Certified Coding Specialist Resume Samples

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T Johns

Tyson

Johns

474 Hintz Mountain

Houston

+1 (555) 904 6332

474 Hintz Mountain

Houston

Phone

p +1 (555) 904 6332

Experience Experience

Los Angeles, CA

Certified Coding Specialist

Los Angeles, CA

Feest-Carter

Los Angeles, CA

Certified Coding Specialist

Work with departments to optimize reimbursement, ensure charge capture, reduce late charges and provide feedback to providers
Maintains working knowledge of clinical documentation improvement program and functions as liaison for RN clinical documentation specialists (inpatient coding professionals only)
Codes and abstracts diagnosis and procedure information from patient medical records according to AHA ICD-9-CM/ICD-10-CM/PCS and AMA CPT-4 coding conventions, UHDDS and CMS guidelines and regulations. Utilizes the 3M Encoder to verify and assign AHA ICD-9-CM/ICD-10-CM/PCS and AMA CPT-4 codes, and MS-DRG/APR-DRG assignment
Work with department management on coding interface, development, enhancements and changes, as well as implementation of those functions
Maintains daily productivity and turnaround times as outlined in Department’s Performance Improvement plan
Abstracts relevant clinical and demographic information from the medical record to assign ICD-9, ICD-10 and CPT-4 codes in accordance with coding and reimbursement guidelines
Identify incomplete documentation in the medical record and formulate a physician query to obtain missing documentation and/ or clarification to accurately complete the coding process

present

Detroit, MI

Certified Coding Specialist

Detroit, MI

Steuber Group

present

Detroit, MI

Certified Coding Specialist

present

Per standard process reviews and evaluates participant medical records to identify diagnoses and procedures and accurately assigns and sequences ICD and CPT codes. Abstracts and validates information. Seeks out validating information (queries physicians, clinicians) when provided information is inadequate, ambiguous or unclear for coding purposes
Assures that accurate, complete client care documentation is completed timely, in preparation for billing (RAPS, charge tickets, etc). Ensures staff are aware of and respond to alerts/queries/questions by computer, voice mail and other means. Provides feedback to clinicians and others that support completion of LIFE plan within site timelines
Identify incomplete documentation in the medical record and formulate a physician query to obtain missing documentation and/or clarification to accurately complete the coding process
Codes and abstracts diagnosis and procedure information from patient medical records according to AHA ICD-10-CM/PCS and AMA CPT-4 coding conventions, UHDDS and CMS guidelines and regulations. Utilizes the 3M Encoder to verify and assign AHA ICD-10-CM/PCS and AMA CPT-4 codes, and MS-DRG/APR-DRG assignment
Monitor billing performances to ensure optimal reimbursement while adhering to regulations prohibiting unbundling. Prepares periodic reports for clinical staff identifying unbilled charges due to inadequate documentation
Maintains daily productivity and turnaround times as outlined in Department’s Performance Improvement plan (attachment A)Responsible for remaining up-to-date with knowledge of AHA ICD-9-CM/ICD-10-CM/PCS and AMA CPT-4 coding conventions, MS-DRG and APR-DRG principles and guidelines
Advise and instruct coders/providers regarding billing and documentation policies, procedures, and regulations; interacts with providers regarding conflicting, ambiguous, or non-specific medical documentation, to obtain clarification

Education Education

Bachelor’s Degree in Accuracy

East Carolina University

Bachelor’s Degree in Accuracy

Skills Skills

Professional Coder certification
Proficient computer skills (MS Word, Excel, ICD-9-CM, CPT-4, Encoder)
Knowledge of coding guidelines, payer guidelines, federal billing guidelines
Coding experience and knowledge in medical terminology
Ability to research coding related issues
Knowledge of anatomy, physiology and disease processes
Inpatient Medical coding experience

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Certified Coding Specialist Resume Examples & Samples

Professional Coder certification
Proficient computer skills (MS Word, Excel, ICD-9-CM, CPT-4, Encoder)
Knowledge of coding guidelines, payer guidelines, federal billing guidelines
Knowledge of anatomy, physiology and disease processes
Ability to research coding related issues
Inpatient Medical coding experience

Certified Coding Specialist Resume Examples & Samples

Previous experience in medical records department preferred
Possess thorough knowledge of anatomy and medical terminology
Knowledge of CPT and ICD-9, ICD-10, HCPCS coding, medical billing functions, and medical record storage, retrieval and interpretation
Strong Computer skills
Insurance Or Medical Billing experience preferred

Certified Coding Specialist Resume Examples & Samples

Minimum of three to five years’ experience in similar position in a medical office setting preferred
Coding experience and knowledge in medical terminology
Proficient use of computer preferred

