Clinical Coding Specialist Resume Sample
Kaleigh Klocko
560 Dietrich Pike,
New York,
NY
+1 (555) 390 0463
Work Experience
Clinical Coding Specialist
06/2017
-
PRESENT
New York, NY
- ICD-10-CM and CPT-4 Coding Certificate
- Level 1 = 1- 2 years Level 3 = 5- 7 years
- Level 2 = 2 -5 years Level 4 = 7+ years
- Analyzes medical records and abstract clinical data by assigning codes from patient records in accordance with coding classification systems
- Reviews patient encounters for accurate code assignment of all relevant diagnoses and procedures, creating APC or DRG group assignments
- Coder codes and maintains a production rate of no less than 3.5 charts per hour for inpatient records and no less than 7 charts per hour for outpatient and ambulatory surgery records
- Coder maintains an accuracy rate of 90% on all coded records
- Maintains coding knowledge and skills through attending continuing education activities and reviewing pertinent literature, attending institutional coding meetings, AHIMA seminars, and other educational forums
Clinical Coding Specialist
09/2014
-
02/2017
Phoenix, AZ
- Resolves billing edits by performing second review of medical record documentation and code assignments
- Reviews patient encounters for accurate code assignment of all relevant diagnoses and procedures. Exports appropriate codes from CodeRyte and Epic charge systems
- Assign appropriate modifiers, and apply guidelines as indicated through the Limited Coverage Diagnosis (LCD), as well as the National Correct Coding Initiative (CCI)
- Meet or exceed department production and accuracy standards
- Maintains coding knowledge and skills through attending continuing education activities and reviewing pertinent literature, attending institutional coding meetings, AAPC/AHIMA seminars, and other educational forums
- Queries physicians and/or departments when code assignments are not straightforward or documentation in the record is inadequate, ambiguous or unclear for coding purposes
- Resolves coding edits/denials by performing second review of medical record documentation and code assignments
- Proficiently navigates the patient health record and other computer systems/sources in determination of diagnoses procedures and modifiers to be coded and/or for APC assignment
Education
Grand Valley State University
2009 - 2013
Bachelor's Degree in Health Information Management
Professional Skills
- Maintains a working knowledge of applicable coding and reimbursement Federal, State and local laws and regulations, the Compliance Accountability Program, Code of Ethics, as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical and professional behavior
- CCS: Certified Coding Specialist Certification and two years of coding experience assigning ICD-9/ICD-10 and CPT-4 codes in a hospital setting
- CCS: Certified Coding Specialist Certification and one year experience assigning ICD 9/ICD-10 and CPT 4 codes in a hospital setting
- CCS-P: Certified Coding Specialist - Physician and two years experience assigning ICD-9/ICD-10 and CPT-4 codes in a hospital setting
- CCS P Certified Coding Specialist ' Physician and three years experience assigning ICD-9/ICD-10 and CPT-4 codes in a hospital setting
- CPC: Certified Professional Coder Certification and two years experience assigning ICD 9/ICD-10 and CPT 4 codes in a hospital setting
- CPC: Certified Professional Coder and three years experience assigning ICD-9/ICD-10 and CPT-4 codes in a hospital setting
How to write Clinical Coding Specialist Resume
Clinical Coding Specialist role is responsible for training, basic, software, auditing, database, health, leadership, powerpoint, general, coding.
To write great resume for clinical coding specialist job, your resume must include:
- Your contact information
- Work experience
- Education
- Skill listing
Contact Information For Clinical Coding Specialist Resume
The section contact information is important in your clinical coding specialist resume. The recruiter has to be able to contact you ASAP if they like to offer you the job. This is why you need to provide your:
- First and last name
- Telephone number
Work Experience in Your Clinical Coding Specialist Resume
The section work experience is an essential part of your clinical coding specialist resume. It’s the one thing the recruiter really cares about and pays the most attention to.
This section, however, is not just a list of your previous clinical coding specialist responsibilities. It's meant to present you as a wholesome candidate by showcasing your relevant accomplishments and should be tailored specifically to the particular clinical coding specialist position you're applying to.
The work experience section should be the detailed summary of your latest 3 or 4 positions.
Representative Clinical Coding Specialist resume experience can include:
- Codes Emergency Department and Outpatient Observation utilizing encoder software and online tools and references, in the assignment of ICD-, CPT, and HCPCS codes and modifiers
- Research, analyze and assimilate information from various on-site or virtual sources based on technical and experience-based knowledge
- Change and be flexible with work priorities
- Using the clinical coding tools and other established SCHARP guidelines, select the clinical code most closely aligned with the reported term
- Leading or participating in the local functional/cross-functional implementation of best practices and process improvement initiatives
- Understanding of medical terminology and diagnosis desired
Education on a Clinical Coding Specialist Resume
Make sure to make education a priority on your clinical coding specialist resume. If you’ve been working for a few years and have a few solid positions to show, put your education after your clinical coding specialist experience. For example, if you have a Ph.D in Neuroscience and a Master's in the same sphere, just list your Ph.D. Besides the doctorate, Master’s degrees go next, followed by Bachelor’s and finally, Associate’s degree.
Additional details to include:
- School you graduated from
- Major/ minor
- Year of graduation
- Location of school
These are the four additional pieces of information you should mention when listing your education on your resume.
Professional Skills in Clinical Coding Specialist Resume
When listing skills on your clinical coding specialist resume, remember always to be honest about your level of ability. Include the Skills section after experience.
