Medical Coder Resume Sample
Marcella Volkman
823 Runolfsdottir Ports,
Chicago,
IL
+1 (555) 235 6757
Work Experience
Senior Medical Coder
12/2015
-
PRESENT
Dallas, TX
- To be able to verify charts notes meet the criteria for the level of visit and enter into the billing software,
- Release claims through the billing software to the clearinghouse
- Correct any claims that are rejected or denied due to coding issues
- Translates billable charges into CPT4 procedural codes and ICD9 diagnosis codes
- Provides education to physicians and staff concerning coding in accordance with National Correct Coding Initiative (NCCI)
- Provides coding audits to Executive Director in accordance with NCCI coding initiatives
- Receives inpatient and outpatient bills for coding appropriateness
- Meets with providers in assigned area on a regular basis on carrier guidelines, coding regulations and fee schedules identifying updates and changes in process
- Responsible for all charge corrections in assigned area using IDX data processing system
Medical Coder
09/2009
-
06/2015
Phoenix, AZ
- Updates CPT and ICD codes on a yearly basis and assesses impact to practice
- Comprehend the medical record to identify all diagnosis, operations and procedures relevant to the current encounter documentation and orders in a Stage 7 electronic medical record
- Gaps in documentation or potential gaps are escalated for remediation, trending and reporting
- Select, assign and sequence the appropriate ICD-10 Diagnosis, ICD 10 PCS (inpatient only), CPT, Modifiers (both EAPG based and non-EAPG based) , HCPCS codes to patients’ current period of care according to established sequencing guidelines for optimal reimbursement for the emergency department, hospital outpatients, and recurring patients
- Contact the appropriate health care provider if there is inadequate information on which to base code assignment; or clarify inconsistent, doubtful or non-specific information in a medical record by querying the responsible Physician
- Comprehend revenue categories for auditing claims prior to billing and/or perform post billing random audits
- Coding knowledge of infusion hierarchy with knowledge of medications for charge capture for all Emergency department patients
- Validate that each outpatient encounters has a provider order for the service prior to coding
Medical Coder Outpatient
04/2007
-
08/2009
Dallas, TX
- AHIMA credential: RHIT, RHIA, and/or CCS
- In-office position requires sitting at a desk at our office in Denver
- Verify that chart notes meet the criteria for the level of visit and enter into billing software
- Communicate with providers regarding chart notes
- Release claims to the clearinghouse through the billing software
- Monitor and correct any claims that are rejected or denied due to coding issues
- Understand the life-cycle of the medical bill
- Provides quality assurance for medical records. For all assigned records and/or areas assures compliance with coding rules and regulations according to regulatory agencies for state Medicaid plans, Center for Medicare Services (CMS), Office of the Inspector General (OIG) and the Health Care Financing Administration (HCFA), as well as company and applicable professional standards
- As assigned, compiles daily and monthly reports; tabulates data from medical records for research or analysis purposes
Education
University of the West
2001 - 2006
Bachelor's Degree in Business Administration
Professional Skills
- One year clinical experience to include general office skills and computer experience
- Demonstrated proficiency working with Epic work queues as well as prior charge posting experience
- Strong computer skills; understanding of RIS system
- Adobe Acrobat experience and experience working collaboratively on projects using Microsoft SharePoint experience
- Demonstrated proficiency in spelling, punctuation, and grammar skills
- Demonstrated customer service and organizational skills
- Excellent verbal and written communication skills and have the ability to function under the pressure of daily work requirements
How to write Medical Coder Resume
Medical Coder role is responsible for coding, basic, computer, medical, general, education, learning, efficient, oncology, security.
To write great resume for medical coder job, your resume must include:
- Your contact information
- Work experience
- Education
- Skill listing
Contact Information For Medical Coder Resume
The section contact information is important in your medical coder 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 Medical Coder Resume
The section work experience is an essential part of your medical coder 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 medical coder responsibilities. It's meant to present you as a wholesome candidate by showcasing your relevant accomplishments and should be tailored specifically to the particular medical coder position you're applying to.
The work experience section should be the detailed summary of your latest 3 or 4 positions.
