Coding Specialist Resume Sample
Katrina Heaney
9808 Orn Cape,
Philadelphia,
PA
+1 (555) 253 1880
Work Experience
Coding Specialist
01/2017
-
PRESENT
Phoenix, AZ
- Intermediate knowledge in Microsoft Excel including
- Certified Coding Specialist-CCS or Registered Health Information Technician or Admin-RHIT or RHIA or equivalent coding certification required
- Consistently exhibits behavior and communication skills that demonstrate HealthCare Partners’ (HCP) commitment to superior customer service, including quality, care and concern with each and every internal and external customer
- Proactively disseminates coding updates to the clinicians
- Performs pre-audit and documentation with clinician follow up
- Works with clinician departments to review and explain medical chart audit results
- Submits and follows up on query forms to clinicians based on “inferred” chart audit data
- Abstracts and codes all ambulatory surgery center charges
Bwpo Coding Specialist
11/2009
-
08/2016
Los Angeles, CA
- Maintains an electronic database of all medical chart audit results performed
- Provides updates and status reports to management on a weekly basis
- Submits weekly audit totals to management
- Stays abreast of industry coding and compliance issues
- Participates in coding / auditing discussions to ensure best practice efforts and processes are implemented ensuring maximum reimbursement through appropriate coding
- Uses, protects, and discloses HCP patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards
- Act as coding resource for Practices and Patient Business/Financial Services and assist with coding-related issues
- Prepare and present specific coding education as required
- Review medical records for coding accuracy
CMT Administrative Coding Specialist Lead
01/2003
-
07/2009
Detroit, MI
- Optimize revenue through utilization of most appropriate coding methods, following regulatory and insurance guidelines
- Prepare reports for administration as needed to summarize coding issues
- This is an onsite position
- Clear applicable Epic Work Queues on a daily basis
- Assist with and accomplishes Radiation Oncology and Medical Oncology pre-authorizations and pre-certifications according to departmental and interdepartmental policies and procedures, while adhering to the patient focused admissions process
- Work as a team with the other Coding Specialist and Supervisor as needed
- Understand the treatment plan(s) for radiation oncology and medical oncology at a level that allows for accurate pre-authorizations
- Interact with the physicians and clinical team to perform timely pre-authorizations in a manner that prevents the least amount of delay for patients
Education
DeVry University - Pomona Campus
1998 - 2003
School's Degree in Health Information Technology
Professional Skills
- Score above average level on coding skills assessment indicating advanced coding knowledge, skills and abilities for both ICD-9-CM and CPT-4
- Coding experience with demonstrated analytical skills
- Logical thinker with strong analytic abilities, problem solving skills and understanding of database design and
- Strong verbal and writing skills with the ability to communicate with staff and department operations
- Prioritize effectively. Ability to manage multiple tasks effectively, following established protocols, and work within systems
- Excellent computer, interpersonal/communication and training skills
- EXPERIENCE: 3 years experience with ICD-9/ICD-10 and CPT coding and reimbursement activities with 2 years of supervisory or leadership experience
How to write Coding Specialist Resume
Coding Specialist role is responsible for computer, coding, medical, education, analytical, software, microsoft, billing, interpersonal, training.
To write great resume for coding specialist job, your resume must include:
- Your contact information
- Work experience
- Education
- Skill listing
Contact Information For Coding Specialist Resume
The section contact information is important in your 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 Coding Specialist Resume
The section work experience is an essential part of your 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 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 coding specialist position you're applying to.
The work experience section should be the detailed summary of your latest 3 or 4 positions.
