Medical Billing Health Information
Resume:
MS. DENETRA Y YOUNG
Lithonia, GA 30058
Mobile: 678-***-****
Email: ***********@*****.***
Professional Summary:
Dependable, thorough, and dedicated Outpatient Coder with over 2 years of experience in Coding for the Veterans Affairs Medical Center, seeking a part-time Coding position.
Strong Administrative skills to include: Exceptional knowledge of health information management and administrative subject matter, Strong analytical/ decision making and research skills, ability to research effectively via internet, exceptional typing speed at 60+ wpm, superior data entry (alpha and numeric) skills, business management and administrative skills to include MS Word, word processing, Excel, most computer functions. Exceptional customer service and interpersonal skills (with providers and other professionals) via orally, phone, email or written, can work with, learn from, teach, and collaborate with a diverse group of people.
Work Experience:
Department of Veterans Affairs
6010 Amarillo Blvd West
Amarillo, TX 79106 United States
03/2019 – Present (REMOTE)
Hours per week: 40
Series: 0675 Pay Plan: GS Grade: 06 Step:02
Medical Records Technician (Outpatient Coder) (This is a federal job)
Duties, Accomplishments and Related Skills:
-Analyze and extract relevant medical information from patient's medical records, compare to what is documented, and coding accordingly (using ICD-10-CM Expert for Physicians, AMA-CPT Professional, HCPCS Level II, medical dictionary, and creditable internet sources), also checking edits, guidelines to ensure accurate coding for maximum billing reimbursement
-Utilizing knowledge and understanding of medical terminology, anatomy and physiology, healthcare reimbursement methodologies, health information management to determine correct codes needed for further billing processes.
-Researches and determines correct coding and intricate details needed to process in Coding Compliance Manual.
-Exceptional navigation through CCM, Vista Imaging, Clintegrity, NCoder, Nuance, and Codify---also understanding edits and all aspects of VA coding software
-Reviews (analyze) entire medical record (demographics, personal/social history, history of illness, review of systems, medical complexity, diagnoses code, procedure code) to determine Evaluation and Management, and arrange codes in order of primary to secondary codes
-Interpret and apply regulatory policies and regulations on the confidentiality of health information (PHI, HIPAA, FOIA)
-Query providers (secure email, phone call, or physical visit) for clarity in documentation and also educate them on proper clinical documentation in order to ensure accurate coding and reduce possible fraud
-Experience with Epic, 3M CAC and HDM system, AAPC ENCODER, CODIFY
-Contributions include: decreasing the Prosthetic backlog from the months of March 2019-present, using exceptional research and data entry skills, also assist Supervisor with Compliance issues stemming from inaccurate E/M codes from Podiatry and Dermatology (May 2019) consistently work as a team player to keep backlog or TAT under 5 days, also consistently work overtime to contribute in decreasing Non-VA PTF backlog
CLINICS CODED INCLUDE: Primary care, Labs, Diagnostics, ER, Endoscopy, Anesthesia, Dermatology, Endocrinology, Nephrology, Podiatry, Urology, Dental, Cytopathology, Pathology, Optometry, Prosthetics (create encounters for), Non-VA PTF (create), Mental Health, Substance Abuse, C & P, Wound Care, Flu Shots, etc., to name a few
Asset Protection Unit
6900 I-40
Amarillo, TX 79106 United States
01/2019 - 03/2019
Salary: 14.00 USD Per Hour
Hours per week: 40
Overpayment Recovery Specialist (temporary position)
Duties, Accomplishments and Related Skills:
-Using exceptional interpersonal and customer service skills, contact Billing services in which patients using Aetna supplement to Medicare obtained services, to collect overpayments or refunds
-Understanding and knowledge of insurance payments particularly Medicare and supplement payments, also understanding and knowing how to analyze hospital and physician bills are a must (CMS 1500 and UB-04 claims forms)
-Excellent computer skills required, particularly Excel, frequent update of spreadsheet to notate conversations between Billing department for other ORS to use
-Create letters and emails to request payments in check form from Billing offices to be sent to company
-In the 2 months in this position, helped recover over 200k worth of overpayments from Aetna Supplement
-Constantly achieved goals of exceeding the 85 calls per hour, 4 hours per day
Optum360 via Quest Diagnostics
1777 MONTREAL CIR
Tucker, GA 30084 United States
10/2005 - 11/2018
Salary: 34,257.60 USD Per Year
Hours per week: 40
Senior Data Entry Operator (Billing department)
Duties, Accomplishments and Related Skills:
-Analyze laboratory requisitions ensuring demographics are clear, health insurance (Medicare, Medicaid, and third party) information is present, and patient's diagnosis codes were clear, eligible, and correct
-Enter data information (demographics, insurance information, ICD-10) into billing software for further billing processing by Accounting department.
-In a production manner, meet and exceed deadline of entering 100 or more requisitions into system every hour.
-Also, work together as a team to meet month end deadlines
which required that monthly bills are processed with 1.5 days to spare
-Occasionally contact providers and medical administration personnel via phone, secure email, or fax to obtain clarity for illegible or unclear data and patient information.
-Contributed to team by exceeding both quantity and quality on a consistent basis by entering information accurately, gathering information on any discrepancies, correcting missing or illegible information to prevent delay of billing process
United States Air Force Reserves
Dobbins Air Reserve Base
1291 Cobb Pkwy SE
Marietta, GA 30067 United States
05/2001 - 12/2010
Salary: 300.00 USD Per Month
Hours per week: 4
Medical Logistics Technician (primary) /Medical Records Technician (secondary)
Rank: E-6 (Enlisted-Technical Sergeant)
Duties, Accomplishments and Related Skills:
-Administrative functions in Clinical setting during Reserve (drill) status to include:
ordering supplies and equipment for clinic, inventory management, issue supplies and equipment as needed, perform inspections in various departments to ensure no expired or damaged items, replace or destroy expired items.
-Customer Service functions to include negotiating prices with selected and qualified vendors, communicating effectively with leadership in each clinical department to ensure items are ordered correctly and to highest standards.
-Processes and monitor requests for contracts.
-Perform stock control level management, requisitions, ensuring correct storage and delivery upon receipt of supplies and equipment
-Contributed as a leader, by training subordinates, updating and maintaining member's records, providing briefings to newcomers of Clinic on duties and responsibilities of Logistics organization.
-Worked as the liason between main vendor and our small clinic by collaborating to order needed supplies and equipment to ensure an effective drill weekend month after month.
**Assisted in Medical Records department manually filing, sorting, updating Airmen’s records during all OSHA inspections and during drill weekends from 2001-2010**
Education:
Devry University (2016-2018) Decatur, GA United States
Technical or Occupational Certificate 06/2018
GPA: 3.75 of a maximum 4.0
Credits Earned: 54 Quarter hours
Major: Medical Billing and Coding Honors: Magna Cum Laude
Georgia State University (2000-2003) Atlanta, GA United States
Bachelor of Science
GPA: 2.9 of a maximum 4.0
Credits Earned: 120 semester hours
Major: Psychology Minor: Biology and Sociology
CERTIFICATIONS: Certified Coding Specialist, Physician (CCS-P) APRIL 2020
Certified Coding Associate (CCA) -APRIL 2019
MEMBERSHIPS: American Health Information Management Association (AHIMA)
Member since 2019 #2769650
American Association of Professional Coders (AAPC)
Member since 2021 #01828871
Contact this candidate