Representative Medical Coder resume experience can include:
- Demonstrates experience in professionally handling and protecting items confidential in nature
- Communicates effectively with internal and external sources concerning diagnoses and procedure(s) to assure proper coding and reimbursement
- Six months of prior CPT-4, ICD-9 and ICD-10 coding experience
- One year of prior CPT-4, ICD-9 and ICD-10 coding experience
- One year prior CPT-4 and ICD-9 coding experience
- Research and analyze the medical records when there is a discrepancy in coding; validate the coding and supporting the department in the reporting of findings
Education on a Medical Coder Resume
Make sure to make education a priority on your medical coder resume. If you’ve been working for a few years and have a few solid positions to show, put your education after your medical coder 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 Medical Coder Resume
When listing skills on your medical coder 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 medical coder skills:
- Demonstrated skill/experience working with computerized reports to abstract information
- Demonstrated medical coding skills
- Good interpersonal skills and a basic understanding of team management concepts
- Good communication skills both verbally and written and the ability to communicate clearly and concisely
- Strong computer, customer service and communication skills
- Organizational skills to prioritize workload and meet deadlines; develop and carry out project assignment in an efficient and timely manner
List of Typical Experience For a Medical Coder Resume
1
Experience For Certified Medical Coder Resume
- Skill and ability to communicate effectively both orally and in writing
- Patient Skills Types: Inpatient Acute Hospital
- 1) Experience with Outpatient Coding (transforming descriptions of medical diagnoses and procedures into universal medical code numbers)
- 3) Experience with reviewing complex patient data and being able to investigate a solution
- Experience coding patient records in a hospital HIM department
- Two (2) years of experience with ICD-9 and CPT coding
- Patient Skill Types: Inpatient Acute Care
- Patient Skill Types: Inpatient Acute Hospital; Observation; Same Day Surgery
2
Experience For Medical Coder Outpatient Resume
- Skill and ability to maintain working relationships with physicians and other staff
- Skill and ability to research and analyze data, draw conclusions, and resolve issues
- Skill and ability to review the work of others and maintain confidentiality
- Demonstrates ability to handle multiple items simultaneously and produce high-quality work in a timely, accurate and efficient manner
- Demonstrates ability to learn and work independently
- Ensures pre-certifications/authorizations are valid for the procedure performed
- Uses only pre-approved source documents as validation for recommendations
- Validate and abstract CPT, ICD-10 and HCPCS codes from professional and facility medical documentation
3
Experience For Senior Medical Coder Resume
- At least 3-5 years experience as a medical coder
- Examining and verifying coding errors through audits
- Correcting rejected claims, researching, and contacting physician offices
- Reprocessing and researching of coding denials
- Understanding of ICD - 10 Coding in relation to DRGs
- Tracking their own continuing education credits to maintain professional credentials
4
Experience For Remote Medical Coder Resume
- Answering Medical Representatives coding questions
- Providing timely bill processing per state guidelines
- Coding Certification required; CPC or equivalent certification
- Coding claims from Pathology Reports
- Ensuring appropriate code was given
- Willing to travel to provider offices in Orange county
5
Experience For Medical Coder Supervisor Resume
- Works in conjunction with the Reimbursement staff to answer all inquires regarding coding and billing for physicians' services
- Trains clinical staff on coding guidelines, ensuring compliance around documentation, coding and payor guidelines
- Updates physicians and managers of regulatory and coding system changes, reviews training needs and creates and implements training plans as needed
- Maintains updated knowledge of coding requirements; including continuing education and certification renewal
- Communicates with families, assisting with billing/insurance questions and collecting surgical prepayments
- Our coding colleagues work for coding records for multiple clients where the hospital has outsourced either all or a part of the coding functions to nThrive
- Works in conjunction with the Reimbursement staff to answer all inquiries regarding coding and billing for physicians' services
- Correcting rejected claims, researching, and contacting physician offices
- Assist coding trainer with all training/audits or retraining audits
6
Experience For Optum Data Management Medical Coder Resume
- Adapt to continually changing coding requirements and regulations
- Provides regular and on-going communication with management and medical staff to resolve coding issues and associated problems
- Collaborates with the coding team at the external billing company
- Audit medical records to ensure compliance with the organizations coding procedures and standards according to government regulations
- Medical Billing/Coding Diploma or Certificate Required (CPC)
- A sound knowledge of medical coding guidelines and regulations including compliance and reimbursement
- Identify appropriate assignment of CPT and ICD -10 Codes for physician and facility services provided in an Observation service setting, and Inpatient setting
7
Experience For Medical Coder Analyst, Claims Resume
- Comply with all legal requirements regarding coding procedures and practices
