Connie Gammon-McMillan

Henrico, VA ***** 804-***-**** addgj2@r.postjobfree.com

Medical Coder

Coding Integrity Auditing & Quality Assurance

Well-versed and highly knowledgeable when it comes to medical billing and coding. Demonstrates an in-depth understanding of the insurance claims processes with the ability to facilitate the process by working collaboratively with all involved parties. Recognized by peers and management for executing tasks accurately and proficiently and exceeding performance expectations.

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•Medical Terminology

•Medical Coding

•Insurance Authorization/Verification

•Medical Claims Processing

•Account Management

•Customer Service

•Referrals & Provider Verification

•Team Leadership

Professional Experience

HCA Hospitals,

Medical Coder / E/M Biller / E/M Charger / Editor / Auditor, 2001-2019

Progressive member of the team promoted several times while taking on increasing responsibility. Demonstrates sound knowledge and expertise with strong attention to detail to assure accuracy and quality of all activity. Conducts research to service patient accounts, confirms dates of services, respond to queries and resolve issues. Maintains up to date patient records, deaths and transfers from the ER in the system; collaborates effectively with cross-functional staff to confirm all information. Communicates with doctor’s offices to ensure that all codes for services are equivalent to the hospitals billing codes.

•Ensures that all coding functions are free of errors by verifying the work of other coders.

•Promotes organization and optimal workflow by preparing various types pf charts for staff.

•Leverages knowledge in ICD-9 and ICD-10, CPT and HCPCs codes to proficiently code all charts.

•Reduces delay of billing and issues regarding payment by researching undefined providers prior to finalizing billing.

•Strengthened skill set by taking on new responsibilities consisting of completing Trauma Accounts, E/M Charging of ER's that consisted of infusions, injections, hydrations and procedures performed in the ER setting from the ER Dr’s & other Specialist’s in the ER setting. This is including Trauma Accounts.

•Recognized for attention to detail that led to becoming an editor/auditor of ER and Trauma Accounts.

Additional Career History

Medical Supervisor, Dominion Medical Management, Richmond, VA, 1999-2001

•Supervised New Jersey radiology accounts and managed coding of the reports with the medical terminology used on the reports by the Radiologist with the use of ICD9-CM and CPT-4 codes.

•Assisted with the Richmond based patient accounts department, answered patient phone calls from patients concerning their accounts, posted patients and voucher payments, and researched multiple accounts held by single patients.

Medical Claims Processor, Cigna Health Care of Virginia, Richmond, VA, 1992-1998

•Processed medical claims in a timely and accurate manner.

•Conducted medical reviews with nurses, customer service and provider representatives.

•Oversaw authorization requirements, analyzed benefits and dental accident claims.

Assistant Claims Examiner, Lindsey Morton Claims Management, Inc., Richmond, VA, 1990-1992

•Supported operations by completing receptionist related duties, filing, billing and managing and organizing files and documents.

Office Clerk, Kelly, Olsten and Quantum, Richmond, VA, 1989-1990

•Tasked with a range of duties that included filing, billing, and administrative support functions.

Office Clerk, Southern States, Richmond, VA, 1987-1989

•Performing administrative functions such as filing, mailroom functions and completed billing activities.

Medical Claims Processor, Blue Cross and Blue Shield of Virginia, Richmond, VA, 1979-1984

•Processed medical claims and reviewed medical records to assure that all claims corresponded with subscribers and medical providers.

Technical Skills

Meditech, 3M Encoder, HPF, MPF, Artiva, 3M 360, CAC ( Computer Assisted Coding )

Professional Training

C-Part Tool Training, Healthstream, AHIMA, Web Cast, HIPPA, CPT Assistance

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