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0-5 years of experience
Reviewed member medical records for providers to verify and insure appropriate and accurate diagnosis and procedural data in compliance with CMS and state specific guidelines.
- Reviewed member charts, lab and consult reports for identifying documented diagnosis
- Advised providers of missed opportunities
- Developed relationships with providers and staff with consistent communication and training
- Developed and maintained standard auditing policies and procedures
- Educated providers in correct documentation and coding and provided educational material
0-5 years of experience
Researched and provided proper and current medical/anesthesia codes, using the CPT and ICD-9 books
- Coded for 9 different practices out of 5 different states
- Utilized all the correct coding initiatives for each and every insurance policy as well as state law requirements
- Reviewed EOB's for various insurance carriers and completed necessary appeals needed for denials received
0-5 years of experience
Reviewed scanned medical records for documentation related to disease or symptoms and diagnostic descriptions for a given encounter.
- Demonstrated knowledge and ability to assign ICD-9 CM codes to the highest specificity ensuring that diagnostic codes and documentation accurately reflect and support the visit encounter.
- Maintained a 97% or above accuracy rate
- Maintained consistent daily production of greater than 40-60 reviews per day
- Ability to identify ICD-9CM codes with HCC or RxHCC value
- Worked on Special Projects including RADV Audits, CPT Assessment, and Vendor Training
- Reviewed In Home Physician Evaluations for Prospective Risk Adjustment
- Performed audits of Prospective and Retrospective employees
- Performed IDQA for charts in preproduction stage
0-5 years of experience
Abstracted ICD and CPT codes for Radiology department which included MRI's, CT Scans and X-rays
- Assisted with Pain Management and GI coding
- Assembled paper charts and scanned them into system
- Assisted Medical Records department with filing
- Attended all coding meetings and seminars
0-5 years of experience
- Abstract clinical information for a variety of medical records
- Assigned appropriate ICD-9 and CPT codes to patient records
- Analyzed, entered and manipulated databases and confirmed appropriate DRG assignments
0-5 years of experience
Responsible for accurately coding medical claims to obtain reimbursement from various insurance companies and governmental health programs.
- Ensure healthcare providers meet specific documentation requirements that are essential in proper recordkeeping and claim reimbursement.
- Record, store, and report medical coding information to create statistics of healthcare encounters.
- Specialize in coding for Wound Care and Physical/Occupational Therapy Departments.
- Serve as a liaison between the healthcare providers and Billing Department.
- Compare account charges with documentation to ensure it is correct for final claim submission.
6-10 years of experience
Responsible for timely and accurate coding/filing for ER physicians, Cardiovascular/Thoracic Surgery and General Surgery
- Accurately assign ICD 9 codes, sequencing diagnosis per patient medical record for physician billing in CVT Surgery and General Surgery specialties
- Review and abstract relevant clinical data from electronic medical records to select the appropriate CPT code for procedures
- Audit E/M billing for ER department to improve coding data accuracy for Medicare compliance reimbursement
- Ensure all coded data accurately reflects service provided, based on documentation, guarding against fraud and abuse
- Consult with physicians to ensure optimal reimbursement and compliance for organization's clients
0-5 years of experience
Code medical records with ICD-9, CPT-4 and HCPCS processing 200 claims daily while maintaining 95% accuracy and achieving productivity goals
- Responsible for performing claims review based on medical records documentation and compliance guidelines to ensure accurate patient billing
- Coordinate and review all patient accounts to ensure proper billing-coding following medical guidelines and compliance rules
- Code drugs and anesthesia for pain management
10+ years of experience
Interpret health record documentation using knowledge of anatomy, physiology, clinical disease processes, pharmacology and medical terminology to identify code able diagnosis and procedure.
- Assign and sequence the correct ICD-9 CM and CPT code accurately and completely.
- Interpret and applied regulatory guidelines to coding and reimbursement decisions.
- Assure adherence to department quality and productivity standard.
- Reconciles NCCI correct edits and discrepancies prior to final coding.
- Maintain 100% correct coding and accuracy.
- Experience in coding ER E/M level, Radiology, Laboratory, MRI, Pre-Natal, Labor Observation, Pre -admission Testing.
