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Medical Coder Credentialing Coordinator

Location:
Manchester, NY, 14504
Posted:
February 28, 2023

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Resume:

CAREER OBJECTIVE

Obtain a position within a people-oriented organization where I can maximize my people-oriented experience, communication skills, and problem solving abilities to achieve corporate goals in a challenging environment while continually improving upon myself and the skills I'm able to offer my employer as we reach new heights together.

EXPERIENCE

MEDICAL IMAGING SPECIALIST

eHealth Technologies, W. Henrietta, NY / Feb 2019 - Present

Ensures customer imaging requests are processed in a timely and accurate HIPAA compliant manner while maintaining appropriate documentation.

Processes traveling, loading and processing accurately and in a timely manner.

Responds professionally and in a timely manner to all inbound calls received.

Undertakes additional activities at the request of the customer.

Proactively addresses and elevates customer service issues to department manager.

Adheres to established business procedures, policies, and regulations.

Appropriately prioritizes work to support team goals.

Ensures all policies and procedures are followed appropriately with emphasis on

strict adherence to HIPAA guidelines.

Proactively monitors request activity and takes necessary action to avert potential customer service issues.

Performs at a high level of quality to eliminate the potential for incorrect transfer of Patient Health Information.

C-PRINT CAPTIONIST

Monroe 1 BOCES, Rochester, NY / Nov 2017 - Feb 2019

Provide real-time transcription / note-taking in a classroom setting for hearing impaired students.

Edit transcripts

Use student feedback, assess effectiveness, and adjust transcription accordingly.

Develop rapport with consumers and facilitate resolution of support service concerns.

Provide information to faculty, staff, and students regarding the real-time speech-to-print service.

Required knowledge and abilities in phonetics

Excellent communication and listening skills with the ability to understand and summarize information while typing.

Ability to handle pressure of using transcription system in classroom setting

MEDICAL CODER

Rochester Regional Health, Rochester, NY / Aug 2013 - Oct 2017

Accounts for coding and abstracting of patient encounters, including diagnostic and procedural information, significant reportable elements, and complications.

Researches and analyzes data needs for reimbursement.

Analyzes medical records and identifies documentation deficiencies.

Serves as resource and subject matter expert to other coding staff.

Reviews and verifies documentation supports diagnoses, procedures and treatment results.

Identifies diagnostic and procedural information.

Audits clinical documentation and coded data to validate documentation supports services rendered for reimbursement and reporting purposes.

Assigns codes for reimbursements, research and compliance with regulatory requirements utilizing guidelines.

Identifies discrepancies, potential quality of care, and billing issues.

Researches, analyzes, recommends, and facilitates plan of action to correct discrepancies and prevent future coding errors.

Identifies reportable elements, complications, and other procedures.

Serves as resource and subject matter expert to other coding staff.

MEDICAL CODER

University of Rochester, Rochester, NY / Dec 2011 - Aug 2013

Extracting relevant information from patient records.

Liaising with physicians and other parties to clarify information.

Examining documents for missing information.

Assigning CPT, HCPCS, ICD-10-CM, and ASA codes.

Assigning APC and DRG codes.

Ensuring documents are grammatically correct and free from typing errors.

Performing chart audits.

Advising and training physicians and staff on medical coding.

Informing supervisor of issues with equipment and computer program.

Fee schedule maintenance

Ensured compliance with OMIG, Hospital policies, 403b regulations, and family planning compliance.

MEDICAL INSURANCE COLLECTIONS SPECIALIST

University of Rochester, Rochester, NY / Jul 2007 - Dec 2011

Responsible for charge and payment entry within Electronic Health Record.

Coordinates and

clarifies with providers, when necessary, on information that seems incomplete or is lacking

for proper claims adjudication

Responsible for correcting, completing, and processing claims for all payer codes

Analyze and interpret that claims are accurately sent to insurance companies

Perform follow up with Medicare, Medicaid, Medicaid Managed Care, and Commercial

insurance companies on unpaid insurance accounts identified through aging reports

Process appeals online or via paper submission

Assist in reconciling deposit and patient collections

Assist with billing audit related information

Process refund requests

Attend provider meetings / workshops when needed

Communicate with billing and credentialing coordinator to identify and resolve audit review

issues

Process billing calls and questions from patients and third party carriers

Answer/respond to correspondence related to patient accounts.

Communicate daily with internal and external customers via phone calls and written

communications

Identify trends, and carrier issues relating to billing and reimbursements. Report findings to Team Lead and/or Supervisor

Pursue and participate in education to remain current with changes in the Healthcare

industry.

Promote effective working relations and work effectively as part of a team to facilitate the

department's ability to meet its goals and objectives.

MASSAGE THERAPIST

Massage Therapy, Rochester, NY / Mar 2005 - Jul 2007

Talk with clients about their symptoms, medical history, and desired results

Evaluate clients to locate painful or tense areas of the body.

Manipulate muscles and other soft tissues of the body as needed based on client condition.

Provide clients with guidance on stretching, strengthening, overall relaxation, and how to improve their posture.

Document clients' conditions and progress.

Use touch to treat clients' injuries and to promote the clients' general wellness.

Talk with clients about what they hope to achieve through massage.

Develop personalized treatment plans for clients, including information about additional relaxation techniques to practice between sessions.

Apply specialized techniques to best assist in client recovery including many different types of massage or modalities such as Swedish massage, deep-tissue massage, sports massage, elderly massage, and prenatal massage.

PATIENT CARE ASSISTANT

Edna Tina Wilson Living Center, Rochester, NY / May 1998 - Apr 2003

Assisted with the care and treatment of patients suffering from dementia.

Assists with the collection of lab specimens.

Transports patients to and from operating rooms, laboratories, and examining rooms.

Helps with bathing and grooming tasks.

Assists patients who need help walking or standing.

Communicates a patient's needs to nurses and doctors as appropriate.

Feeds patients, ensuring that any special dietary needs are strictly adhered to.

Aids people in the use of any medical devices and equipment required for their specific condition.

Assists individuals with taking medication when needed.

Lifts patients in order to move them and prevent bedsores.

Updates relief workers on any unusual situations that may need to be addressed during their shift.

Interview patients to obtain medical information and measure their vital signs, weight, and height.

Record patients' medical history, vital statistics, or information such as test results in medical records.

REFERENCES

References available upon request

advmra@r.postjobfree.com

585-***-****

6 South Ave, Manchester, NY, 14504

EDUCATION

PRACTICE MANAGEMENT INSTITUTE

Medical Coding (Jan 2011)

ONONDAGA SCHOOL OF THERAPEUTIC MASSAGE - MASSAGE THERAPY

(Jan 2004)

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NICOLE ENNOCENTI



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