- Acts as a liaison between the CBO (Central Business Office) department, billers, and third party payers in resolving billing and reimbursement accuracy
- Report coding problems or irregularities to Coding leadership as appropriate
- Contact leadership, billing, and or coding representatives for information and assistance with denied or incorrectly paid claims
- Assists in finding resolutions to billing issues – rejections, non-paid accounts, etc
- Advise physicians on a day-to-day basis regarding documentation and coding standards
- Advise physicians on a day to day basis regarding documentation and coding standards
8
Experience For Medical Coder / Educator Resume
- Responsible for maintaining current knowledge of coding guidelines through the use of current CPT, HCPCS II and ICD10 materials
- Communicates with staff, relaying messages or other information relevant to maintaining timely workflow and customer satisfaction
- Performs all audits of documentation, coding and billing practices in whatever office or capacity it is required
- Assists with working the missing condition reports from all carriers
- Assists with all quality measures initiatives – working with the PCP offices in capturing the data to support the variables
- Assists in teaching any office staff and/or providers in proper documentation and coding guidelines as necessary
- Perform ongoing analysis of medical record charts for the appropriate coding compliance
- Sequences the diagnoses and procedures using coding guidelines
- Acts as liaison between the Billing Department and medical staff, clinical staff for coding and documentation issues
9
Experience For Inpatient Certified Medical Coder Resume
- Maintains knowledge of and complies with coding guidelines and reimbursement reporting requirements
- Our coding colleagues code records for multiple clients where the hospital has outsourced either all or a part of the coding functions to nThrive
- Support Director of Risk Adjustment Coding with department projects including some project management
- Presenter of HCC Coding Education to network providers with Medical Directors (evening workshops)
- Assist with coding supervisors and coding staff to ensure that concerns are investigated and appropriate action is taken
- Assists and confers with other coders and Coding Manager concerning any problem records
- Prepare individual report for each Level 1 audit to the supervisor/trainer, identifying and communicating potential quality issues
- Assist with auditing on MRTS in incomplete and unbillable chart reviews, or any other department reviews to ensure coding accuracy and adherence to policies
- Assist with coding and/or correcting charts sent by all departments
10
Experience For Hospice Medical Coder Resume
- Assists with US Oncology audit and compliance or reimbursement audits such as providing records, audit reports, and standard operating procedure manuals
- Interacts with clinician and other clinic/corporate departments to assure completeness of charts for billing
- Interacts with Medical Billers to assure compliance and appropriate billing practices
- Be a key player in the revenue cycle process by working closely with the client’s HIM and other support departments
- Ensure compliance with CMS’s Diagnostic Coding Guidelines for Hospital-based Outpatient Services
- Reviews billing and/or EMR system to identify and analyze trends, recommend and implement corrective actions
- Medical coding through medical record abstraction
- Proficient knowledge of medical terminology, ICD-10 and CPT coding
- Look into any coding errors and ensure resolution
List of Typical Skills For a Medical Coder Resume
1
Skills For Certified Medical Coder Resume
- Excellent interpersonal skills
- Coding Technical Skills –Regulatory coding (ICD-9-CM, ICD-10 and HCPCS/CPT) and associated reimbursement knowledge
- Coding Technical Skills –Regulatory coding (ICD-9-CM and HCPCS/CPT) and associated reimbursement knowledge
- Coding Technical Skills – Regulatory coding (ICD-9-CM, ICD-10 and HCPCS/CPT) and associated reimbursement knowledge
- Medical coding experience with demonstrated sustained coding quality
- Exemplary attention to detail and critical thinking skills
- Effectively present coding issues to internal or external clients
- Adaptability to change and learning new skills
2
Skills For Medical Coder Outpatient Resume
- Prior experience with correcting diagnosis codes and modifiers assigned to outpatient services
- 18+ months prior medical coding experience
- Prior Evaluation and Management or Surgical coding experience
- Analytical or critical thinking skills
- Prior experience in a role/s within a medical office environment
- Third party medical billing and coding experience from Evaluation and Management documentation and coding experience from a narrative/report format
- Four ( 4 ) years experience in CPT-4 and ICD-9-CM coding and abstracting experience for a physician office, hospital or insurance carrier multi-specialty areas
- Works efficiently and effectively to minimize overtime
3
Skills For Senior Medical Coder Resume
- Coding experience in obstetrics, primary care or oncology
- CCS coding credential requires inpatient coding experience before taking exam
- Charge entry/cleaning claims for coding accuracy prior to submitting to insurance
- Recent and relevant hands-on coding experience including active production coding
- Recent and relevant hands-on coding experience including active medical production coding
- Professional Coding experience in a Hospital or Physician setting
- Inpatient Coding experience in a Hospital setting
4
Skills For Remote Medical Coder Resume
- Demonstrate flexibility to accommodate rapidly changing needs of a growing organization
