• Microsoft Outlook

• Home health

• Medical terminology

• Microsoft Word

• ICD-9

• EMR Systems

• HIPAA

• ICD Coding

• Anatomy Knowledge

• Physiology Knowledge

• Microsoft Excel

• Insurance Verifications

Certifications and Licenses

AAHIM Certification of Revenue Cycle Management Analysts

Medical Coding Certification

Certified Coding Specialist

Certified Professional Coder

Property & Casualty License

Medical terminology — Proficient July 2021

Understanding and using medical terminology

Medical billing — Proficient March 2022

Understanding the procedures and forms used for medical billing

Electronic Health Records: Best Practices — Highly Proficient July 2020

Knowledge of EHR data, associated privacy regulations, and best practices for EHR use.

Contact this candidate