Representative Coding Specialist resume experience can include:
- Demonstrates organizational, communication and inter-personal skills
- Effectively communicates utilizing the telephone, form letters or internal correspondence to resolve patient inquiries
- Effectively present coding issues to internal or external clients; deliver information in a one-on-one or small group format to peers
- PC skills including Word, Excel, Power Point and ability to utilize internet search resources
- Experienced level with at least 3-5 years acute care inpatient coding experience in a hospital setting
- Working knowledge of human anatomy and physiology, disease processes and demonstrated knowledge of medical terminology
Education on a Coding Specialist Resume
Make sure to make education a priority on your 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 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 Coding Specialist Resume
When listing skills on your 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 coding specialist skills:
- One year demonstrated knowledge/experience with coding.Demonstrated PC skills in Word, Excel, and Microsoft Access
- Related experience in medical billing and demonstrated analytical skills
- Possess highly effective organization skills to handle multiple tasks with changing demands and priorities
- Effective verbal and written communication and listening skills are required to interact with various individuals seeking accounting-related information
- Demonstrated personal skills: organization and time management, human relations and teamwork, personal adaptability, personal motivation and listening
- Highly organized self starter with excellent problem solving skills
List of Typical Experience For a Coding Specialist Resume
1
Experience For Bwpo Coding Specialist Resume
- Demonstrates critical and system thinking skills
- Demonstrated problem solving, written, and verbal communication skills
- Working knowledge of medical terminology, human anatomy and coding skills including ICD-10-CM, ICD-10-PCS & CPT coding are required
- Five years coding experience and experience working with coding systems
- Over 5 years and up to and including 7 years of experience of ICD9, CPT and HCPCS coding experience
- Over 1 year and up to 3 years of experience of ICD10, CPT and HCPCS coding experience or successful completion of Coding Program internship
- Over 5 years and up to and including 7 years of experience of ICD10, CPT and HCPCS coding experience
- Over 1 year and up to 3 years of experience of ICD-10, CPT and HCPCS coding experience or successful completion of Coding Program internship
2
Experience For Certified Procedural Coding Specialist Resume
- Over 5 years and up to and including 7 years of experience of ICD10 CPT and HCPCS coding experience
- Demonstrated experience with Boolean, regular expressions, database querying, or text analytics software
- Applies knowledge and skills in a highly organized fashion while adhering to regulatory guidelines, global SOPs and client expectations
- Excellent understanding of clinical/medical terminology with strong attention to detail
- Progressive Computer skills
- 3 – 5 years coding experience using CPT/ICD-10 coding in a medical billing environment, including more complex coding
3
Experience For CMT Administrative Coding Specialist Lead Resume
- 3 – 5 years coding experience using CPT/ICD-9 coding in a medical billing environment, including more complex coding
- Demonstrated understanding of data science, including data collection and preparation, sampling, modeling, model deployment and model assessment
- Experience coding; proficient in basic coding and successfully able to handle more complex coding assignments
- ICD-9-CM and CPT coding experience performing hospital based inpatient and outpatient coding
- Experience working in an acute hospital setting coding inpatient procedures required
- Knowledge of and experience using ICD-10-CM and CPT Professional coding
- Knowledge of and skill in using personal computers in a Windows environment with an emphasis on basic word processing and data entry
- At least five years of coding experience in ICD-9/ ICD-10 diagnosis and CPT.HCPCS procedure coding
- Five years’ experience working with coding systems
4
Experience For Quality Assurance Coding Specialist Resume
- Coding Training experience
- CPT and ICD-10 coding experience and understanding
- Experience in physician inpatient/outpatient billing, coding, required. Knowledge of anatomy, physiology and medical terminology required
- Two years of experience in hospital inpatient coding for a large teaching and/or pediatric hospital
- Experience in physician inpatient/outpatient billing/coding
- 6 months experience with medical insurance, billing, or clinical coding
- Relevant coding experience is required
5
Experience For Network Program Manager, Coding Specialist Resume
- Three to Five years Hierarchical Condition Category (HCC) auditing experience
- Strong understanding of UHDDS guidelines
- Experience with Radiation Oncology coding
- Experience with coding in Radiation Oncology
- One to three years coding experience & ICD-9 & 10 knowledge
- Three (3) to five (5) years of ICD-9-CM coding experience
- Three (3) to five (5) years of CPT-4 coding experience
6
Experience For Claims Coding Specialist Resume
- A Certified Coder in good standing with the professional organization under which they are certified (AHIMA or AAPC)
- One (1) year experience with Physician Office billing software
- Three (3) to five (5) years’ experience with physician office billing
- Experience in hospital and/or physician practice outpatient coding
- Related experience. Comprehensive knowledge of CPT, ICD-10 CM coding, payer and governmental policies
