Medical Coding Billing

Rhonda L King MCBC

903-***-**** **********@*****.*** Tyler, Texas 75708

PROFESSIONAL SUMMARY

Experienced Medical Coder and Biller with a solid background and foundation in medical coding and billing, transitioning back into the workforce after a period dedicated to personal health recovery. completed a comprehensive medical coding and billing program, earning an MCBC certification through the American Medical Certification Association (AMCA). Eager to apply refreshed skills and knowledge in medical coding and billing to contribute effectively to healthcare operations and ensure accurate reimbursement and compliance.

PROFESSIONAL SKILLS

•Understand various insurance types, carriers, and plans and appropriate rules for coverage determination

•Review patient records and assign numeric and alphanumeric codes for each diagnosis and procedure

•Assign accurate medical codes for professional (physician) procedures, services, and diagnosis

•Recognize ICD-10-CM, CPT, HCPCS, and modifiers and how to utilize them for billing

•Comprehend payment adjudication various claim statuses and the resubmission process

•Handle issues related to medical necessity claim denials, bundling issues, and charge capture

•Possess in-depth knowledge of the CPT coding system and familiarity with the ICD-10-ICM and HCPCS Level II coding systems

•Audit medical billing and prevent fraud and abuse assigning diagnostic and procedure codes and how to submit clean claims for reimbursement

•Adhere to medical coding guidelines, regulations, and compliance

ADDITIONAL SKILLS

Communication Teamwork Collaboration Medical Terminology Medical Coding System (ICD-10- CM, CPT, HCPCS Level II) Electronic Health Records Insurance Claims Processing Billing Software Auditing and Compliance Reimbursement Data-Entry Analytical Thinking Attention to Detail Problem-Solving Time Management Organized Adaptable Ethical Commitment to Continuous Learning

EDUCATION

MedCerts Livonia, MI Jan 2023 - Mar 2024

Medical Billing Specialist Program - AMCA: MCBC Certified

Joliet Junior College Joliet, IL Sep 1974 - May 1975

Medical Office Clerk - Certificate of Completion

RELEVANT PROFESSIONAL EXPERIENCE

UT Health Science Center - Tyler

Medical Assistant

Tyler, TX May 2012 - Aug 2013

•Recorded patient vitals, medical history, and current concerns accurately, maintaining detailed electronic health records

•Assisted healthcare providers during examinations and procedures, ensuring patient comfort and efficient workflow

•Collected laboratory specimens, performed basic tests, and recorded results in patient records

•Filed and organized patient charts and documentation, ensuring accuracy and compliance with healthcare regulations

•Utilized Superbill for coding procedures and diagnoses, ensuring proper documentation for billing purposes

•Demonstrated knowledge of various insurance plans including Blue Cross and Blue Shield, United Healthcare, Humana, Medicare (MCR), and Medicaid (MCD)

•Communicated effectively with patients to explain procedures, gather information, and address inquiries

Henderson Memorial Hospital Rural Health Clinic

Medical Assistant

Henderson, TX Aug 1997 - Aug 2007

•Checked patients in and out efficiently, collected co-pays, deductibles, and managed outstanding balances to ensure smooth financial transactions

•Balanced day sheets at the end of each day, reconciling payments received and ensuring accuracy in financial records

•Verified insurance coverage for patients, processed referrals, and utilized ICD-9-CM coding for accurate documentation and billing

•Demonstrated proficiency in navigating various insurance plans including Medicare (MCR), Medicaid (MCD), and private insurers, adhering to their specific rules and requirements

•Maintained confidentiality of patient information and adhered to HIPAA regulations in all interactions and documentation

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