Medical Coder
Resume:
Chiyoka L. Gough
CPC
Professional Certification
CPC (Certified Professional Coder)
AAPC ( American Academy of Professional Coders)
E D U C A T I O N
Anthem College Online
Phoenix, AZ
04 / 2006 - 05 / 2008
Associates in Science
Medical Billing and Coding
Buckingham County High School
Buckingham, VA
Graduation Date: 06 / 2000
Skills
Certified in Medical Coding and Billing from AAPC
Trained in Medisoft software, EPIC, A2K3,
Midas,
Atrivia, Vista, Vista Gui, CPRS,
OnBase, Navi health, Meditech, HIS Soft Med and IDX programs
EPIC Super User
Knowledge of insurance verification,
authorizations, billing, claims, and payments
Knowledge of medical coding with the CPT
manual, ICD-9, and HCPS book Medical Terminology
Microsoft Word, Excel, Access, PowerPoint,
Outlook, and One Note
Knowledge of regular and commercial insurance, Medicare, and Medicaid Great communication skills
Can type 60-65 words per minute
Experience with EMR systems
Insurance websites, Availity, Navient, Medicaid, Medicare, Kepro Atrezzo, United Healthcare, Coventry, Evicore, Tricare, Molina Healthcare, and Humana.
W O R K E X P E R I E N C E
Advanced Medical Support Assistant
Primary Care- CBOC Charlottesville
U.S. Department of Veteran Affairs
Charlottesville, VA
11 / 2023 – Present
Advises clinical staff on current administrative processes
Coordinates administrative functions regarding emergent and non-emergent transfers to other V.A
facilities or private hospitals
Collaborates with clinical team members to determine daily clinic needs
Coder/Billing Specialist
Juel’s Therapeutic Solutions, LLC
Remote
03/2022 – Present
Reviews medical record documentation to determine appropriate ICD-10-CM/CPT codes and modifiers in
accordance with official coding guide.
Communicate effectively with staff when clarifying diagnosis codes and CPT assignment-Provide feedback to
staff on billing/coding related matters.
Submit claims to insurance companies and follow up on unpaid claims.
Resolve any issues that arise with claims or payments
Answer patient inquiries regarding billing and payment
Maintain accurate records of billing and collection activities
Generate monthly reports to track billing and collection performance
Coder/Billing Specialist
Access Associate Senior
Infectious Disease Clinic - University of Virginia Medical Center
Charlottesville, VA
08 / 2022 – 10/2023
Educates patients and families on managed care processes; Communicating authorizations and reviewing
potential financial obligations necessary.
Schedules single and multi-visit appointments to the correct provider, including all corresponding
information.
Assists customers in obtaining access to medical services at UVA Health Systems. Investigates,
documents, resolves, and/or refers appropriate issues and conflicts.
Trains new employees
Experienced in Epic User Web
Call Center Advanced Medical Support Assistant
McGuire Holmes Physical & Rehab Department
U.S. Department of Veteran Affairs
Richmond, VA
04 / 2022 - 08 / 2022
Advises clinical staff on current administrative processes
Coordinates administrative functions regarding emergent and non-emergent transfers to other V.A
facilities or private hospitals
Collaborates with clinical team members to determine daily clinic needs
Medical Office Specialist
Nephrology Clinic - University Physicians Group
University of Virginia Medical Center
Lynchburg, VA
08/ 2021 - 04 / 2022
Responsible for ensuring efficient administrative operations in coordination with leadership.
Responsible for obtaining approval of professional and technical services which may include obtaining
insurance referrals, procedure authorizations, or pre-certifications required for patients to receive
physician services, medical procedures, equipment, supplies and medications.
Answers telephones, screens calls, confirms appointments, maintains appointment schedule following
Office scheduling procedures. Refers callers to appropriate individuals, and gives routine information
in accordance with established procedures.
Checks in patients upon their arrival and verifies patient information; updates patient tracking, provides
patient with medication list, assures accuracy and completeness of co-pays, charges and insurance
information. • Checks out patients at their departure and schedule follow-ups.
Assigns codes to documented patient care encounters (inpatient facility and/or professional services)
Selects and assigns codes from the current version of several coding systems to include current versions
of the International Classification of Diseases (ICD 10), Current Procedural Terminology (CPT), and/or Healthcare
Common procedure Coding System (HCPCS).
Access Associate Senior
Infectious Disease Clinic - University of Virginia Medical Center
Charlottesville, VA
09/ 2020 - 08 / 2021
Educates patients and families on managed care processes; Communicating authorizations and reviewing
potential financial obligations necessary.
Schedules single and multi-visit appointments to the correct provider, including all corresponding
information.
Assists customers in obtaining access to medical services at UVA Health Systems. Investigates,
documents, resolves, and/or refers appropriate issues and conflicts.
Trains new employees
Experienced in Epic User Web
Utilization Review Coordinator
Acute Inpatient - Hospital Corporation of America (HCA)
Richmond, VA
06 / 2017 - 05 / 2020
Verifies pre-certifications for all inpatient admissions and surgeries
Analyzes information to complete inpatient admission pre-certifications with insurance carriers.
Assigns codes to documented patient care encounters (inpatient facility and/or professional services)
Selects and assigns codes from the current version of several coding systems to include current versions of the
International Classification of Diseases (ICD 10), Current Procedural Terminology (CPT), and/or Healthcare Common
procedure Coding System (HCPCS).
Pre-Certification Authorization Coordinator
Radiology - University of Virginia Medical Center
Charlottesville, VA
09 / 2014 - 05 / 2017
Obtains pre-certifications for all inpatient admission and pre-authorizations for all outpatient diagnostic
tests.
Analyzes information required to complete pre-certifications and/or authorizations with insurance
carriers, service area contacts and workman’s compensation carriers. Demonstrates skill in the
proficient use of PC and UVA software systems.
Assigns codes to documented patient care encounters (inpatient facility and/or professional services)
Selects and assigns codes from the current version of several coding systems to include current versions
of the International Classification of Diseases (ICD 10), Current Procedural Terminology (CPT), and/or
Healthcare Common procedure Coding System (HCPCS).
Patient Access Insurance Verification Specialist
University of Virginia Medical Center
Charlottesville, VA
06 / 2005 - 09 / 2014
Verifying outpatient insurance by telephone or internet.
Experience in running ADHOC reports
Contact this candidate