- CPT-4 coding experience
7
Experience For Coding Specialist, Behavioral Health Resume
- Wound Care Coding experience is highly desired
- ICD-9-CM coding experience
- One year EMR/Eagle coding experience required
- Demonstrates extensive knowledge of medical terminology, anatomy and physiology, human disease process, and ICD-10-CM and CPT coding conventions
- Strong working knowledge of H.I.M. computer applications and software integration with multiple systems is
- Maintains patient/physician confidentiality at all times and maintains effective communication and professional interaction with patients and physicians
- Demonstrates working knowledge of ICD10 & CPT coding, CMS Guidelines
- Understands project protocol and Data Valida
- Understands project protocol and Data Validation
8
Experience For Coding Specialist Auditor Resume
- Develop strong relationships across our teams to provide support and insight
- Willingness to participate in education programs to increase skill level as needed
- Medical Terminology, Anatomy, and Physiology courses or demonstrated appropriate knowledge
- Recent experience with Medicare regulations
- Surgical Coding experience is highly desirable
- Three to five years Hierarchical Condition Categories (HCC) auditing experience
- Very Effective 96-97% accuracy
- Operate in multiple documentation platforms and computer software programs
- Effective 95% accuracy
9
Experience For Medical Billing & Coding Specialist Resume
- Strong grasp of English grammar, syntax, and phraseology, with the ability to construct linguistic taxonomies
- Adapt to changes and set priorities to meet tactical plans
- CPC or CCS-P or equivalent certification or related, relevant experience
- Working knowledge of CPT/HCPCS and ICD-9/ ICD-10 in a physician office setting or acute care hospital outpatient setting
- Working knowledge of CPT/HCPCS and ICD-10-CM in a physician office setting or acute care hospital outpatient setting
- Interfacing with division personnel on an as needed basis for physician education, affiliate policy development, affiliate marketing and public relations
- Understanding of Medicare, Medicaid, commercial payers and CPT coding rules and regulations
- Working knowledge of insurance and third-party billing
10
Experience For Compliance Coding Specialist Resume
- Coding (CPT and ICD) procedures and diagnosis from medical records and charge tickets
- Coding and documentation support for TeamHealth senior management
- Outstanding 98-100% accuracy
- Understanding of third party payer issues
- Working knowledge of physician fee schedule
- Testing and confirming client intent
- Performing quality assurance on various coding related reviews
- Interfacing with internal clients via conference calls and written communication
List of Typical Skills For a Coding Specialist Resume
1
Skills For Bwpo Coding Specialist Resume
- Strong organization skills and attention to detail with the ability to work in a fully computerized environment
- Demonstrate customer service and public relations skills
- Demonstrate team process and facilitation skills
- Updates knowledge and skills by reviewing quarterly Coding Clinic and completing semi-annual quiz, and other coder training as required
- Experience: At least five years of coding experience in ICD-9-CM diagnosis and CPT. HCPCS procedure coding. Working knowledge of Physician fee schedule
- Other skills & knowledge: Working knowledge of CPT/HCPCS and ICD-9-CM in a physician office setting or acute care hospital outpatient setting
- Proven detail orientation and good problem-solving related to coding
- Experience: At least 2 years of Physician coding experience
- Basic computer skills (i.e., use of email, create a file, save a file) required
2
Skills For Certified Procedural Coding Specialist Resume
- Advanced computer skills, working in multiple systems and proficient in Microsoft Office Applications
- Prior Cardiology/Cardiovascular Surgery coding specialist experience
- Computer knowledge and keyboard skills
- Experience in a clinical data management role. Related experience (e.g. within a clinical environment) would be taken into account
- Demonstrated expertise and experience coding at least two types of actue care patient encounters
- Coding experience in an ambulatory or clinic practice setting
- Working experience with Windows applications
3
Skills For CMT Administrative Coding Specialist Lead Resume
- Reviewing retirement plan and trust documents for valid and timely signatures
- Reviewing documents, system validation, and trending analysis
- Experience: Three or more years coding/abstracting using ICD-9-CM, ICD-10-CM and CPT-4 in an acute care hospital based setting required
- Assist with maintaining an effective system for coding and charge processing
- Experience in conducting coding and billing audits
- If Certified, 2+ years of Anesthesia coding or any surgical specialty coding and ICD10 coding experience in a high production environment
- If not Certified, 5+ years of Anesthesia coding or any surgical specialty coding and ICD10 coding experience in a high production environment
- ICD-9 and CPT Coding – required with a strong emphasis on surgical coding as well as evaluation and management leveling
4
Skills For Quality Assurance Coding Specialist Resume
- Two years of hospital acute care coding experience using ICD and CPT coding
- Flexible with changing priorities and ability to interact with, and advise internal client service team regarding
- Establish and maintain effective working relationships (including administrative staff and faculty)
- Knowledge of and experience using ICD and CPT coding