Certified Coding Specialist Resume Examples & Samples

Per standard process reviews and evaluates participant medical records to identify diagnoses and procedures and accurately assigns and sequences ICD and CPT codes. Abstracts and validates information. Seeks out validating information (queries physicians, clinicians) when provided information is inadequate, ambiguous or unclear for coding purposes
Assures that accurate, complete client care documentation is completed timely, in preparation for billing (RAPS, charge tickets, etc). Ensures staff are aware of and respond to alerts/queries/questions by computer, voice mail and other means. Provides feedback to clinicians and others that support completion of LIFE plan within site timelines
Monitors and informs manager of records that are not completed timely. Monitors, investigates and takes appropriate action for records that are not coded, billed, or rejected
Keeps current in area of expertise and assures that standards and practices within the site reflect best practice in coding and LIFE plan accuracy. Attends educational opportunities to enhance knowledge in coding and reimbursement systems and obtains/maintains certification from AHIMA or AAPC to validate coding skills
Formal training in ICD and CPT coding or previous work experience utilizing ICD and CPT coding principles is required
Licensure/Certification: certified coding specialist through AHIMA or Certified Professional Coder through AAPC is required
Two years' experience in a risk adjustment coding environment or another healthcare institution input/output coding preferred
Demonstrates knowledge of medical terminology, human anatomy and physiology, and diseases processes
Candidates must have the ability to travel 10% of the time

Certified Coding Specialist Resume Examples & Samples

Codes and abstracts diagnosis and procedure information from patient medical records according to AHA ICD-10-CM/PCS and AMA CPT-4 coding conventions, UHDDS and CMS guidelines and regulations. Utilizes the 3M Encoder to verify and assign AHA ICD-10-CM/PCS and AMA CPT-4 codes, and MS-DRG/APR-DRG assignment
Maintains 95% data quality coding accuracy rate as measured through quarterly department quality reviews
Maintains daily productivity and turnaround times as outlined in Department’s Performance Improvement plan (attachment A)Responsible for remaining up-to-date with knowledge of AHA ICD-9-CM/ICD-10-CM/PCS and AMA CPT-4 coding conventions, MS-DRG and APR-DRG principles and guidelines
Maintains a working knowledge of prospective payment systems as it relates directly to coding process
Participation in department and sectional meetings, education sessional sessions and workshops as scheduled
Maintains working knowledge of clinical documentation improvement program and functions as liaison for RN clinical documentation specialists (inpatient coding professionals only)

Certified Coding Specialist Resume Examples & Samples

Codes and abstracts diagnosis and procedure information from patient medical records according to AHA ICD-9-CM/ICD-10-CM/PCS and AMA CPT-4 coding conventions, UHDDS and CMS guidelines and regulations. Utilizes the 3M Encoder to verify and assign AHA ICD-9-CM/ICD-10-CM/PCS and AMA CPT-4 codes, and MS-DRG/APR-DRG assignment
Maintains 95% data quality coding accuracy rate as measured through quarterly quality reviews
Maintains daily productivity and turnaround times as outlined in Department’s Performance Improvement plan

Certified Coding Specialist Resume Examples & Samples

Abstract required medical and demographic information from the medical record and enter the data into the system to ensure accuracy of the database. Responsible for correcting any data found to be in error after reviewing the medical record and comparing with system entries. Complete work assignments in a timely manner. Submit a monthly auditing/training schedule to the Manager. Submit completed Inpatient, SDS, and ED audit spreadsheets with details for each chart. Submit audit summaries for Inpatient, SDS and ED coding. Submit all educational documents for all patient types to Management. Perform reviews on Third Party Audit findings/outcomes and prepare report for HIM and Compliance
Assist with identifying continuing education needs and opportunities. Coordinate continuing education by contacting clinical staff and arranging in-services for the coding staff, as well as keeping current with other education being offered by AHIMA and other professional organizations. Assist with training new staff for inpatient, SDS and ED coding. Also coordinate re-training of staff as needed due to coding changes/updates, results of audits, etc. Communicate effectively with Patient Business Services, physicians and ancillary departments as necessary to submit accurate and timely billing
Code Inpatient, SDS and ED charts as necessary. Assign the principal and secondary diagnoses and procedures by thoroughly reviewing all documentation in the medical record utilizing knowledge of anatomy, physiology, medical terminology and pathology. Review the discharge summary, history and physical, physician progress notes, consultation reports, radiology, laboratory, pathology, operative records, emergency room record to accurately assign a diagnosis and / or procedure. Determine diagnoses that were treated, monitored and evaluated and procedures done during the episode of care and assign appropriate codes
Ensure the diagnoses and procedures are sequenced in order of their clinical significance to accurately assign the appropriate DRG, APC or payment tier under the Prospective Payment system to guarantee accurate reimbursement on UPMC patients. Review coding for accuracy and completeness prior to submission to billing. Utilize standard coding guidelines and principles and coding clinics to assign the appropriate ICD-9-CM and CPT codes including modifiers for correct DRG/APC assignment and accurate reimbursement. Identify incomplete documentation in the medical record and formulate a physician query to obtain missing documentation and/ or clarification to accurately complete the coding process. Utilize computer applications and resources essential to completing the coding process efficiently, such as QuadraMed encoder, Cerner and MARS to ensure timely billing
Review and evaluate focused UPMC DRG or APC medical records for accurate payment prior to billing to ensure that all documented principal and secondary diagnoses, complications and co-morbidities, and procedures are accurately coded . Perform internal quality assurance audits on inpatient, SDS, and ED coded records. Summarizes findings and report these to the Manager. Identify areas of coding weakness and develop training plans to address these. Provide audit findings to coding staff members electronically for coders to review. Discuss audit findings with each coder individually as needed for further clarification. Develop and present Inpatient/SDS/ED coding seminars for continuing coder education as