- Experience in a healthcare environment dealing with medical coding
- Experience using ICD and CPT coding systems
- 6 months or more of experience in medical coding
- Good working knowledge of medical terminology and anatomy required
- ICD-9 Coding or Medical Record Audit experience in a consultative role
5
Skills For Medical Coder Supervisor Resume
- Strong problem solving and resolution abilities
- Experience using Athena Health practice management or a similar system is required
- Experience in medical coding
- Experience using ICD-10
- Coding experience
- Experience using ICD-9-CM, CPT, HCPCs or equivalency
- Minimumof two years related coding experience required
6
Skills For Optum Data Management Medical Coder Resume
- Experience using ICD-9-CM, CPT
- Experience presenting data to leadership
- Experience with coding and reimbursement activities
- Demonstrated knowledge of ICD-9 and CPT4 Coding
- Healthcare Coding experience
- Excellent understanding of clinical documentation requirements in order to support an active diagnosis
- Experience in medical coding
- 6 months or more of medical coding experience
- Experience in Medical Coding (ICD-10, CPT, and HCPCS)
7
Skills For Medical Coder Analyst, Claims Resume
- Or more of professional experience in clinical/medical setting
- Medical Coding Certificate-currently valid (CPC through AAPC) or (CCA or CCS through AHIMA)
- Knowledge of or experience with ICD-10 and CPT coding
- ME/Team Lead experience working with cross functional teams
- Experience in working in a healthcare insurance environment
- One (1) year of recent and relevant hands-on coding experience
- Demonstrates ability to work in a team environment, and to build trust in the working relationships with other staff and faculty
- Good working knowledge of medical terminology and anatomy required
8
Skills For Medical Coder / Educator Resume
- Strong billing knowledge
- Min 6 months experience in coding
- Monitor and report the effectiveness of internal/external understanding of LHI services
- Demonstrates knowledge of ICD-10-CM and CPT coding guidelines and medical terminology
- Five years of experience in hospital inpatient coding required
- Profee/physician coding experience is required
9
Skills For Inpatient Certified Medical Coder Resume
- Organize and prioritize and meet deadlines
- Excellent knowledge of medical record review and abstraction
- Demonstrated knowledge of ICD-10-CM, CPT, PQRS (Physician Quality Reporting System-Medicare), and HCPCS coding guidelines and principles required
- Able to demonstrate full knowledge of insurance payers and their coding requirements per their Clinical Policy Bulletins, NCCI edits and Medicare LCDs
- Strong ICD-10, HCPCS and CPT Coding knowledge
- Prioritize responsibilities and meet deadlines
- Coding experience in a medical office environment
10
Skills For Hospice Medical Coder Resume
- CPC, CRC, CCS-P, or CPC-A (with experience) coding certification
- CPC, CPC-A (with experience), CRC, or CCS-P Coding Certification
- Experience as a Certified Medical Coder
- Experience with Medicare, Medicaid, and commercial carrier coding guidelines
- Experience using a computer and Microsoft Office (Microsoft Word, Microsoft Excel, and Microsoft Outlook) to create, copy, edit, send, and save documents
- Experience in defining business requirements, traceability and system configuration
- Facility based coding experience
- At least 1-year medical coding experience
- Experience orthopedic coding
List of Typical Responsibilities For a Medical Coder Resume
1
Responsibilities For Certified Medical Coder Resume
- Working knowledge of medical terminology, basic coding skills including familiarity with ICD-10 and CPT coding is required
- Working knowledge of medical terminology, basic coding skills including familiarity with ICD-10 and CPT coding (required)
- Previous experience coding for PCP and / or skilled nursing facilities, or specialty clinics
- Work independently and proactively with critical thinking skills
- Coding experience in either inpatient or outpatient setting
- Of 3 yrs. Ambulatory Procedure Visit (APV) coding experience within the last 6 yrs. in a military coding environment
- One of the following Professional Services Certifications: CPC, RHIA, RHIT, CPMA, CCS-P or COC with professional membership in good standing
- Experience working in healthcare in an academic setting
- Experience working as a Certified Medical Coder directly with Physicians, for coding accuracy
2
Responsibilities For Medical Coder Outpatient Resume
- Experience working in a teaching/academic/research oncology center
- Experience in the coding field
- Risk adjustment experience in a managed care setting
- Experience with the Common Procedure Coding System (HCPCS)
- 1-2 years Medical Coding experience
- Coding experience in Family Practice / Internal Medicine
3
Responsibilities For Senior Medical Coder Resume
- Experience of Outpatient Coding from Electronic medical records
- Coding experience
- One (1) year of Radiation Oncology coding experience
- At lease two years of progressively complex billing & third party payer experience
- Pediatric Coding Experience
- Demonstrated ability working directly with Physicians in a consultative manner
- Professional coding experience
- Experience working with Modifiers
- Experience working with CPT, ICD-9, ICD-10
4
Responsibilities For Remote Medical Coder Resume
- +2 years of related work experience in medical coding
- Of medical coding experience
- Good working knowledge of medical terminology and anatomy
- Coding certification to include the following: CPC, CPC-H, CCS,CCS-P, CCA, RHIA and RHIT
- Coding certification to include the following: CPC, CCS, RHIA, and RHIT (no CPC-A, RHIT – A, etc.)
