(Intergy, Clinical R&V, G4 Studio, OWAN), Review Medicare Local Coverage Determinations (LCDs) and Medicare bulletin updates and Medicare NCCI, Detail oriented and possesses excellent analytical skills, Work under limited supervision with ability to understand and meet deadlines as workload necessitates, Ensure applicable laws and regulations of working with confidential information are adhered to, Consistently reports to work on time and prepared to perform duties of position, Demonstrate flexible and efficient time management and ability to prioritize workload, Communicate regularly with Management about Department issues or process improvement initiatives, Medical Billing/Coding Diploma or Certificate Required, 2 or more years of coding experience in hospital or medical office setting required, Excellent computer skills including Microsoft Office especially Word and Excel, Ability to communicate clearly and effectively verbally and in writing, Confirm patient demographic, insurance and referring physician information is accurately entered into practice management system, Confirm insurance verifications and authorizations, as required, Communicate with Financial Counselors regarding insurance authorizations and referrals, Review daily physician schedules and evaluate office consults and office visits for appropriate complexity using CPT coding guidelines, Enter all CPT and ICD-9 coding into practice management system timely and accurately for code capture, Enter all word codes into practice management system per company policy and procedures, Follow established check and balance systems to ensure complete and accurate code capture, Respond to audit findings and make applicable coding additions or corrections, Update practice management system patient’s account notes with any changes made to patient information or as otherwise dictated by company policy and procedure, Confirm all documentation required for coding is complete and meets required regulations, Must be able to plan and prioritize workflow, Experience in hospital or medical office setting, Certified Professional Coder Certification (AAPC), Extensive travel outside the office is required and a valid driver’s license is required. Actively code diagnoses (ICD-9) based on medical record documentation, Review records for completeness, accuracy and compliance with regulations. Other duties listed on a Hedis Nurse example resume are ensuring clinical support, educating staff on Hedis system issues, implementing corrective action plans, taking part to audits, and preparing reports. Carefully coded disease and injury diagnoses, acuity of care, and procedures in an inpatient and outpatient setting. Responded to billing and coding questions from providers, staff and administrators. Produce medical reports, correspondence, records, patient-care information, statistics, medical research, and administrative material. hospital, large physician group practice, health plan, etc. Initiated, performed and documented quarterly coding audits for physicians. Choose the Best Format for Your Medical Coder Resume . Took part in training all externs that were brought in. Coding and charging facility services for outpatient observations. Answer inquiries concerning the progress of medical cases, within the limits of confidentiality laws. Objective : Intermediate-level position in medical coding, billing Office and also looking to work front desk and billing patient accounts. 1 Certified Medical Coder Resume Examples & Samples. Resume Database Template Menu. I am seeking a position with a company or facility where I can apply my knowledge and expertise in the field of Medical Insurance Billing and Coding. Keep your resume up-to-date. Skills : MS OFFICE, MS WORD, MS EXCEL, Internet Research, Medical Billing, Medical Coding. Receive and screen telephone calls and visitors. As a general rule of thumb, your resume does not need to expand upon every single job or duty you have held. Create, maintain, and enter information into databases. Headline : Responsible ER Clerk proficient in Check Patient In/Out, Prepare Patients for transfer, update Patients demographics as needed. Resume for Entry Level Medical Coder (No Experience) ... Medical coders find work of coding explicit codes of any given system so that the payments of a healthcare professional can be managed. This education is being used by some of the top health systems in the country, You’re a key player in Precyse's Compliance Program, demonstrating knowledge of HIPAA Privacy and Security Regulation information, promoting confidentiality in handling patient information, Our coding colleagues work for Precyse, coding records for multiple clients where the hospital has outsourced either all or a part of the coding functions to Precyse, Active RHIA, RHIT, CCS, CCS-P, CPC or CPC-H, A minimum of two (2) years’ experience coding patient records in a hospital HIM department, Must have a thorough knowledge of medical