CPC

Professional Objectives:

Participate as an integral member within an environment where I will expand upon and fully utilize my skills.

Qualifications:

Over nineteen years experience with Deseret Mutual Benefits Administrators Organization. I have worked in imaging, processing, customer service, auditing, and as a team leader. I have specialized in coding reviews with the McKesson CCI editing web site for GMIS Reports, Ingenix, iCES reviews, and high cost billing, as well as Issue Trak via the Claims Management Reviews.

I have worked with the resolution of claim appeals related to claim coding and proper reimbursement.

Professional Accomplishments:

CPC certification, May 2004.

Accomplished written and oral communication skills.

Ability to read and interpret medical documentation with an understanding of clinical, coding, and legal ramifications.

Completed the Dean Vaughn Medical Terminology program.

Worked with Configuration Department to preempt system problems.

Word Perfect, Access, and Excel knowledge.

Basic knowledge of Amisys processing system.

Experience with iCES, Ingenix and McKesson CCI Editing web site.

Experience with Medicare reimbursement policies rules and regulations.

Assistant to the Deseret Mutual Fraud and Abuse investigator.

Work with and maintained close relationships within various departments.

Performed audits and compiled spreadsheets and reports on various State and Federal Cases.

Develop scenarios for computer analysis that may indicate fraud.

Skilled and knowledgeable in providing customer service.

Ability to clearly articulate coding related issues to Claims Processors Customer Service representative's and other associates who are unfamiliar with medical claim coding.

Skilled in organization and detail.

Ability to communicate with providers, vendors, and facilities in a very professional manner.

Ability to work well with all levels of people in a company.

Ability to juggle multiple tasks at one time and prioritize based on need.

Work History:

Deseret Book 1988-1991

Deseret Mutual 1992- Oct. 2011

Education:

High School Diploma

CPC Certification

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