Data Entry Medical Coder

JENNIFER AQUINO

****************@*****.*** 908-***-**** Old Bridge, NJ 08857

Passionate Certified Medical Coder with comprehensive knowledge in health information management and medical billing processes with over 15 years of experience. Solid understanding of medical terminology, coding, ICD-10-CM, and CPT principles. Known for accuracy in data entry and ability to handle confidential patient information responsibly. Demonstrated success in streamlining operations for increased efficiency within previous healthcare settings. Exceeds expectations in every interaction and believes in maintaining high standards with strong ethical principles. Medical coding expertise

Proficiency in medical management systems

Continuous integration

Advanced programming

Data entry and management

Jira

OnBase

Prizem

Avality

Navinet

Epic

Clinical documentation

Revenue cycle management

Edit Configuration Analyst Zelis Health Care - Bedminster, USA 08/2022 - Current Directed comprehensive management of edits involving customizations, updates, and various client interactions. Ensured client satisfaction by working closely with Account Management and CPS. Partner with IT and Operations to streamline processes, create or enhance reports and tools impacting the edit setup/customization process, including the identification of requirements, functionality, and user acceptance testing.

Participate in client-facing meetings as needed relating to Claims Editing, including, but not limited to implementation meetings, calls, ongoing education, and customization support. Conduct Claims Editing training sessions with new and existing clients to obtain the client's edit package for setup, pinpoint necessary customizations, and conduct periodic reviews of existing customizations to ensure validity and proper performance.

Coding Analyst Zelis Health Care - Bedmister, USA 12/2019 - 08/2022 Review medical records, operative reports, and related documentation to assign correct ICD-10 codes, CPT codes, and modifiers, displaying knowledge and experience with CCI edits, payer edits, and payer policies, including Medicare NCD and LCD.

Maintains a personal appeals queue within the company's turnaround times while working closely with other departments to provide written solutions to client inquiries. Create and update SOPs for appeal processing to more efficiently respond to appeals questions and appeals inquiries, utilizing the most current coding guidelines. Assists with mentoring and training current and new coding analysts. Provide educational support to coding analysts, and other departments.

Conduct weekly meetings with coding analysts. Identify revenue trends and potential revenue opportunities through the creation of edits.

Medical Biller/Coding Saint Peter's Hospital - New Brunswick, USA 05/2015 - 12/2019 Summary

Skills

Experience

Scrubbing all claims for all payors: Commercial, Medicare, and Medicaid; inpatient and outpatient facility hospital billing with Gaffey, Allscripts, and Athena.

Coding data from inpatient and outpatient records, utilizing a computerized coding system, and medical records in paper or electronic format, such as 3M Coder.

Accurately select appropriate diagnoses and procedures to reflect patient care for hospital reimbursement, research, education, and quality assurance.

Ensure claims are entered and submitted accurately for submission of electronic claims for all inpatient and outpatient claims.

Verify the correct ICD-10 and CPT codes on claims, benefits with Navinet or Availity, and DRGs. Medical Biller Avenel-Iselin Medical Group - Iselin, USA 06/2012 - 04/2015 Responsible for scrubbing roughly 240 cardiology, urology, podiatry, PCP, gastroenterology, physiatry, and nephrology claims daily.

Accountable for collections and up to $10,000 worth of insurance payment postings daily, the issuing of patient and insurance refunds, linking and scanning EFTs and ERAs, while providing excellent customer service throughout my day.

Responsible for following up on a minimum of 20 accounts per day, generating daily balancing reports, separating daily mail, and training other employees.

Creating payment batches in E-bridge, allocating batches in Aprima, correcting denial claims with correct information, and re-submitting claims, utilizing experience in both hospital and surgical billing. Provider relations, assisting patients with payment arrangements, documenting patient accounts. Medical Assistant Dr. R Siva - Ocala, USA 05/2010 - 06/2012 Escort patients to exam rooms, interview patients, measure vital signs, including weight, blood pressure, pulse, and temperature, document all information in the patient's chart, provide patient instructions following the physician's directives, and administer immunizations when needed. Ensure all related reports, labs, and information are filed and available in patients' medical records prior to their appointment.

Keep exam rooms stocked with adequate medical supplies, maintain instruments, and prepare sterilization as required.

PT/INR

Perform a Pulmonary Function Test.

Receptionist/Billing Silver Lake Pediatrics - Leesburg, USA 11/2010 - 05/2011 Verify payment posting of ERA's

Manual post-payment for multiple insurance carriers. Generated patient statements and summarized outstanding balances for collections. Collect all co-payments and coinsurance.

Scheduling, referrals, appointment confirmations, and follow-up calls. Medical Assistant/Receptionist Gastro Consultants Dr. Sanjeev Nayyar - Old Bridge, USA 05/2005 - 10/2010 Welcomes patients and visitors by greeting them, in person or on the telephone, and answering or referring inquiries.

Optimizes patients' satisfaction, provider time, and treatment room utilization by scheduling appointments in person or by telephone.

Keeps patient appointments on schedule by notifying the provider of the patient's arrival, reviewing service delivery compared to the schedule, and reminding the provider of service delays. Responsible for posting co-pays, insurance claims, and calling in prescriptions. Escort patients to exam rooms, interview patients, measure vital signs, including weight, blood pressure, pulse, temperature, and document all information in the patient's chart. Education and Training

AAPC Linden, New Jersey 01/2019

Certificate: Professional Coder

AAPC Linden, New Jersey 01/2019

Certificate: Professional Medical Auditor

Cittione Institute Edison, New Jersey 01/2005

Certificate: Medical Billing

English:

Native/ Bilingual

Spanish:

Native/ Bilingual

References available upon request.

Languages

References

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