- Clinical medical record coding experience in preferably a hospital setting
5
Skills For Network Program Manager, Coding Specialist Resume
- ICD - 9 / 10 hands on coding experience - preferably in a managed care setting
- Inpatient coding experience in a hospital setting
- Proven working knowledge of CPT (Current Procedural Terminology) and ICD (International Classification of Diseases) coding systems required
- Experience: CPT Coding, ICD9 Coding, Medical Terminology, use of Excel spreadsheets, proficiency with Microsoft Office suite
- Previous Coding experience
- Coding experience
6
Skills For Claims Coding Specialist Resume
- Participates in seminars and continuing education activities pertinent to areas of job responsibility and maintains skill level and proficiency
- At least five (5) years experience in inpatient or outpatient coding
- Experience interacting directly with physicians and other allied health professionals
- Review write-offs for timely issues prior to sending to management for approval
- Demonstrated proficiency in medical record analysis and ICD-9-CM and CPT/HCPCS coding methodology required
- Demonstrated knowledge of medical codes, coding conventions and rules
7
Skills For Coding Specialist, Behavioral Health Resume
- Medical terminology coding experience
- Specialty specific coding experience
- ICD-9-CM and CPT experience
- Experience with and exposure to compliance matters. Preference for coders with revenue management or background from the healthcare industry
- CPC or CPCA with outpatient experience or both(outpatient and inpatient) required
- Two years of experience in medical practice or outpatient coding
- Educate physicians and physician extenders on appropriate documentation in order to support diagnoses submitted on a claim and validated in a RADV audit
- Promotes and demonstrates professional standards to enhance the development of the department
8
Skills For Coding Specialist Auditor Resume
- Anatomy and Physiology courses or demonstrated appropriate knowledge
- Able to operate basic office equipment, e.g. photo copier, fax machine, scanner, PC, telephone, etc
- ICD-9-CM coding experience required
- CPT-4 coding experience required
- Experience with E&M & Interventional Coding advantageous
- Experience with Psychiatric, Family Medicine, or Internal Medicine
- EPIC or OPTUM/A-LIFE experience helpful
- At least five years of coding experience in ICD-10-CM diagnosis and CPT/HCPCS procedure coding. Working knowledge of Physician fee schedule
- Previous experience working with EPIC
9
Skills For Medical Billing & Coding Specialist Resume
- Epic EMR experience necessary
- One-year experience in a medical office
- Previous experience in ICD-10-CM and CPT coding in hospital setting
- Demonstrated proficiency in medical record analysis and ICD-9-CM and CPT coding methodology
- Health care experience required
- Demonstrated literacy with Microsoft Office software
- Experience in Healthcare
10
Skills For Compliance Coding Specialist Resume
- Strong insurance knowledge
- EPIC and Microsoft experience
- Two years’ experience in group education with provider audiences
- Demonstrated knowledge of medical terminology, anatomy and physiology, pharmacology, and computers
- Performs quality assurance on every case prior to completion
- Working knowledge of JHU/ PBS Billing Applications. Utilize online resources to facilitate efficient claims processing
- Working knowledge of JHU/ Epic Billing Applications
List of Typical Responsibilities For a Coding Specialist Resume
1
Responsibilities For Bwpo Coding Specialist Resume
- Works with the business office on any and all follow up related to the Group’s billed accounts. This includes providing updated patient demographic and financial information, documentation to support billed procedures, authorization numbers and other information as needed to ensure maximum reimbursement
- Reviews the entire medical record to identify attending physician, consulting physician(s), surgeon(s), principal and secondary diagnoses, complications, comorbidities and procedures performed
- Assigns appropriate ICD-10-CM and or CPT-4 codes/modifiers upon review of the medical record documentation. Identifies the principal diagnosis, principal procedure, and properly sequences secondary diagnoses and procedures
- Reads and effectively integrates the Coding Clinic and CPT Assistant publications references in making accurate coding decisions
- Effectively interacts with providers for clarification of coding/ documentation issues
- Proficiency in MS Office/PC skills
2
Responsibilities For Certified Procedural Coding Specialist Resume
- Coding instruction and/or experience
- Two years of experience working with insurance coding and billing using ICD10-CM, CPT-4, HCPCS, and DSM-5
- Demonstrates working knowledge of ICD & CPT coding
- Knowledge of and experience using ICD-10-CM and CPT Professional coding for procedures and evaluation management
- Experience presenting complex information and or training materials
- Experience with inpatient profee coding
3
Responsibilities For CMT Administrative Coding Specialist Lead Resume
- One year experience auditing professional fee services
- Knowledge and experience working with diverse populations
- Adjust to changing priorities and work load volume
- Education: 2 years college or equivalent experience
- Organize work to ensure all assigned work queues are reviewed and appropriately prioritized on a daily basis
- Demonstrates extensive knowledge of medical terminology, anatomy and physiology, human disease process and ICD-9-CM, CPT-4, and E&M codes/modifiers
4
Responsibilities For Quality Assurance Coding Specialist Resume
- Prioritizes tasks and works independently
