Clinical Coding Specialist Resume Samples
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Clinical Coding Specialist Resume Samples
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WG
W Grimes
Wilfredo
Grimes
907 Dibbert Stream
Detroit
MI
+1 (555) 335 7549
907 Dibbert Stream
Detroit
MI
Phone
p
+1 (555) 335 7549
Experience
Experience
Philadelphia, PA
Clinical Coding Specialist
Philadelphia, PA
Feest, Kilback and Jerde
Philadelphia, PA
Clinical Coding Specialist
- Identify opportunities to fine-tune and optimize applications of .Net developed projects
- Provide technical support and consultation for .Net application and infrastructure questions
- Participate in special projects and perform other duties as assigned
- Perform all duties in accordance with system wide competencies/behaviors
- Design, implement and maintain .Net applications within all phases of the Software Development Life Cycle (SDLC)
- Meet deadlines and turnarounds set by the UPMC for You management team
- When necessary, coordinate and present education related to risk adjustment coding policies and documentation to the provider community
present
New York, NY
Clinical Coding Specialist
New York, NY
McLaughlin Inc
present
New York, NY
Clinical Coding Specialist
present
- Completes analysis of documentation, abstracting and code assignment by body system, organ, etiology and morphology according to the American Hospital Association Official ICD-9 and ICD-10 Coding Guidelines (Coding Clinic), CPT4/HCPCS Coding Guidelines, ASC groups, UHDDS Guidelines, HCFA methodology guidelines for coding, state and federal guidelines and hospital abstracting guidelines
- Manage relationships with assigned providers/practices within the UPMC for You network
- Conduct medical chart reviews to determine cases where additional diagnoses should be added to the claims submitted in order to fully represent the treated conditions of the member
- Provide continuous feedback to management and provider practices
- Develop, test, implement and maintain application software working with established processes
- Assist in the development and maintenance of clinical references databases
- Assist practices with integration of correct coding and documentation standards into workflow
Education
Education
Bachelor’s Degree in Accuracy Required
Bachelor’s Degree in Accuracy Required
North Carolina State University
Bachelor’s Degree in Accuracy Required
5 Clinical Coding Specialist resume templates
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1
Clinical Coding Specialist Resume Examples & Samples
- Education: Associates or Bachelor Degree (In Health Information Management preferred)
- Experience: ICD-9 CM and/or CPT coding experience preferred
- Licensure: RHIT or RHIA eligible/required. Must obtain RHIT or RHIA within 6 months of employment
- Skills & Abilities: Basic knowledge of human anatomy, physiology, and medical terminology. Effective oral and written communication skills. Basic computer skills and excellent ability to concentrate
2
Clinical Coding Specialist Resume Examples & Samples
- Completes analysis of documentation, abstracting and code assignment by body system, organ, etiology and morphology according to the American Hospital Association Official ICD-9 and ICD-10 Coding Guidelines (Coding Clinic), CPT4/HCPCS Coding Guidelines, ASC groups, UHDDS Guidelines, HCFA methodology guidelines for coding, state and federal guidelines and hospital abstracting guidelines
- Performs queries and obtains documentation required for coding for records maintained in other departments
- Answers customer calls
- Confirms appropriate DRG assignments (Not required for ICP INTEGRIS Cardiovascular Physicians)
- Codes any type of record, inpatient and outpatient including Rehab, Skilled Nursing, outpatient, ER, outpatient procedure, observation, recurring and any other records that required ICD-9, ICD-10 or CPT codes
- Knowledge of medical terminology, anatomy and physiology, coding and application
- Knowledge and understanding of disease process and etiology
- Knowledge of various computer applications including Windows, Excel, hospital information systems and encoders
- CCS-P: Certified Coding Specialist ' Physician and two years experience
- CPC: Certified Professional Coder and two years experience
3
Clinical Coding Specialist Resume Examples & Samples
- Design, implement and maintain .Net applications within all phases of the Software Development Life Cycle (SDLC)
- Develop, test, implement and maintain application software working with established processes
- Communicate effectively with other engineers and QA
- Establish, refine and integrate development and test environment tools and software as needed
- Identify production and non-production application issues
