Outpatient Coder Senior

fort Worth TX 682-***-****

Theresa M. Thornton CPC

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Experience

August 29, 2022 – Present USMD - United Health Group Irving, TX

Senior Coder

Senior coder for General Surgery abstracting & verifying surgery CPT codes, Diagnosis codes, with the proper Modifiers, as well as abstracting and verifying CPT,, Diagnosis code for the E/M visits.

June 25,2021-January 2022 United Health Group/Optum Irving, TX

Contract HCC Coder

Various contract Positions with Various contract Companies Lasting from February 2022- August 2022.

April 16,2018 –June 22, 2021 Methodist Health Systems Dallas, TX

Outpatient Coder 3

Outpatient coder for Endocrinology, neurology, Infectious Disease 50% of the time. Work with the business office follow up team with appeals and denials, correcting diagnosis per the medical records and assisting the follow up team with appeal letters to various Health plans.

Various contract positions with various companies that were temporary, lasting 3-6months, from 2017-April 2018.

May 2013 – June 2017 Parkland Hospital Dallas, TX

Outpatient Coder II

Outpatient Coding for Dermatology, Ophthalmology and Neurology with ICD-9 and ICD-9CM

ICD10 training completed, and certificate awarded.

Certified Coder.

Productivity is 8 charts per hour with 95-98% accuracy.

Assist all team members as needed.

Sept. 2011 – Jan. 2012 North Texas Specialty Practice Fort Worth, TX

Physician Educator

Review patients' records for coding and documentation of Chronic conditions

Educating physicians on the proper coding and documentation according to coding to ICD-9-CM Guidelines, and HCC documentation coding.

Jan.2011-Oct. 2012

Ultimate Medical Academy

Online, Florida

Medical Billing, Coding and Insurance Instructor

Educated students in the disciplines of Medical Coding (ICD-9, CPT-4, HCPCS, DRG's and coding guidelines).

Provided students with coursework that would help them handle a wide variety of medical claims including physical therapies, ENT, primary care and, dental, eye/vision, surgeries, diagnostic testing, ER, and E&M.

Aug 2009 – May 2011

Medifacts, Surgical & Diagnostic Center

Euless, TX

Medical Coder/ Auditor

Abstract CPT, ICD-9 codes from pain, and orthopedic operative reports for Surgical and Diagnostic Center.

E&M chart auditing for Total Pain Physicians.

Review appeal and denials correspondence from the various insurance companies.

Oversee that the accounts receivables, billing, and correspondence is within coding compliance.

Feb.2008 – June 2009

Pinnacle Partners Consultants Anesthesiology Group

Dallas, TX

Insurance Coder

Abstract CPT and ICD-9, from operative reports for the Pain Physicians, insure the pain coding guidelines, and Guidelines for the anesthesia code were followed as well as billing.

Aug.2007 – Feb.2008 Everest College Arlington, TX

Medical, Billing, Coding and Insurance Instructor

Educated students in the disciplines of Medical Coding (ICD-9, CPT-4, HCPCS, DRG's and coding guidelines). Provided students with coursework that would help them handle a wide variety of medical claims including physical therapies, ENT, primary care and, eye/vision, surgeries, diagnostic testing, ER, and E&M.

Jun. 2001 – Aug. 2007 Harriman Jones/ Healthcare Partners Long Beach,CA

Insurance Coder

Serve as a liaison between the doctors and insurance companies.

Duties consist of tracking and coding diagnoses for inpatient and custodial charges by processing minus debits (retraction).

Additional duties consist of auditing claims, generating spreadsheet and maintaining client satisfaction.

Provide training to other employees in the Corporate Office.

HCC Coding from the beginning with Blue Shield HMO, Medicare, and Senior HMO (2004-2007)

Education

2010

University of Phoenix

Phoenix, AZ

Bachelors of Healthcare Administration

Professional Affiliations .

2001 - Present American Academy of Professional Coders

Certified Professional Coder

References

References are available on request.

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