Data Entry Quality Assurance

SUMMARY

Efficient and accurate medical

coder knowledgeable in all areas

of medical coding and billing

having worked over 20+ years in

various lines of duties including

coding, charge entries, corrections

and resubmissions, adjudication of

claims, audits, insurance

verification, data entry, electronic

health records, training, and

development. Ready to take on a

new and challenging role.

SKILLS

ICD-10-CM, HCPCS level II CPT,

CPT Surgery Codes, ASA Codes,

ERISA/HIPAA/EEO, Medicare,

Medicaid, Blue Cross and Blue

Shield insurance regulations,

medical terminology, data entry,

claims adjudication, training and

development, program

implementation, quality assurance,

communication, leadership,

mentoring, claims resolution,

negotiations, presentations

EXPERIENCE

CREDITS REVIEW SPECIALIST / Tegria

Seattle, WA 09/2022 – Current

Revenue cycle credits review specialist providing the most effective and efficient methods to evaluate and streamline systemic billing processes to facilitate easier management of the overall credit balance process. Optimize work queues to reduce the number of patient credits and limit the number of unnecessary queues for duplicate postings and adjustments. Review best practices and training manuals to update processes as industry standards and changes take place in real time. ENGLISH TEACHER / Learnship,

Cologne, GERMANY 02/2017 – Current

Senior level instructor providing training ranging from basic to advanced language skills to employees and business executives throughout Europe. English level assessments, exam prep and testing, lesson planning and lesson design, evaluations, coaching, letter writing and presentation skills. ENGLISH TEACHER / 7Speaking,

Paris, FRANCE 04/2010 - 09/2018

Communications instructor providing training ranging from basic to advanced language skills to employees and business executives throughout Europe. Test prep, assessments, evaluations, language training and development, lesson planning and design development and implementation.

SR. EMPLOYEE BENEFIT SPECIALIST / Principal Financial Group, San Diego, CA 08/2005 – 12/2009

Benefits specialist providing face to face training and education in medical, dental, life and retirement benefit plans. Provided individual financial assessments as well as group meetings. Set up and implemented health fairs and healthy programs to assist employees to make better choices for their families. Conducted recruiting, training and educational seminars. REGIONAL ACCOUNT MANAGER / Aim Healthcare Inc.,

Franklin, TN 04/2003 – 08/2005

Regional account manager auditing the financial records for local area hospitals to correct credit balances. Revenue cycle billing and adjustments trainer and manager. Credit balance specialist auditing and reviewing the coding parameters to assure accurate billing and coding tables had been implemented into the hospitals electronic payment systems. Billing auditor and claims review investigator.

PW

P AULA WISE

27751 CALLE RABANO

Menifee, CA 92585

EDUCATION

Current AAPC COC Training 2023

AAPC Certified Professional Coder - April 2022

PENN FOSTER CAREER SCHOOLS - MEDICAL BILLING AND

CODING PROGRAM - GRADUATED 11/2020

Successfully completed the coursework for this accredited diploma program consisting or medical terminology, pharmacology, SimChart electronic medical claims processing and electronic health records keeping. CPT, ICD-10-CM, HCPCS II and ICD-10- PCS coding disciplines.

MT. SAN JACINTO COMMUNITY COLLEGE - ASSOCIATES

DEGREE 08/2013- 05/2015

Human Development Social and Behavioral Science- Associates Degree Coursework in early childhood development through retirement, Sociology, languages and adult and child education TEFL EXPRESS - 09/2012 - CERTIFIED

Advanced 160- hour TEFL Certified English Instructor- Coursework in English grammar, Linguistics and language development, Secondary language acquisition coursework

CANADIEN INSTITUTE OF ENGLISH - TEFL/TESOL

CERTIFICATION - 05/2009

Advanced English TESOL/TEFL Certification- Coursework in English grammar, basic through advanced language development, methodologies and kinesiology techniques, testing and evaluation coursework, lesson planning and designing, business English communication and writing skills, test preparation. *********@*****.*** 951-***-****

2

PW

PAULA WISE

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