- Identify opportunities to fine-tune and optimize applications of .Net developed projects
- Provide technical support and consultation for .Net application and infrastructure questions
- Serve as a mentor to less experienced developers
- Assist in the development and maintenance of clinical references databases
- Standard and internet based research to understand coding and reimbursement issues
- Interpreting ICD-10-CM/PCS, CPT and HCPCS coding conventions and guidelines
- Interpreting CMS regulations
- Respond to client inquiries and issues
4
Clinical Coding Specialist Resume Examples & Samples
- Formal training in ICD-9-CM and CPT coding classification
- AHIMA certification or current RHIT/RHIA or Certified Coding Specialist (CCS) Familiar with DRG/APC assignment, ICD-9-CM and CPT-4 codes for all diagnosis and procedures, UHDDS, Medicare/Medi-Cal coding guidelines with ability to meet quotas as per expectations
- Minimum of three (3) years of hospital coding experience in each of the following coding systems: ICD-9-CM, CPT, E&M, and HCPCS
- Proficient use of the Cerner, HDM, Onbase IDX computer systems and component programs used with it
- Must exhibit clear communication skills by demonstrating the ability to communicate clearly and effectively, both written and verbally
- Promotes effective working relationships and works effectively as part of a team
- Ability to work with detail and clinical information essential
- Ability to perform multiple tasks/reports and within expected turnaround times
5
Clinical Coding Specialist Resume Examples & Samples
- A Bachelor degree with a background in healthcare, medical terminology or life sciences, with around 5 years relevant coding experience. Alternatively, a relevant combination of education, training and work experience
- The ability and experience to extract relevant information from scientific literature
- Good communication (written and oral) skills
- Demonstrated consulting, creativity, critical thinking, project planning, and attention to detail capabilities
- Effective ability to work in a fast-paced environment
6
Clinical Coding Specialist Resume Examples & Samples
- Assist practices with integration of correct coding and documentation standards into workflow
- Conduct medical chart reviews to determine cases where additional diagnoses should be added to the claims submitted in order to fully represent the treated conditions of the member
- Coordinate with practices to have applicable claims resubmitted with proper diagnoses and / or educate the providers to ensure future claims are coding completely and accurately. Conduct routine follow-up with practices to ensure coding practices are conducted appropriately and efficiently
- Manage relationships with assigned providers/practices within the UPMC for You network
- Meet deadlines and turnarounds set by the UPMC for You management team
- Participate in special projects and perform other duties as assigned
- Perform all duties in accordance with system wide competencies/behaviors
- Provide continuous feedback to management and provider practices
- When necessary, coordinate and present education related to risk adjustment coding policies and documentation to the provider community
- Work with the UPMC for You manager of Finance and supporting analytical team to develop retrospective and prospective programs for provider groups tailored to the practice needs and the Health Plan goals for improving coding efficiencies and completeness. Ensure programs are communicated in a comprehensive and timely manner to provider practices
- Minimum of four (4) years of coding experience
- Graduate of an approved Health Information Management or Health Information Technology program with extensive knowledge of coding and documentation requirements including ICD-10-CM, CPT-4, and HCPCS in the inpatient and outpatient settings
- Thorough knowledge of MS-DRG and APC assignments
- Excellent verbal and written communication skills, analytical skills and organizational skills required
- Extensive problem-solving experience is required
- Presentation experience and the ability to present information in a clear and professional manner
- Experience working with physicians and physician practices preferred. Independent decision-making skills required
- Knowledge of Microsoft Office and excel spreadsheet program preferred
- Knowledge of Pennsylvania or other state Medicaid enrollment terminology preferred
- Ability to manage relationships with practices in a diplomatic and tactful manner, while representing the Health Plan effectively, and maintain records of all activities
- Requires frequent travel to conduct onsite medical chart gathering and reviews, along with provider education
- Flexibility in schedule required to meet business needs
- Self-motivated with the ability to work with minimal supervision