Certified Coding Specialist Resume Examples & Samples

CPC or RHIT required
Must have previous experience in insurance billing, ICD-10, and CPT coding and charge entry
Must have two years of experience in a medical office setting
Must have attended recent courses in coding or demonstrated advanced coding and reimbursement experience
Must have basic knowledge of medical terminology, CPT, and ICD coding principles and practices
Must have computer knowledge, typing skills, and knowledge of basic mathematics to make simple calculations
Ability to read, understand, and follow written and oral instruction including instructions related to computer software
Must demonstrate friendly and caring attitude with good telephone and communication skills
Accurate data entry skills preferred over speed
Ability to collect data, establish facts, and draw valid conclusions
Must be able to communicate clearly and establish and maintain effective working relationships with patients, staff, and the public
Must be able to operate multi-line telephone, fax, copy machine, computer, and calculator

Certified Coding Specialist Resume Examples & Samples

Abstracts relevant clinical and demographic information from the medical record to assign ICD-9, ICD-10 and CPT-4 codes in accordance with coding and reimbursement guidelines
Identifies principal and secondary diagnosis with minimal error based on the national based standards
Codes with an accuracy of 97% based on QA internal reviews
Records all diagnostic procedures and assigns appropriate procedure codes
Requests diagnosis from physicians when information is not recorded
Determines and records the required medical information
Updates coding procedures and guidelines. Works with medical assistants and other staff in coordinating medical information and patient charts
Maintains the confidentiality of the medical information contained in each record
Minimum of three (3) years medical coding experience required
Completion of a course in medical record technology is required
RHIT certification preferred
Knowledge of medical records and coding procedures is required
Working knowledge of ICD-9, ICD-10 and CPT-4 coding systems required

Certified Coding Specialist Resume Examples & Samples

Abstract required medical and demographic information from the medical record and enter the data into the system to ensure accuracy of the database
Also coordinate re-training of staff as needed due to coding changes/updates, results of audits, etc. Communicate effectively with Patient Business Services, physicians and ancillary departments as necessary to submit accurate and timely billing
Assign the principal and secondary diagnoses and procedures by thoroughly reviewing all documentation in the medical record utilizing knowledge of anatomy, physiology, medical terminology and pathology
Assist with identifying continuing education needs and opportunities
Assist with training new staff for inpatient, SDS and ED coding
Code Inpatient, SDS and ED charts as necessary
Complete work assignments in a timely manner
Coordinate continuing education by contacting clinical staff and arranging in-services for the coding staff, as well as keeping current with other education being offered by AHIMA and other professional organizations
Determine diagnoses that were treated, monitored and evaluated and procedures done during the episode of care and assign appropriate codes
Develop and present Inpatient/SDS/ED coding seminars for continuing coder education as coding issues are identified from the auditing process
Discuss audit findings with each coder individually as needed for further clarification
Ensure the diagnoses and procedures are sequenced in order of their clinical significance to accurately assign the appropriate DRG, APC or payment tier under the Prospective Payment system to guarantee accurate reimbursement on UPMC patients
Identify areas of coding weakness and develop training plans to address these
Identify incomplete documentation in the medical record and formulate a physician query to obtain missing documentation and/ or clarification to accurately complete the coding process
Perform internal quality assurance audits on inpatient, SDS, and ED coded records
Perform reviews on Third Party Audit findings/outcomes and prepare report for HIM and Compliance
Provide audit findings to coding staff members electronically for coders to review
Responsible for correcting any data found to be in error after reviewing the medical record and comparing with system entries
Review and evaluate focused UPMC DRG or APC medical records for accurate payment prior to billing to ensure that all documented principal and secondary diagnoses, complications and co-morbidities, and procedures are accurately coded
Review coding for accuracy and completeness prior to submission to billing
Review the discharge summary, history and physical, physician progress notes, consultation reports, radiology, laboratory, pathology, operative records, emergency room record to accurately assign a diagnosis and / or procedure
Submit a monthly auditing/training schedule to the Manager
Submit all educational documents for all patient types to Management
Submit audit summaries for Inpatient, SDS and ED coding
Submit completed Inpatient, SDS, and ED audit spreadsheets with details for each chart
Summarizes findings and report these to the Manager
Utilize computer applications and resources essential to completing the coding process efficiently, such as QuadraMed encoder, Cerner and MARS to ensure timely billing
Utilize standard coding guidelines and principles and coding clinics to assign the appropriate ICD-10-CM and CPT codes including modifiers for correct DRG/APC assignment and accurate reimbursement
Graduate of an AHIMA or AAPC Certified Coding Program that includes Anatomy & Physiology, Pharmacology and Medical Terminology
Associates Degree from an accredited Health Information Management program preferred
Five years of total experience