- Using Modifier and HCPC and adding charges when needed.
10+ years of experience
- Worked from home & on-site Coding Office Visits and Procedures ICD9 & CPT into PACE Software System
- Used Encoder Software Coding Program
- Responded to patient and Insurance inquiries
- Coordinated Coding with Medical Transcriptionists and Front Desk Staff
- Consistently meet or exceed three day turn-around time of coding
- Clarified treatment with Doctors, Physician Assistants & Physical Therapists ensuring assignment of the correct code
0-5 years of experience
Apply ICD-9-CM Psychiatric and Rehabilitation diagnostic codes to patient encounters in compliance with applicable state and federal statutes/guidelines and Company policies and procedures.
- Reviews medical record documentation to select and appropriate coding sequence.
- Query providers as needed to ensure coding and documentation compliance.
- Meet quality and productivity standards and deadlines/turnaround times established by Company policies.
6-10 years of experience
Coding inpatient, outpatient, observation, emergency room, and diagnostic medical services with the appropriate codes from ICD9CM and CPT manuals
- Responsible for management and distribution of work to team members
- Ensure proper determination of billing requirements to Third party payers
- Verifies signatures and checks medical charts for accuracy and completion
- Utilizing company software and input information into computerized patient record system
- Handle the tasks of verifying the diagnoses and procedures of the patients with the physicians
- Handle the tasks of identifying billable claims, correcting and submitting insurance claims
- Handle other essential duties as assigned or required
0-5 years of experience
Communicate with the Auditor/Trainer discrepancies with the physician's coding.
- Responsible for coding 120-135 outpatient encounters on a daily basis.
- Designed a timecard sheet on Excel for the company and a production sheet in Excel.
- Report daily productivity twice a month.
0-5 years of experience
Transcribe medical information for more than 100 patients
- Assign medical diagnosis codes to patient records for insurance purposes
- Apply charges and update patient records
- Prepare patient charts for registration according to physician's assessment
- Provide interdepartmental support and service, e-mails and faxes
10+ years of experience
Assign diagnoses and procedural codes to Inpatient, Outpatient, Observation and ER encounters
- Meets and exceeds coding productivity requirements while maintaining performance in accordance with corporate compliance
- Participates in and applies the principles of the 3M DRG Assurance Program to ensure DRG assignment accuracy
- Extensive education in and knowledge of MS DRGs and POA
6-10 years of experience
Accurately evaluate and code diagnostic and procedural information for highly complex pediatric general
surgery procedures.
- Assist surgeons with development and implementation of electronic templates to ensure precise coding and billing.
- Chart auditing to insure that the level chosen by the physicians are correct.
- Contributing team member of monthly quality coding committee.
0-5 years of experience
Manage outpatient coding for medical centers registered with the hospital
- Process a minimum of 100 claims a day conforming to ICD-9 and CPT-4 standards
- Punch patient information into database
- Handle claims relevant to surgeries, chiropractor visits and diagnostic testing
0-5 years of experience
Protected the security of medical records to ensure that confidentiality is maintained.
- Reviewed records for completeness, accuracy, and compliance with regulations.
- Released information to persons or agencies according to regulations.
- Entered data, such as demographic characteristics, history and extent of disease, diagnostics procedures, or treatment into computer.
0-5 years of experience
Perform ICD-9-CM, CPT and HCPCS coding for reimbursement.
- Review, analyze, and approve codes for diagnostic and procedural information that determines Medicare, Medi-Cal and private insurance payments.
- Reviews non-CC/MCC records
- Ensure compliance with established coding guidelines, third party reimbursement policies, regulations, and accreditation guidelines.
- Review health records to identify proper relationships between procedure and diagnosis codes utilizing EndCoder systems and modifier relationships.
- Guarantee the final diagnoses and operative procedures as stated by the physician are valid and complete.
- Confirm appropriate Evaluation & Management (E & M) levels are assigned using the correct CPT code.
- Collaborate with the health care professionals to resolve discrepancies in coding practices.
0-5 years of experience
Ensure CPT and ICD-9 codes are correctly linked as per National Correct Coding Initiative Guidelines.
- Process insurance company denials by auditing patient files, researching procedures and diagnostic codes to determine proper reimbursement.