terminology, anatomy and physiology, Must be able to pass a pre-employment assessment, Work closely with the client’s HIM and other support departments, Active RHIA, RHIT, CCS, CCS-P, CPC, COC, CIC, or CPC-H, Experience coding Inpatient Acute Facility and/or Outpatient medical records, Be an active participant in client and nThrive staff meetings, training and conference calls, often using online technology, Learning is a daily part of your role with nThrive – keep your coding knowledge base current with nThrive Education, available to all coding colleagues. Communicates with the Operations Manager to find solutions and implement changes to increase productivity and department efficiency, Performs all duties and interacts with others in a professional manner, Two years of Outpatient Coding experience required, Must meet CPC Certification eligibility requirements and must obtain CPC Certification within 3 months of position, Comprehensive understanding of ICD10 and CPT coding, Demonstrated ability to create strong working relations with physicians and practices, Capable of working independently as well as in a team environment, Responsibilities include: Applying CPT - 4 and ICD - 10 codes by translating dictated pathology reports, in a timely and accurate manner, Responds to accounts receivable department when coding discrepancies need reviewed due to payer denials, Active AAPC coding certification CPC or Active AHIMA coding certification CCS, Experience working in a measured production and quality based environment, Compile, abstract and maintain patient medical records to document condition and treatment. Thoroughly researched newly identified diagnoses and/or medical procedures to expand skills and knowledge. Medical Billing And Coding Resume … Core competencies include accurate diagnosis, timely filing and accurate account receivables as well as excellent communication and time management skills. Prepare for shipping out to another office/business Update patients demographic as needed. Staff will meet with physicians in the clinical setting as needed for documentation instruction, Provides education to physicians and staff clinicians in accordance with National Correct Coding Initiative (NCCI) guidelines, Provides documentation and coding audits of all billing providers within the practice based on documentation guidelines, Medicare Teaching Guidelines and NCCI coding initiatives, Identifies bundled charges and bills appropriately according to University compliance guidelines, federal regulations and NCCI coding initiatives, Prior experience as a Medical Coder I or equivalent work experience, Medical, dental, vision and life insurance benefits, Ongoing training and opportunities for career advancement, Award winning, inclusive environment with Employee Resource Groups, Enter medical billing information into medical audit system (ICD9 diagnosis codes, CPT4 procedure codes), Ensure billing codes correspond accurately with the claim notes, Apply all applicable fee schedule and coding rules, making appropriate adjustments where applicable, Provide fee schedule reimbursement date for subrogation claims, Ensure AOB (Assignment of Benefits) has been submitted to provider, Answer incoming calls from customers, providers, billing offices or attorneys; providing timely responses to their claims inquiries, Sort incoming bills by coder and distribute accordingly, Review unmatched bills and correctly identifying the claim, Mail EOB (Explanation of Benefits) statements to providers, Strong data entry skills, communication & customer service skills, Prior CPT-4 and ICD-9 coding experience preferred, Prior experience as a Medical Coder I or equivalent work, 2+ years of Coding experience in a Hospital setting, RHIT / RHIA, CCS, AHIMA or CCP certification, Knowledge of Coding guidelines, Payor guidelines, Federal Billing guidelines, Microsoft Office/Suite proficient (Excel, Word, etc. The medical billing courses of action have the medical coders as vital supports of this industry. Verify accuracy of documentation such as Medical Records, Procedures, Medical Coverage and Date of Service to insure a correct claim is sent and prompt payment from payers. Reviews the records for compliance with established third party reimbursement agencies and special screening criteria. and/or as requested by medical leadership or CBO management, Monitor Coding changes to ensure that most current information is available, Provide coding support to Central Billing Office as requested, ICD-10 Proficiency Certification required, Certified Medical Coder with either CPC, CCS-P, Knowledge and experience in health care/managed care environment, Direct Cardiology coding experience ideal, Certified Cardiology Coder (CCC) preferred, Experience with HEDIS performance measures and Medicare STAR ratings, Prior work experience with curriculum design combined with stand up and delivery of complex content - specific to medical coding, Medical