- Working knowledge of ICD-10 and CPT coding
- Working knowledge of medical terminology, human anatomy, and coding
- Coding certification to include the following: CPC, CCS, RHIA and RHIT (no CPC-A, RHIT A, etc.)
5
Responsibilities For Medical Coder Supervisor Resume
- Coding certification to include the following: CPC, CCS, RHIA, and RHIT (no CPC-A, RHIT, RHIA, etc.)
- Coding certification to include the following: CPC, CCS, RHIA, and RHIT (no CPC-A, RHIT)
- Coding certification to include the following: CPC, CCS, RHIA, and RHIT (no CPC - A, RHIT - A, etc.)
- Working knowledge of ICD-9/ICD-10/CPT coding
- Coding scheme and reimbursement practices required
- Coding credential (RHIA, RHIT, CCS, CCS-P, CPC, CPC-H)
6
Responsibilities For Optum Data Management Medical Coder Resume
- Understanding of ICD-10 anesthesia codes
- Coding certification from AAPC or AHIMA REQUIRED
- Coding certification from AAPC, AHEMA required
- Provide Anesthesia cross walk codes, procedure, diagnosis and modifier coding using CPT and ICD-10 coding systems
- Knowledge of CMS, Medicaid and third party coding, billing and data processing system
7
Responsibilities For Medical Coder Analyst, Claims Resume
- Utilizes 3M coding software in coding process for each account and/or Regs for assistance when unsure of proper coding
- Maintain knowledge of CPT-4 and ICD-9/10-CM coding principles, governmental regulations, protocols and third-party requirements pertaining to billing
- Assist leadership, billing and coding staff to ensure that concerns are investigated and appropriate action is taken
- Monitor, interpret and advise management regarding changes to third party reimbursement activities and trends with coding related denials
- Focus on specific patient accounts regarding matters of billing and reimbursement
- Responsible for reviewing patient logs and other report of clinical activity to ensure billing is captured for all patients
- Performing medical coding for multispecialty physician and hospital services
8
Responsibilities For Medical Coder / Educator Resume
- CPC Certified Professional Coder, CCS Certified Coding Specialist, or CCA Certified Coding Associate
- Completion of a formal medical coding training program
- Medical Billing/Coding Diploma or Certificate
- Knowledge of payers & medical insurance terminology for billing lines, including but not limited to, Managed Care, Medicare, Medical Assistance and Self-Pay
- Knowledge of third-party billing and payment requirements for third party payors including managed care benefits
- Knowledge with third-party medical insurance, diagnostic & procedural coding, and medical billing
- ICD-9, ICD-10 and CPT coding with an emphasis on Radiology specific coding
- Medical Coding and/or Auditing in two or more medical, ancillary or surgical specialties (w/in past 10 years)
9
Responsibilities For Inpatient Certified Medical Coder Resume
- Internal US Oncology Billing and Coding Integrity Program certification (BCS-M) in Medical Oncology and (BCIP) in Radiation Oncology within the first 90 days
- Active AAPC coding certification CPC or Active AHIMA coding certification CCS or CCA
- Perform all coding functions by assigning appropriate CPT, ICD10, HCPCS codes to operative reports
- Able to interpret and understand medical content, including knowledge of CPT and ICD-10 CM coding
- Knowledge of Medical Documentation requirements, National Correct Coding Initiative edits, LCD and Physician Billing requirements
10
Responsibilities For Hospice Medical Coder Resume
- Medical billing/coding
- Knowledge of CPT, ICD-10-CM, and HCPCS Level II coding with additional knowledge of modifier uses, CCI edits, and payers bundling guidelines
- Support Precyse’s Compliance Program by demonstrating adherence to all relevant compliance
- Responsible for the ongoing identification and implementation of revenue integrity solutions
- Conduct audits and coding reviews to ensure all documentation is accurate and precise
- Collaborate with billing department to ensure all bills are satisfied in a timely manner
- Communicate with insurance companies about coding errors and disputes
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