- Reviewed account information to confirm that patient and insurance information is accurate and complete.
- Charge entry and payment posting
- Knowledgeable of Medicare, Medicaid, Blue Cross/Blue Shield and Commercial health insurance policies
- Assist and coordinate with physician office staff in resolving claim and coding issues.
- Posting A/R according to individual insurance contracts.
- Professionally responded to customer inquiries regarding account status.
- Resolve complex billing denials related to coding errors by submitting Operative Reports to all insurance companies for claim reconsideration.
- Attended appropriate training sessions and continuing education on current coding practices to stay up to date on physician billing practices.
0-5 years of experience
Assigned ICD-9 for diagnoses, treatments, and procedures according to the appropriate classification system for patient
- Entered patient's demographic information into MedBook computer software.
- Reviewed patients registration forms for accuracy and completeness.
- Handled front office duties including filing, check in and checkout patients.
0-5 years of experience
Assign codes for anesthesia services for a large physician group, using CPT codes and guidelines.
- Ensure appropriate documentation is available for anesthesia start and stop times.
- Append the appropriate ASA status modifiers and determine optimal base unit values.
- Remain current with state and federal guidelines relative to anesthesia coding.
0-5 years of experience
Code an average of 100 E/M and procedures services that are performed in the ER daily
- Query physicians for accuracy on documentation of medical charts and procedures
- Work closely with other team members to improve the functionality of our department
- Document data and error rates on excel spreadsheets for data entry
0-5 years of experience
- Abstracts clinical information from a variety of medical records and assigns appropriate ICD 9 and/or CPT codes to patient records according to established guidelines.
- Assist staff members with medical necessity denials as well as payer rules regarding CPT, ICD 9 assignment.
- Provide coding and documentation advice to the physicians.
- Seek clarification from physicians and other hospital personnel for answers to any needed coding interpretations prior to abstracting records.
- Attend training seminars/webinars to maintain coding guidelines and reimbursement reporting requirements.
- Attend bi-monthly meetings with IR Chief to address unresolved issues/questions.
0-5 years of experience
Abstract and code HCC diagnoses and documentation information
- Research and resolution of coding projects
- Document requested information from the medical record
- Determine valid encounters, including legibility and valid signature requirements
- Identify valid face-to-face encounters
- Perform ongoing analysis of medical record charts for the appropriate coding compliance
- Meet daily production and quality goals
0-5 years of experience
Code, enter and review office visits for accurate ICD-9, CPT and HCPCS codes for Patient charges and Laboratory charges.
- Created and submitted claims to insurance companies
- Insurance follow up on claim appeals/denials
- Generate reports for denied claims
0-5 years of experience
- Responsible for the coding for the out patient for the medical center.
- Responsible for handling different types of medical claims which includes surgery, physical therapy, ER, diagnostic testes, etc.
- Utilized HCPCS level III, ICD-9 and-3 for the coding.
- Maintained the 97 percent of accuracy and productive quality.
10+ years of experience
- Accurately assign ICD-9-CM and CPT-4 codes and sequence diagnosis and procedures per patient medical record.
- Assure the assignment of complete, accurate, timely and consistent codes by the coding department.
- Reconcile clinical notes, patient encounter form, and health information for compliance with HIPAA rules and CMS regulations.
- Provide coding and documentation advice to the coding and billing departments.
- Ensure coded data accurately reflects service provided, based on documentation, guarding against fraud and abuse.
- Conduct training, in-service and other education regarding diagnosis, procedure code assignment, regulatory requirements for compliance and data quality.
- Tutored new coders for compliance with ICD-9 classification systems and coding guidelines.
