Remote Senior Medical Coder (Optum)

Amanda Marie Jones, CPC

(***) ***- **** *********@*****.*** https://www.linkedin.com/in/amandamjones1985/ Latrobe, PA

OBJECTIVES

Seasoned and motivated, Remote Senior Medical Coder with Optum, a subsidiary of UnitedHealth Group. Optum's mission & core values hold me to a higher standard enabling me to reach my potential as a medical coder holding me accountable for my decisions and actions eensuring compliance by following accrediting organization coding guidelines leading to accurate coding. Optum ensures I meet these higher standards by holding annual criminal background checks including the National Sex Offenders Registry & the NAC clearance process.

Coding experience; Risk Adjustment/HCC using a computerized medical program/electronic medical record, HCC Index, Encoder, Gamma, MRM, Salesforce, and Episource software/interfaces. Degree; Medical/Healthcare Management AAS. Current AAPC member obtaining CPC credential in Dec 2021. Looking for opportunities that will allow me to leverage my skills attained in the medical coding arena & opportunities to help me advance my career.

EDUCATION

Westmoreland County Community College Youngwood, PA

Medical/Healthcare Management AAS, Diploma, and Certificate December 2021

Office Technology Customer Service, Certificate Summer 2021

President’s List, with Certificates Spring/Summer 2021

The Phlebotomy Training Center Pittsburgh, PA

Basic Phlebotomy Program, Diploma December 2011

RELATED COURSEWORK/CREDENTIALS

Credential; CPC, Virtual Internship, Abstract Coding, ICD-10-CM/PCS, & CPT-4/HCPCS

Anatomy & Physiology for the Medical Office, Biology, Business Math, Law & Ethics in Healthcare, Electronic Health Record, Medical Terminology, Procedural Medical Coding, Diagnostic Medical Coding, Hospital Billing & Coding

COMPUTER/CODING SKILLS

Microsoft Office 365 including OneDrive & SharePoint, User Interfaces: HCC Index Coder, Encoder, MRM, Salesforce, Episource, NPI Registry, Agora, MyLearning, Global Service, Gemstone, & Gamma Suites

Meeting at minimum 90% of CPH/PPH & production hours established metrics/goals

Completing monthly Coding Mastery Assessments (CMA) at 95% in accuracy/completeness

Risk adjustment coding utilizing guidelines & various charts/encounters; Medicare, Optum, Cigna, Aetna, Aetna SV/IOA guidelines & Hospital Chart Review, Physician Chart Review, Inpatient, Outpatient, Artificial Intelligence Enabled Review (AIER), First Time Coding (FTC), & Second Level Review (SLR) chart/encounter

Proficiency capturing; life-threatening, acute, chronic, non-chronic or life-long conditions/diagnoses based on applying various guidelines while using different EMR chart components, note types, & encounters

EMPLOYMENT/EXPERIENCE

CSI Companies 7720 Baymeadows Rd East Jacksonville, FL 32256 March 2022-April 2023

Optum/UnitedHealth Group 9900 Bren Rd East Minnetonka, MN 55343 April 2023-Current

Remote Senior Medical Coder with Optum, a subsidiary of UnitedHealth Group. Initially hired with CSI as a contract employee for Optum March 2022. Transitioned to full-time-employee with Optum April 2023.

Adhering to Optum, ACA, Aetna/Aetna SV-IOA, Cigna, Medicare, & ICD-10-CM guidelines to achieve accurate coding while upholding Optum Policies & Procedures using interfaces/software; HCC Index Coder, Encoder, MRM, Salesforce, Episource, Gamma Suites, & Gemstone

Maintaining coding QA at 95% in accuracy & completeness at the DX level.

Reaching or exceeding established metrics/goals at a minimum of 90% for CPH/PPH & production hours

Excela Health Latrobe Hospital One Mellon Way Latrobe, PA 15650 March 2012-August 2022

Senior Phlebotomist

Contact this candidate