Medical Billing Coder

Nellie Garcia, CPC

Email: ***********@***.***

Cel Number: 956-***-****

Objective: To obtain a remote or (in office) medical coder and or biller position that will allow me to utilize my detail

oriented skills and extensive hands on experience knowledge of medical record reviewing, risk adjustment trained, medical billing, medical coding, EOB posting, specialized in appeals, chart reviewer, ICD-10 & CPT expertise resulting in being an asset for any healthcare medical office or facility.

Certification and Education

AAPC – (CPC) Certified Professional Coder, Since September of 1998 and current

ICD-10-CM Certified by Ahima and AAPC

San Antonio College of Medical and Dental Assistants – Graduated as a Medical

Assistant 1980

Edcouch-Elsa High School Graduate Class of 1979

Experience:

Cigna-HeathSpring July 15, 2010 – January 31, 2020

Senior Field Coder

Review Charts Remotely at Provider Offices-Abstracts Diagnosis-Follow Best

Practices and Guidelines for Risk Adjustment and ICD-10-CM-Extensive

coding knowledge – review medical records and other clinical documentation to identify possible risk adjustment codes – collect and review documents to support the providers healthcare management and the company’s risk adjustment initiatives – maintains a 95% and above coding accuracy - possess strong knowledge of anatomy, physiology, and medical terminology.

Verley Gordon MD PA – Pediatric Facility – 2006 -Present

(Remote)

Enter All Superbills into system

Electronic Medical claims submittal (Availity) clearinghouse

Manage patient accounts and extensive appeals knowledge

Prior authorization protocols specific to payor

Credentialing & re-credentialing of providers

Electronic Patient Statements

Extensive Knowledge of Microsoft Office programs.

I work well independently (remote) and I’m detailed-oriented

I’ve got excellent people & customer service skills

Extensive knowledge of heavy claim management & provide quality work

Unique organizational skills. Currently use Medisoft for all claims and statements.

1

Cont’ Nellie Garcia, CPC

McAllen Oncology – June 2000 – March 2010 Office Manager/Medical

Biller/Coder

Responsible for current CPT, ICD-9, HCPCS coding updates on medical record

and claims

Reviewed office/hospital reports and medical records

Coded new procedures and diagnosis alongside physician

Supervise 10 employees

Responsible for A/R and productivity reports

Excellent customer service training and implementation for employees

Manage patient accounts, Post charges and Post payments

Submit Claims and Statements via Electronic Transmission

North Point Ambulatory Surgical Center – Sept 1998 – June 2000

Office Manager/Medical Biller

Credentialing, Coder, Biller

Electronic transmission, Appeals

Demographics, post charges and payments to patient accounts

Managed accounts for different specialties

Tracked status and followed up on delinquent pending claims

McAllen MRI 1995-1998 Office Manager - Medical Coder/Biller

Performed internal audits

Coded new procedures and diagnosis

Credentialing

Post Charges, Payments and Appeals

Patient Demographics, Verify Insurance Benefits, Obtained Authorizations

2

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