- Demonstrates knowledge of the Meditech Information System and the 3M Encoder
- Working knowledge of coding rules and payer guidelines
- Working knowledge of JHH Billing Applications
- Billing and Collection Maximization
- Coding certification through AAPC or AHIMA required
5
Responsibilities For Network Program Manager, Coding Specialist Resume
- Coding certification (CCS or CPC through AHIMA / AAPC)
- Willing to travel 10%- NJ, NY
- Coding certification required within 3 months of hire
- Working knowledge of medical record practices, state and federal laws relating to release of medical information
- Coding Certification through AHIMA or AAPC
- Assists other staff in developing routine support services, including producing meeting summaries and follow-up correspondence as necessary
- Three (3) years in a hospital or acute care setting with multidisciplinary service lines, including inpatient coding using ICD, required
- Responsible for identifying and placing products accurately into our coding framework
- Assists in maintenance of billing hardware coding dictionaries. Forwards coded documentation to MPBS/GE IDX system for billing and reimbursement activity
6
Responsibilities For Claims Coding Specialist Resume
- Keeps educated about current coding updates per management’s direction – including ICD coding guidelines, and DRG methodologies
- Responsible for coding concurrent or retrospective inpatient accounts using ICD-10 CM/PCS, in compliance with the Official Coding Guidelines and conventions
- Continued medical coding and billing education to remain current with coding changes
- Assist with developing and maintaining policies/procedures for coding processes
- Provides coding expertise to staff members in other departments as needed, e.g., Scheduling
- Responsible for updating in store promotion information and ensuring that the data reflects the promotions accurately
- Act as resource for coding and documentation inquiries from HCFS, TeamHealth corporate or affiliate divisions in area of coding and provider documentation
- Knowledge and familiarity with CPT coding and ICD-10 coding
7
Responsibilities For Coding Specialist, Behavioral Health Resume
- Participate in review of Senior Billing Specialists’ claims; assist in developing procedures for claims review
- Conducts coding training sessions when necessary
- Responsible for New Provider Coding and Tap Training
- Provide training to surgeons, NP’s and PA’s, and other staff for ICD-10 documentation requirements and compliant coding
- Review medical documentation for assigning billing modifiers to insurance claims where appropriate and applicable
- Maintains 95% coding accuracy while meeting department's productivity standards
- Ensures the proper utilization and assignment of coding for clinical documentation, insurance and reimbursement, regulatory compliance, and reporting functions
- Coordinates coding details/requirements between TPA, Clearing House, insurance companies to ensure information flow is accurate and timely
- Responsible for verifying that payment is correct for CPT, HCPCS, and ICD coding used
8
Responsibilities For Coding Specialist Auditor Resume
- Assigns CPT procedure codes following CPT Assistant and other coding guidelines
- Create training curriculum and facilitate training for business and clinical staff
- A review of each provider’s individual charting tools and preference lists to ensure accurate CPT, HCPCS and ICD-9/ICD-10 coding
- Job requires sitting and working at a computer for extended periods of time; 8.0 hours
- Assists with working all CCI/LMRP edits, claims manager rules and other coding associated charge review WQ rules for each clinic or department supported
- Develops and maintains a current knowledge of regulations and legislation regarding billing compliance issues
- Outpatient Facility Coding (ER, OPS, OBS, Ancillary, Recurring Therapy, Clinic, etc.)
- Outpatient Facility Coding (Ancillary, Recurring Therapy, Clinic, etc.)
9
Responsibilities For Medical Billing & Coding Specialist Resume
- In depth understanding of ICD-9 and CPT coding
- Places charges on hold from billing to payers for additional documentation when incomplete or inaccurate coding is in question
- Obtain working knowledge of payment posting function, demographics, charge entry and overall business office functions
- Attend various meetings within Business Office and practice to gain understanding of overall functions to ensure compliance for billing
- Reports inaccuracies found in coding software to HIM coding supervisor
10
Responsibilities For Compliance Coding Specialist Resume
- Diagnostic and procedure coding of provider services according to established guidelines
- Reviews patient encounters and assigns diagnostic ICD-10 and or/procedural CPT codes according to established coding, CMS and hospital guidelines. (95%)
- Reviews patient encounters and assigns diagnostic ICD-10 and or/procedural CPT codes according to established coding, CMS and hospital guidelines
- Certified Coding Specialist (CCS) or American Association of Professional Coding (CPC) background
- Communicate on a daily basis with your Supervisor/Lead and provide feed-back and updates pertaining to any and all coding or reviews
- Strictly adheres to the Holy Family HIM Compliance Program as it pertains to coding decisions
- Consults with attending physician when selection of the principal diagnosis, procedure, complication, or comorbidity is in question
- Abstracts all coded data into Meditech Abstracting System (ABS) with less than a 5% error rate in audited cases
- Make recommendations to Chief Medical Officer of Coding Policy on changes to current policy status
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