Certified Coding Specialist Resume Examples & Samples

Adhere to internal system-wide policies, competencies, behaviors and procedures to ensure efficient work processes. Actively participate in periodic coding meetings and shares ideas and suggestions for operational improvements
Advise and instruct coders/providers regarding billing and documentation policies, procedures, and regulations; interacts with providers regarding conflicting, ambiguous, or non-specific medical documentation, to obtain clarification
Code all diagnoses and procedures by assigning and verifying the proper ICD and CPT codes. Assign the principal and secondary diagnoses and procedures by thoroughly reviewing all documentation available at the time of coding
Identify incomplete documentation in the medical record and formulate a physician query to obtain missing documentation and/or clarification to accurately complete the coding process
Investigate and resolve reimbursement issues, including denials, in a timely manner and demonstrate proficiency on billing system
Lead, participate in and/or assist with departmental coding audits
Monitor billing performances to ensure optimal reimbursement while adhering to regulations prohibiting unbundling. Prepares periodic reports for clinical staff identifying unbilled charges due to inadequate documentation
Progress within the training period toward meeting departmental coding accuracy standards within the first year of employment by assigning correct principal diagnosis/procedure, complications and co-morbidities, and secondary diagnoses as reviewed by the designated trainer. Coder should meet appropriate coding productivity standards within the time frame established by management staff
Refer problem accounts to appropriate coding or management personnel for resolution
Supervises staff including assignments and Kronos approval and signoff. Also assist with recruitment
Train all new Coders to observe established coding guidelines and to utilize the appropriate billing system
Utilize advanced, specialized knowledge of medical codes and coding procedures to assign and sequence appropriate diagnostic/procedure billing codes, in compliance with third party payer requirements
Work with department management on coding interface, development, enhancements and changes, as well as implementation of those functions
Graduate of an approved certified coding program preferred
Proficient computer skills with MS excel knowledge preferred
Five years surgical coding experience (includes anesthesia coding) OR advanced E/M coding experience
Certified Coding Specialist or Certified Professional Coder or Registered Health Information Administrator or Registered Health Information Technician

Certified Coding Specialist Resume Examples & Samples

Reviews/queries, assigned fee tickets documentation to ensure proper ICD-10 and CPT coding for every charge submitted, including proper linking ICD-10 codes
Abstracts and codes by body system, organ, etiology and morphology
Applies CPT 4, ICD-10- CM, HCPCS and modifiers
Provides feedback to physicians on revenue opportunities, documentation and compliance standards
Work with departments to optimize reimbursement, ensure charge capture, reduce late charges and provide feedback to providers
Answer customer calls
Enters charges into applicable billing system
Works directly with physicians and clinical staff
Communicates effectively with others
Problem solves issues independently and with teams
CPC (Certified Professional Coder), RHIT (Registered Health Information Technician), RHIA (Registered Health Information Administrator), CCS (Certified Coding Specialist) or CCA (Certified Coding Associate) Certification required within 12 months of hire
For applicants without certification 5 years of experience demonstrating coding knowledge and proficiency may be substituted for certification
Continued education in a healthcare related field as required by certifying body (AAPC, AHIMA)
3 years experience in a multi specialty physician environment working with CPT and ICD-10 coding
Advanced knowledge of CPT 4, ICD-10 -CM, HCPCS and modifiers
3 years experience with Medicare, Medicaid, and all major commercial payers

Certified Coding Specialist Resume Examples & Samples

Supervises staff including assignments and Kronos approval and sign-off
High School or GED equivalent required
Completed an AHIMA or AAPC-certified Coding program, Bidwell Training School or equivalent program
Curriculum includes Anatomy and Physiology, Pharmacology, Pathophysiology, Medical Terminology, ICD-10-CM and CPT Coding Guidelines and Procedures or Certified Coding Specialist (CCS)

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