Medical Coder Billing
Resume:
ZAYDA BOLES, CPC
Elk Grove, CA *****
**.*****@*****.***
Knowledgeable medical office professional at correcting and resubmitting claims, preparing patient charts and reviewing health records to identify proper procedure codes and diagnosis codes for billing. Offers background in reviewing, analyzing and managing medical record information to obtain prior authorizations from insurance companies and ensure payment.
Critical thinking and technical analysis
IDX, EpicCare, EMR and Cerner systems
Optum Encoder Pro, 3M Encoder
Coding medical departments such as Family
Practice, Internal Medicine, Pediatrics,
OB/Gynecolgy, Urology, Oncology, Radiology,
Rural Health, Gastroenterology, Podiatry, Sports
Medicine, Cardiology, Palliative Care, Nuclear
Medicine, General Surgery, etc.
Medical claims billing and follow up, payment
posting, denials and filing appeals
Word processing softwares, Excel spreadsheets
Customer experience
Protected Health Information and government forms
11/2018 to Current
N/A
Elk Grove, CA
Volunteering/Spend Time With Family/Options Trader Volunteer (2/4/2021- 8/18/2022)- participated in the research study for Janssen (Johnson & Johnson's) COVID 19 vaccine prior to FDA Approval and side effects of the vaccine. The study was done by Benchmark Research. Spent more time with my son who suffered from delayed grieving due to the death of his father in 2015, suffered sports injury and undergoing issues with school.
Traded stocks and options for income as a means of livelihood during those times. 03/2015 to 10/2018
ADVENTIST HEALTH/ CERNER CORPORATION
Roseville, CA
Medical Coder
Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements.
Maintained updated knowledge of coding requirements, which included continuing education and certification renewal.
Read through patient health data, histories, physician diagnoses and treatments to gain understanding for coding purposes.
Added modifiers as appropriate, coded narrative diagnoses and verified diagnoses. Guarded against fraud and abuse by verifying coded data accurately reflected services provided Interacted with physicians and other healthcare staff to ask questions regarding patient services. 06/2010 to 03/2015
SUTTER HEALTH
Roseville, CA
Lead, Revenue Cycle Dept
Fostered positive employee relationships through communication, training and development coaching. Delegated daily tasks to team members to optimize group productivity. Monitored team progress and enforced deadlines. Organized and prioritized incoming work and optimized team workflows and resources to handle dynamic demands. Allocated resources and organized processes within assigned area of responsibility to drive efficiency and productivity.
Audited staff works for quality, accuracy and compliance. Responsible for Coding worqueue for private and commercial payors. Handled huge account (10K plus) workqueue accounts' billing, follow up and appeals. SUMMARY
SKILLS
EXPERIENCE
Coordinated with supervisors, managers and directors on staff performances and development. 10/1991 to 06/2010
PALO ALTO MEDICAL FOUNDATION
Sunnyvale, CA
Lead, Revenue Cycle Dept
Coached team members in techniques necessary to complete job tasks. Trained new team members on IDX system in medical claims billing and follow up, payment posting, customer service, patient and insurance refunds, insurance denials and appeals. Established open and professional relationships with team members to achieve quick resolutions for various issues.
Worked on large accounts (10K plus) Aged Trial Balance, aside from my regular workload. Took on additional job duties during unexpected backlog, resulting in meeting project target date. SOME COLLEGE (NO DEGREE): CERTIFIED CODING SPECIALIST 07/2011 JL Academy, Sacramento, CA
ASSOCIATE OF APPLIED SCIENCE: INSURANCE AND CODING SPECIALTY OPTION 03/2007 De Anza College, Cupertino, CA
SOME COLLEGE (NO DEGREE): ADVANCE ICD-9-CM CODING SYSTEM & INSURANCE BILLING 09/2005 De Anza College, Cupertino, CA
BACHELOR OF ARTS: ACCOUNTING AND BUSINESS MANAGEMENT 03/1982 Polytechnic Univ of The Philippines, Manila, Philippines EDUCATION AND TRAINING
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