Medical Coding Resume Sample
Hyman Grimes
426 Mazie Valley,
New York,
NY
+1 (555) 185 5324
Work Experience
Medical Coding / QA Manager
04/2018
-
PRESENT
Los Angeles, CA
- Prepares and monitors the department’s Operating & Capital budgets. Addresses variances in a timely manner
- Assists in the preparation and monitors the department’s Operating & Capital budgets. Addresses variances in a timely manner
- Assists in the development policies, processes, strategies and goals that support the department and the organization’s direction
- Utilizes the hospital’s designated clinical documentation system to identify opportunities for physician and hospital outcomes
- Responsible for the day-to-day evaluation of documentation by the medical staff and healthcare team in accordance with the hospital’s designated clinical documentation system
- Modify instructional methods and strategies to meet diverse students’ needs
- Expertise in the skills needed to solve insurance billing problems, how to manually file claims (using the CPT and ICD-10 manual), complete common insurance forms, trace delinquent claims (EOB’s) and use generic forms (CMS 1500) to streamline billing procedures
- CCSP, CCS, RHIA or RHIT required
Medical Coding
05/2014
-
12/2017
Boston, MA
- Excellent interpersonal, influencing, and presentation skills required
- Utilize different methods and mediums in delivering course material
- Experience in organizing and writing reports and presentations of a technical nature
- Proven educational or administrative experience in critical thinking, problem solving and judgment skills
- Proven track record of project completions, multi-tasking, and the ability to handle a high pressure environment with significant timeline pressures
- Able to obtain and maintain licenses if applicable as required by state or accrediting commissions
- Works in conjunction with the Reimbursement and A/R Claims Follow Up staff to answer all inquiries regarding coding and billing for physicians’ services
Medical Coding Quality Consultant
01/2007
-
01/2014
Phoenix, AZ
- Works in coordination with other members of the Physicians’ Billing Office as necessary
- Recommends new approaches, policies, and procedures to influence continuous improvements in department’s efficiency and services performed
- Continually promote students’ development and effective use of skills in areas such as critical and analytical thinking, evaluation, communication, professionalism, customer service, computation, problem solving, and decision-making
- Maintain regular contact and concise communication with providers. Maintain current coding library for MHS clinics
- