Certified Medical Coder Example Resume

OBJECTIVE

SUMMARY OF QUALIFICATIONS

• CPC Certified Professional Coder (AAPC). Over ten years experience as a medical coding professional in a variety of clinical settings.
• Perform audit coding of disease and injury diagnoses, acuity of care, and procedures
• References used for coding include the current International Classification of Diseases (ICD), Clinical Modification; American Medical Association Physicians' Current Procedural Terminology (CPT); Health Care Common Procedure Coding System (HCPCS); Physicians' Desk Reference
• Knowledge of medical terminology, anatomy and physiology
• Broad medical experience also includes billing, reimbursement, HIPPA rules, insurance verification, scheduling, and report creation
• Key strengths: communication, leadership and interpersonal skills; multi-tasking and overall resourcefulness

PROFESSIONAL EXPERIENCE

• Accurately assign ICD-9-CM and/or CPT-4 code(s) and sequence diagnosis and procedures per patient medical record
• Assure the assignment of complete, accurate, timely and consistent codes by the medical coding unit
• Reconcile clinical notes, patient encounter form, health information for compliance with HIPPA rules and JCAHO standards.
• Provide coding and documentation advice to the coding unit, clinical and professional staff.
• Analyze billing to improve coding data accuracy for Medicare compliance reimbursement
• 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, and use of AHLTA, CHCS I, CCE for compliance and data quality.

Medical Coder
Healdsburg District Hospital
Healdsburg, California
2005 - 2008

• Code inpatient and/or outpatient diagnoses and procedures using current ICD-9 CM and/or CPT-4 classifications
• Follow hospital coding guidelines and regulatory rules in governing corresponding coding decisions
• Review and abstract relevant clinical data/medical records to select and sequence the appropriate ICD-9-CM diagnosis
• Extensive use of 3M-HIS encoder
• Tutors new coders for compliance with ICD-9 classification systems and coding, regulatory guidelines

Remote Coder
Health Care Reimbursement, Inc.
Santa Rosa, California
2004 - 2005

• Code ICD-9-CM and CPT-4 charts, records for physicians
• Medicare, Medicaid, Commercial charts and other third party billing

Certified Professional Coder
Tamalpais Medical Staffing
Petaluma, California
2002 - 2004

• Responsible for compiling data from medical records to document patient condition and treatment according to standardized coding specification
• Reviewed medical records and abstracted ICD-9, CPT-4 and HCPCS codes
• Consulted on practices to ensure optimal reimbursement and compliance for organization's clients
• Ongoing development of Excel reports to record drug codes used during ER visits

Medical Coder / Medical Biller
Marincare Labs
San Rafael, California
2001 2002

• Assigns codes on all diagnoses, procedures, professional service, and supplies with the most accurate and descriptive ICD-9-CM, CPT-4, Evaluation and Management and HCPCS codes for all patient encounters for reimbursement
• Bill insurance claims automated or manual using HCFA 1500 and UB-92form (UB04)
• Verify insurance eligibility, follow-up on all insurance denials
• Audit claims for accuracy, completeness. Correct CPT and ICD10 coding errors
• Submit reimbursement claims to insurance companies and government entities
• Collect patient payments and maintain billing records

Medical Biller & Coder
Golden Gate Imaging & Pain Care
San Rafael, California
1999 - 2001

• Diagnostic Imaging Center specializing in MRI, CT scans, X-Rays and Pain Management
• Code ICD-9 and CPT for outpatient diagnostic ancillary services.
• Research claims denied for non-payment by resubmitting, appealing, or processing accounts for bad debt.
• Prepare Accounts Receivable adjustments for processing and approval
• Collect self-pay account balances, work off A/R, review EOBs and establish payment plans
• Working knowledge of payees: contract insurance, HMOs, PPOs, Medicare/Medicaid, Workers Comp

Medical Records Clerk
Evergreen Home Clinic
Colorado Springs, CO
1996 - 1999

• Retrieve/file charts, medical records
• Answer incoming telephone calls, file reports, manage mail
• Manage release of information requests
• ICD-9 &CPT-4 Coding as directed
• Maintains inventory

EDUCATION

LICENSURE/CERTIFICATION

• Certified Professional Coder (CPC), American Academy of Professional Coders (AAPC)
• Medical Billing Reimbursement Certificate
• Medical Terminology Certificate
• Basic Life Support

AFFILIATIONS

• American Academy of Professional Coders (AAPC)