Medical Coder
Resume:
Airal Randolph
Hopkins, Sc *****
*********.**@*****.***
Licenses:
Certified Professional Coder (CPC)
Cardiopulmonary Resuscitation (CPR) Certification
Registered Medical Assistant (RMA) Certification
Certified Phlebotomy Technician (CPT) Certification Certified Billing and Coding Specialist (CBCS) Certification Skills:
● Taking Patients Vitals
● Patient Education
● Ancillary Testing
● Patient Scheduling
● Blood Draw
● HIPAA
● EMR (GE Centricity) (Al Scripts) ( EPIC)(Cerner)
● Appeal Processor
● Abstracting
● New Hire Training
● Interviewer
Education:
Virginia College- Columbia, SC
Associate’s in Healthcare Reimbursement
September 2016
Medical Assistant Program
● Dean’s List/ 3.8 GPA
Medical Billing and Coding Program
March 2014
● Dean’s List / 3.5 GPA
Professional Experience:
Prisma Health USC-Medical Group Columbia, SC
Physician Billing -Ambulatory Coding Denial Rep 2017-2019 Ambulatory Outpatient Coding 2019-Present
November 2017-Present
• Abstract for assigned specialties based on medical record documentation.
• Utilizes coding software and coding resources in order to determine correct codes
• Review and resolve all claim denials for multiple commercial, government, and state plans
• Process appeals as needed
• Communicate coding issues with physicians, office staff, and billing department
• Resolve claim and coding edits
• Work multiple coding and office workques
• Review, verify and assign CPT, ICD-10, and HCPCS codes
• Assist in the interview process (PEER Panel)
• Assist with training and mentoring new hires
Lexington Medical Center- Southeastern Ortho & Sports Med Lexington, SC Medical Assistant
March 2017- November 2017
• Triage
• Assistant physician during exam and procedure.
• Hot seat- Physician orders, referrals, and surgery orders
• E-prescribe
• Medical Scribe
Kuduz Medical Staffing
Medical Assistant Columbia, SC
November 2016 -March 2017
• Escort patients to exam room, obtain patient vitals and medical history.
• Assist physician during exam and procedures
• E-Prescribed
• Enter correct diagnosis and procedures codes
• Medical Transcribed under physician supervision
• Update patient charts
• Patient education
Wellcare Health Plan Columbia, SC
Customer Service Rep.
October 2014 – August 2016
● Assist members with plan and billing questions
● Record, investigate and resolve member complaints in detail
● Contact pharmacies to ensure authorization are process correctly
● Log, track and appropriately document all issues utilizing on-line systems and procedures
● Responds to member, provider and other inquiries via telephone
Contact this candidate