Present the most important skills in your resume, there's a list of typical clinical coding specialist skills:
- Project oversight and management skills
- Two (2) years of current acute care coding emergency department and observation or physician coding experience is required
- Validates charges by comparing charges with health record documentation as necessary
- Hospital coding experience
- CCS-P: Certified Coding Specialist - Physician and one year of experience
- Excellent communication and and ability to work with many stakeholders
List of Typical Skills For a Clinical Coding Specialist Resume
1
Skills For Clinical Coding Specialist Resume
- Utilizes retrospective edit tool to address possible coding and/or documentation issues related to submitted diagnosis and procedure information obtained from the health record
- Communicates effectively with clinical staff, physicians and office staff regarding documentation issues or needs
- Experience with COC, CCS, CCS-P or RHIT/RHIA
- CPC: Certified Professional Coder Certifications and one year of experience
- Experience with EDC Systems, MS Excel, Word, PowerPoint
- As an acute care hospital inpatient coder required. Ambulatory coder experience perferred
- Manages queries related to coding terms, through closure; including entering queries into EDC and triaging site or Medial Monitor questions
- Collaborates with Regional Shared Services (HIM and Patient Financial Services) in resolving billing and utilization issues affecting reimbursement
2
Skills For Clinical Coding Specialist Resume
- Assist Clinical Coding and Safety Manager in identifying and initiating requests for new medical terms and/or changes to the clinical dictionaries
- Familiarity with distance learning or using web-based training tools desirable
- Tracks issues (i.e., missing documentation or charges) that require follow-up to facilitate coding in a timely fashion
- Codes account types including, but not limited to, ER, outpatient, outpatient procedure, observation and recurring
- Use a standard desktop and windows based computer system, including a basic understanding of e-mail, internet, and computer navigation
3
Skills For Clinical Coding Specialist Resume
- Meets coding quality and productivity standards established by SJHS
- Maintains up-to-date knowledge of changes in coding guidelines and regulations
- CCA- Certified Coding Associate
- CCS- Certified Coding Specialist
- Review reported AEs and ConMeds to identify inadequate, ambiguous or unclear medical terms/medications and generate coding queries as necessary
- Communicates with case management concerning Outpatient Observation documentation issues
4
Skills For Clinical Coding Specialist Resume
- Consistently meets or exceeds coding quality and productivity standards established by Revenue Excellence/RHM
- Maintains up-to-date knowledge of changes in coding and reimbursement guidelines and regulations
- Use other software as required performing the essential functions on the job
- Identifies concerns and notifies appropriate leadership for resolution
- Abides by confidentiality requirements as they relate to the release of individual or aggregate patient information
- AAPC Certified Procedural Coder - Hospital (CPC-H)
- Registered Health Information Administrator
- RHIA- Registered Health Information Administrator
- RHIT- Registered Health Information Technician
5
Skills For Clinical Coding Specialist Resume
- Utilizes an automated editing tool for retrospective coding quality and query opportunity and is able to appropriately resolve edits generated by the auditing tool. In addition, is able to demonstrate learning from edits by demonstrating a reduction of edits generated by the tool
- Using the clinical coding tools and other established SCHARP guidelines, select the clinical code most closely aligned with the adverse event being reported. Review reported AEs and ConMeds to identify inadequate, ambiguous or unclear medical terms/medications and generate queries
- On request, assist other members of the clinical coding and safety staff with information from the MedDRA and WHO-DD Coding tools
- Review coded data to ensure coding is both correct and codes are applied consistently across all studies in accordance with established standard operating procedures
- Participate in the DAIDS MedDRA Implementation Workgroup. Actively participate in cross-network conference calls with other Statistical Data Monitoring Centers to establish consistent coding practices for DAIDS sponsored clinical trials
- Participate in MedDRA and WHO-DD trainings to remain up to date on procedural and coding changes, as well as standard industry practices
- Participate on SCHARP working groups, special projects, and attend network meetings and/or study meetings as needed
6
Skills For Clinical Coding Specialist Resume
- Coordinate the collection and entry of study site-specific laboratory reference ranges. Assist in the management of the reference ranges database
- Works independently on daily activities with minimal supervision. Has a comprehensive understanding of job scope and demonstrates good judgment and capability in managing time and multitude of tasks
- Basic computer skills i.e. Word, Excel, PowerPoint required
- Review coded data to ensure coding is both correct and codes are applied consistently in accordance with established standard operating procedures and guidelines
- Change and be flexible with work priorities. Strong problem solving skills
7
Skills For Clinical Coding Specialist Resume
- Maintaining dictionary databases to ensure safety data is coded consistently in accordance with corporate standards and meets regulatory requirements
- Upon request, assist other members of the Clinical Coding and Safety group or SCHARP staff with information from the MedDRA and WHO-DD Coding tools
- Participate in SCHARP working groups and special projects as needed
- Assist and provide coverage, as needed, in coordinating the collection and entry of study site-specific laboratory reference ranges
- Develop and deliver functional training on processes and coding guidelines to data management, study teams, cross-functional groups, service providers, monitors and investigators
- Identifies concerns and notifies appropriate leadership for resolution. Provides routine problem resolution as needed
- Adheres to Trinity Health and RHM confidentiality requirements as they relate to the release of any individual or aggregate patient information
8
Skills For Clinical Coding Specialist Resume
- Communicate effectively with individuals and groups representing diverse perspectives. Ability to work with minimal supervision and exercise independent judgment
- Perform frequent detailed tasks and provide immediate service with frequent interruptions
- Provides routine problem resolution as needed
- Codes complex outpatient and/or emergency/urgent care patient records (as their primary work assignment) utilizing encoder software, in the assignment of ICD-9-CM, CPT-4®, and HCPCS codes. Assign codes in accordance with AHA Coding Clinic for ICD-9-CM, AMA CPT Assistant, AHIMA’s Standards of Ethical Coding, as well as URO/MO established guidelines
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