0-5 years of experience
- Looked over patient’s electronic health records for missing information and errors
- Applied the correct codes for encounters and submitted claims
- Reported any errors and missing information
6-10 years of experience
- Review, analyze and manage medical record information to identify appropriate coding of diagnostic and treatment procedures based on CMS categories
- Maintain strict patient and physician confidentiality
- Resourcefully use various coding books, procedure manuals and on-line encoders
- Actively maintain current working knowledge of CPT and ICD-9 coding principles, government regulation, protocols and third party requirements regarding billing
10+ years of experience
Code all in patients and out patient procedures in Radiology
- Daily coding of CT's, MRI's, PET's, Ultrasounds, Bone Density
- Electronically transmit Medicare on daily basis
- Assist Administrator with billing and software issues
- Responsible for daily credits and debits to hosp accts
- Assist referring physicians and staff with TARS
- Train all new data entry clerks
- Compile statistical data for PR Director and Medical Director
0-5 years of experience
- Provide accurate Anesthesia coding for hospitals and surgery centers
- Review and properly code surgical Pathology reports
- Audit off-site coders and provide feedback
- Conduct physician chart reviews/audits in preparation for ICD-10
- Research Billing department inquiries concerning diagnosis/procedure codes and duplicate charges
0-5 years of experience
Responsible for entering Patient Demographics in PK system
- Daily verifications of patients insurance on Emdeon System
- Responsible for updating Daily Spreadsheets
- Processed patients prescriptions refills
- Forward prescriptions to Billing Department
0-5 years of experience
- Reconcile anesthesia records from various departments
- Look up insurance information for upcoming charges
- Enter anesthesia charges into IDX for GI, OB, and OR
- Resolve conflicts within calculation reports
- Handle incoming mail, telephone calls and faxes
6-10 years of experience
- Evaluate the effectiveness of the implemented recommendations and decide on its retention.
- Make suggestions to redesign the coding procedures to simplify process and eliminate the possibilities for mistakes.
- Perform medical coding audit of the organization to find out inefficiencies and discrepancies within the billing systems and drafted bills.
- Gather medical records and accounting statements from record department for assessment.
- Review the organization's coding and billing systems for accuracy.
- Bring to notice any calculation errors, overestimations within the bills.
- Daily use of reports and in office procedures using CPT, ICD 9 and HCPCs codes.
0-5 years of experience
Handled patients health records while honoring medical and legal guidelines
- Verified health insurances and process authorizations for patients future surgeries
- Informed patients about medical bills and upcoming appointments
- Scanned and filed medical records in alphabetical order
0-5 years of experience
- Responsible for collecting, posting, and managing account payments
- Review records for completeness, accuracy and compliance with regulations
- Complete insurance and other claim forms
- Answer telephones, and direct calls to appropriate staff
- Interview patients to obtain medical information and measure their vital signs, weight, and height.
- Responsible for submitting claims and following up with insurance companies.
0-5 years of experience
Process medical bills for automobile related claims
- Call providers for updates and, or information
- Process payments for medical providers and insured's
- Responsible for provider line and responding to inquires
- Support team of five typing correspondence for injured parties
- Serves as receptionist when needed
- Deliver incoming mail and/or packages to the proper person upon receipt, processed outgoing mail and distribute faxes
- Provide customer service by assisting customers face-to-face as well as over the phone
- Provide routine office support for claims unit
- Order files from Iron Mountain for entire claims office
0-5 years of experience
Review anesthesia documentation procedural and surgical documentation.
- Assures documentation by physicians conforms to compliance and legal requirements.
- Provide feedback to the practitioners on coding practices.
- Ensures strict confidentiality of medical records and responsible resolution of coding edits that occurs.
- Assign ASA codes, surgery CPT codes as well as diagnosis pertaining to ICD-9 guidelines.
- Additional daily coding of day surgery outpatient procedures, critical care trauma, pain management.
- Critical care trauma acute care facility coding
- Inpatient progress notes, and consults facility coding
- Following CMS guidelines for a teaching facility acute care
- Utilizing Cerner, IDX and Optum Encoder
0-5 years of experience
- Reviewed medical records for accuracy of ICD-9 and CPT codes.
- Ensure accuracy of patient data.
- Maintain confidential information.
0-5 years of experience
Coding from patient medical records based on exams and treatment plans
- Entering changes after coding is completed.
- Obtain daily authorization for PIP/WC/DME as needed for treatment.
- Answering phones and scheduling appointments
10+ years of experience
- Posted charges for family practice and OB specialty providers.
- Monitored patient's medical records for dictation and coding accuracy.
- Monitored patient's insurance demographics thru online verification access.
- Processed clean claims for billing.
