Medical Customer Service

MIA BELL- CPC, NCICS

***** ***** *****, ***** *****, LA 70818 • 225-***-**** • msnv80@r.postjobfree.com

Certified Professional Coder & Insurance Billing Specialist

American Association of Professional Coders

OBJECTIVE - To obtain a position as a Medical Coding Consultant in a company where the application of my prior experience will increase provider knowledge and maximize reimbursement as effectively and accurately as possible.

EDUCATION

American Intercontinental University, 2010 - Present

AABA Business Administration/ Concentration Healthcare Administration

MedVance Institute of Baton Rouge, 2005

Program: Medical Coding and Billing Specialist

Key Courses

• Anatomy & Physiology •Medical Terminology • Law & Ethics

• Medicare & Medicaid Guidelines • ICD-9 CM, CPT-4 & HCPCS Coding

PROFESSIONAL EXPERIENCE

Our Lady of the Lake Regional Medical Center, Baton Rouge, Louisiana

2011- Present

Clinic Coding Quality Coordinator/ Physician Revenue Cycle Department (Network of Over 250 Providers providing over 15 specialties)

• Abstract Diagnosis and Procedure codes for production coding from medical records

• Audit Physician Coding samples and Documentation

• Provide Physician Education

• Create fee tickets, templates, and any materials to improve provider performance and or compliance

• Provide Provider Orientation to all new physicians and mid levels

• Work with collectors to resolve insurance claim denial issues

• Work with Operations Director of Physician Revenue to resolve issues affecting providers documentation, reimbursement, and improving departmental processes

• Provide Education to Clinical Directors, Regional Managers , Clinic Office Managers, Claims Director, Claims Supervisors, Collectors and Clinical staff in decreasing errors resulting in claim denials

• Create coding / billing policies within the organization to ensure physician compliance and correct coding and billing

• Mentor externs through our externship program

• Train new employees

• Our Lady of the Lake Physician Educator

Medical Management and Billing Solutions, Baton Rouge, Louisiana 2007 – 2011

Medical Coder/ Reimbursement Specialist (Pain Management, Internal Medicine, & Hospitalist, and Pulmonary Specialist)

• Abstract Diagnosis and Procedure codes from Medical records for ASC facility, several physician groups and hospitalist.

• Educate Providers and Director of ASC facility of correct coding usage/changes, Insurance guidelines, Medicare LCD’s and NCD’s and documentation guidelines.

• Reconciled all charges for facility and providers

• Entered all charges for ASC facility and providers.

• Audit coding samples

• Audit Physician Documentation

• Work all Medicare AR and delinquent claims

• Patient collections

• Counsel patients with financial responsibility for procedures.

• Train new employees

Drs. Prem and Vimla Menon (Asthma, Allergy and Immunology), Baton Rouge, Louisiana 2007

Medical Coder

• Abstracted Diagnosis and Procedure codes from chart

• Entered charges

• Collected copays and coinsurances

• Reconciled charges

• Balanced all cash, credit card, and check payments.

• Scheduled appointments.

• Medical office procedures.

Drs. Ernest J. Mencer and Jeffery C. Littleton (General Surgeons Specializing in Burn Care) 2005-2007

Medical Coder / Office Assistant

• Abstract Diagnosis and Procedure codes from Medical records.

• Up dated physicians and office manager of coding and insurance billing changes

• Audit charts

• Worked all Medicare, Medicaid and Workers comp delinquent claims and AR.

• Follow up on all Major Burn cases

• Billed all Medicaid claims

• Patient collections

• Scheduled cases

• Verified Insurance and pre-cert procedures

• Assist office Manager

• Medical Office Procedures

PROFESSIONAL ORGANIZATION / BOARDS

• Certified Professional Coder (CPC)- American Association of Professional Coders

• National Certified Insurance and Coding Specialist (NCICS)- National Center for Competency

• Advisory Board – Fortis College

Qualifications

• Code diagnosis and procedures to highest level of specificity per operative notes, modifier usage, Audit claims for correct code usage, Audit physician documentation for compliance, Understands coding guidelines, Understands federal guidelines for correct claims submission, Understands Payer Codes, In depth knowledge of Medicare NCD’s and LCDS’s, Work delinquent claims for all insurance carriers, Understands Medicare appeals and reconsideration process.

Skills

• Type 40-WPM, Communication, Interpersonal, Customer Service, Self-Starter,

Microsoft word, Excel, Medisoft, Advantx, Duxware, Clearing Houses: Zirmed and Navicur,

Allscripts EMR, Encoder, 3M encoding software

References Available Upon Request

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