Certified Professional Coder - Denials & RCM Expert

JACQUELINE ARTEAGA, CPC

Certified Professional Coder

818-***-**** ️ **********.****@*******.***

PROFESSIONAL SUMMARY

Certified Professional Coder (CPC) with 10+ years of experience in medical coding, billing, and appeals within workers’ compensation and healthcare systems. Expertise in ICD-10-CM, CPT, and HCPCS coding, denials management, and revenue cycle optimization. Proven ability to reduce claim denials, improve reimbursement accuracy, and manage high-volume workloads. Experienced working with multiple billing platforms and collaborating with insurance carriers, TPAs, and providers. Bilingual in Spanish and English.

CORE SKILLS

ICD-10-CM, CPT, HCPCS Coding

Denials & Appeals Management

Revenue Cycle Management (RCM)

Workers’ Compensation Billing

Insurance Verification & Claims Correction

Medical Documentation Review

Systems: Allscripts, Daisybill, EZ Claims, Prognosis, OccuSource, Atrium, AS400, BCS- Program

Languages: Spanish (Fluent), English

PROFESSIONAL EXPERIENCE

Coding & Appeals Specialist (CPC) Remote

Agile Occupational Medicine June 2023 – April 2026

Review and correct medical claims to ensure compliance with California fee schedule and coding guidelines

Reduce claim denials by identifying coding errors and submitting accurate corrections and appeals

Manage aging reports and prioritize high-value claims to improve reimbursement timelines

Resolve complex billing issues with insurance carriers, TPAs, and laboratories

Process rebills and ensures accurate documentation for resubmission

Maintain compliance with Timely Filing Guidelines and quality control standards

Revenue Cycle/ Appeals Specialist

Proactive Work Health Services September 2021 – June 2023

Handled high-volume appeals and corrected denied claims in accordance with state and payer guidelines

Investigated and resolved billing discrepancies to recover lost revenue

Communicated with insurance companies and third-party administrators to expedite claim resolution

Assisted in reducing backlog by efficiently managing aging reports and resubmissions

Concentra Occupational Health

Medical Collections Specialist April 2019 –September 2021

Medical Coding Specialist (CPC) February 2013- April 2019

Assigned accurate ICD-9/ICD-10, CPT, and HCPCS codes for surgical and physical therapy services

Reviewed medical records and operative reports to ensure proper E/M coding

Ensured compliance with Official Medical Fee Schedule and coding regulations

Met strict month-end deadlines while maintaining accuracy in high-volume environments

Worked across multiple systems including BCS, Atrium, AS400, OccuSource, and Allscripts

Handled high-volume appeals and corrected denied claims in accordance with state and payer guidelines

Investigated and resolved billing discrepancies to recover lost revenue

Communicated with insurance companies and third-party administrators to expedite claim resolution

Assisted in reducing backlog by efficiently managing aging reports and resubmissions

EDUCATION & CERTIFICATION

Certified Professional Coder (CPC) — AAPC

Associate of Arts, Child Development — Los Angeles Valley College

GED – Verdugo Hills High School

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