coding certification (AHIMA or AAPC), Computer literate (MS Word, Power Point, Excel), Ability to travel within the assigned region as necessary, Prior coding experience in managed care at least 5 years preferred, Understand the importance of accuracy related to charge entry, Knowledge of standard governmental billing requirements, Payer requirements, and HIPPA regulations, Knowledge of insurance guidelines especially Medicare and state Medicaid, Hematology and Oncology coding certification, 2+ years of Coding experience and knowledgeable regarding assignment of DRG codes, invasive procedures and co-morbidities which may affect DRG reimbursement, CPT and ICD 9/10 code, RHIT/RHIA, CCS, AHIMA or CCP certification, Knowledge of Coding, Payor, and Federal Billing guidelines, Knowledge of Anatomy, Physiology & Disease processes, CCS and knowledgeable with 3M/HDS coding application, 2+ years of work experience in a Healthcare-setting or equivalent education, American Academy of Professional Coders (AAPC) Certified Professional Coder –Apprentice (CPC-A) or American Health Information Management Association (AHIMA) Certified Coding Associate (CCA), Knowledge Medical Terminology and Human Anatomy, (AHIMA) RHIA, RHIT, CCS, CCS-P, approved ICD-10-CM trainer, or approved ICD-10-CM/PCS trainer, Certified Medical Coder with either CPC, CCS, COC or CSSP with high degree of competency in this area, Strong knowledge or certification in ICD-10 coding, Ability to visit and educate Clinic Staff, 3 years of Medical Coding experience in an acute care setting, Knowledge of coding guidelines, payer guidelines, and federal billing guidelines, CCS experience and knowledgeable with 3M/HDS coding application, Knowledge of anatomy, physiology and disease processes, CPC or CCS-P Coding Certification or CPC-A with coding experience, Ability to drive to provider offices throughout Polk, Osceola, Orange, and Sumter Counties and be on site at provider offices approximately 75% of the time, Prior experience in a fast paced insurance or health care setting, 1+ year of related Coding experience (CPT, ICD-9, and ICD-10), Experience following-up with insurance companies, Prior experience with Managed Care Companies, Working knowledge of Next Gen or Electronic Health record system, CPC, CRC, or CCS-P Coding Certification or CPC-A with coding experience, Minimum of 18 months of prior medical coding experience, Ability to drive to provider offices in the Memphis and surrounding areas approximately 3-4 days weekly, Bachelor’s Degree in business administration or related field preferred/or a combination of advanced training and experience, 2 years of experience with coding and reimbursement activities, Demonstrated knowledge of ICD-9 & CPT4 Coding, Demonstrated knowledge of computerized billing systems, Knowledge of third party insurance billing policies, procedures, regulations and billing requirements and government reimbursement programs, CPC-A certification with coding experience, Ability to drive to provider offices and be in the field approximately 50%, CPC - A coding certificaiton with coding experience, Responsible for MRA aspects of market management, including managing the MRA coder team, Executes MRA initiatives within the local market, Coordinates and deploys MRA training policies/objectives to the local team, Plans and directs MRA training techniques and suggests enhancements to existing training programs within existing markets, Use detailed analysis/consideration of financial and operational implications to make recommendations to the MSO and physician groups, Medicare Risk Adjustment, Documentation and Medicare Advantage experience, Professional coding certification such as CPC, CCS-P, CRC, or RHIT, Demonstrated experience partnering with senior leadership on strategic initiatives, Proven planning, preparation and presentation skills, Demonstrated ability to manage multiple projects and meet deadlines, Comprehensive knowledge of all Microsoft Office applications, Ability to travel throughout the local market approximately 2-3 days weekly with occasional overnight travel, Strong collaboration and relationship building skills, Proficiency in analyzing and interpreting financial trends for health care costs, administrative expenses and quality/bonus performance, Comprehensive knowledge of Medicare policies, processes and procedures, Evaluate the element of the medical record for diagnosis code selection, Effective Communication and Professionalism, Certification in American Health Information Management Association (AHIMA): RHIA, RHIT, CCS, CCS-P, CCA; American Academy of Professional Coders (AAPC): CPC-H, Solid assessment and documentation skills, Successful completion of a Coding certificate program with AHIMA approval status, 18+ months of prior medical coding experience, Prior experience in a fast paced insurance, health care, or physician office setting, HCC coding experience not required, but is a plus, Associate's