Pathology Medical Coder

Sheila Denise Thomas, CPC

**** ****** *****

Palmdale, CA 93552

Home 661-***-**** Cell 310-***-****

********@******.****.***

Objective

To secure a remote Pathology Coder position with a fast paced, growing company which will allow me to use my superior coding, motivational and organizational skills.

Core Qualities

• Abstract all ICD-9 and CPT, and HCPCS codes according to the guidelines for the Pathology department

• Quality and assurance for Pathology Coders

• Slide presentations for attending Pathologists, Residents, and Fellows

• Training and development of Pathology Coders

• Work closely with Director to implement coding or billing changes within Pathology Department

Experience

UCLA Medical Center January 2006 - Present

Pathology Health Information Coder IV

Under the general supervision of the Director of Billing and Coding manager, as a Health Information Coder IV I support the Pathology Billing Office and have specific responsibility for coding of all surgeries for the Department of Pathology; billing education for Department of Pathology full-time faculty and full-time fellows. I exercise a high degree of independent judgment and creativity in identifying patterns and trends, as well as, potential opportunities or problems. I provide support for the Pathology Billing Office, and have specific responsibility of coding for the Department of Pathology including the Divisions of Outreach, Client Billing, as well as billing education of faculty and staff--including CPT database billing tracking system. Major duties include: coding all lines of business for Pathology; maintain database of CPT codes for research, enabling doctors to have readily available data for scientific presentations, papers, and grants; provide medical billing education to doctors and staff in conjunction with Enterprise compliance office on coding updates, Medicare compliance, Enterprise protocol for Medicare compliance, and insurance carrier updates; monitors and reviews coding outpatient visits to ensure proper completion by doctors and that all appropriate charges are captured; composing appeal letters for claims denied due to CPT codes; meet with faculty/department regularly regarding coding and charges; maintain an understanding of current state of the art medical practice billing.

UCLA Medical Center May 2001 - January 2006

Pathology Health Information Coder III

Verifies and abstracts CPT and ICD-9 coding for Pathology Services according to department standards for quality and productivity. Assign ICD-9 and CPT codes. After abstracting the accurate CPT and ICD-9 codes, I enter all codes and billing information into the Laboratory Information System. Identify errors in pathologist’s and staff coding to ensure compliance with coding and billing guidelines, and assist with corrective measures as needed. Work under the tutelage of an Administrative Assistant III (lead) on a day to day basis. Keep current in coding and billing practices and procedures. Receive incoming calls. Assist with updates of CPT codes and rate schedules as needed. Occasionally assists with in-service for pathologists, house staff, and staff on CPT and ICD-9 coding issues. I also direct calls or inquiries to the correct resource when appropriate. Provide accurate information in a timely manner, which is abstracted from the pathology report.

UCLA Medical Center May 2000 - May 2001

Billing Assistant II

Coordinate the collection of all patient professional fee documents on a daily basis for the Main Operating Room, Jules Stein Operating Room, Dental Operating Rooms, Obstetrics and Gynecology, Cysto / Litho, Surgery Center Operating Rooms, Malignant Hyperthermia, Cath Lab, Pediatric Pain service, Acute Pain Service, and Santa Monica Anesthesia records. Assign log numbers to each charge document and batch to billing agent in a timely manner. Track errors and resolve discrepancies directly with billing agent. Reviewed tracking reports with billing manager to explain how problems were resolved and timeliness of correction. Reconcile the charge documents to the preliminary master schedules for each area and assure that all charge documents have been captured. Resolve discrepancies due to case cancellations, name changes, misfiling of records or charge documents directly into the patient’s record etc…in a timely manner. Provide estimates to patients and / or their families, and to surgeons. Receipt credit card payments, payments made in person, over the phone, or requests mailed in, following procedures by respective credit card companies.

Education

American Career College April 1999 - March 2000

Los Angeles, CA

• Certificate of Completion in Medical Billing/Coding

Made Honor Roll in each module at American Career College

Received certificate for perfect attendance at American Career College

El Camino College August 1983 - May 1986

Torrance, CA

50 units completed

Inglewood High School September 1979 - June 1983

Additional Information

Professional Affiliations

Certified Professional Coder (CPC) licensed through the American Academy of Professional Coders member # 031425

Technical/Computer Skills

Proficient in the following coding software programs: Powerpath, Procoder, Encoder, CodeRyte, SMS, MCCS, RMS

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