and/or Bachelor's Degree in Health Information Management, AHIMA certification; Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS) or Certified Coding Specialist – Physician (CCS-P), Knowledge of ICD-CM (current edition) and ICD-PCS coding systems, Microsoft Office/Suite proficient (Excel and Word, 5+ years of Medical Coding experience or related work experience, Knowledge of 3rd party payer requirements and Federal / State guidelines and regulations pertaining to Coding and Billing practices, Be a key player in the revenue cycle process by working closely with the client’s HIM and other support departments, Be an active participant in client and Precyse staff meetings, training and conference calls, often using online technology, Learning is a daily part of your role with Precyse – keep your coding knowledge base current with Precyse University, available to all coding colleagues. Pulmonology experience preferred, Performs various clerical functions as requested by the supervisor or group lead, Responsibilities include: Applying CPT-4 and ICD-9 codes by translating dictated pathology reports, in a timely and accurate manner, Responds to accounts receivable department when coding discrepancies need reviewed due to payor denials, Understand and follow all department and company SOP’s, Perform special projects as assigned by the manager, Ability to work independently and on a team, Updated Medical Coding Certification is mandatory, Minimum of 1 years of coding experience in an MLTC preferred but not required, Thorough knowledge of ICD-9 and working knowledge of ICD-10 coding is required, Performs clinical coverage review of post-service, pre-payment claims, which requires interpretation of state and federal mandates, applicable benefit language, medical and reimbursement policies, coding requirements and consideration of relevant clinical information on claims with aberrant billing patterns, Performs clinical coding review to ensure accuracy of medical coding and utilizes clinical expertise and judgment to determine correct coding and billing, Possess an unrestricted Nursing License (RN/LVN/LPN) or are a current Certified Coder (CPC/CCS/RHIT etc. Certificate Of Medical Coding Program In Professional Coding, Certificate In Medical Insurance Billing And Coding, How to write Experience Section in Medical Resume, How to present Skills Section in Medical Resume, How to write Education Section in Medical Resume. In the world of medical coding, there’s nothing more important than keeping things universal. Look to the Resume Checklist below to see how Medical Coding, Clinic, and Outpatient shares stack up against the share from resumes. Objective : Highly motivated individual with 10 years experience in the medical billing field that is very knowledgeable and organized. Support organizational initiatives by overseeing and streamlining billing and collections processes. Participate in and support internal and external prospective and retrospective reviews and audits, Educate and advise providers and their staff on proper code selection, documentation guidelines as well as assist with training and education for new hires, Identify training needs, prepare summary reports and conduct coaching as appropriate for clinicians and other staff to improve the quality of the documentation to accurately reflect the burden of illness for our patients, Serve as project and process SMEs when needed, AAPC or AHIMA certified medical coder with a minimum of CPC credential and not limited to CRC, CPC-P, CCS and COC, Ability to manage significant work load, and to work efficiently under pressure meeting established deadlines with minimal supervision, Basic Microsoft office skills: Word, Excel, PowerPoint, Ability to travel locally to various IPA sites, Advanced understanding of medical terminology, pharmacology, body systems / anatomy, physiology and concepts of disease processes, Ability to code from a variety of electronic medical records systems, This position is responsible for the accurate coding of medical records according to current ICD 9/10 guidelines as well as reporting to leadership on various coding metrics, Review insurance payments and denials and recommends coding corrections, National coding certification from AAPC or AHIMA to include one or more of the following: Certified Professional Coder (CPC), Certified Coding Specialist Physician (CCS P), Registered Health Information Administrator (RHIA), or Registered Health Information Technician (RHIT), Experience working with the Affordable Care Act and Medicare Advantage (preferred), Interpret medical record data in order to process physician and/or facility charges, Three years of medical chart abstraction and coding experience or relevant work experience required, Advanced skills with Microsoft applications which may include Outlook, Word, Excel, PowerPoint or Access and other web-based applications.
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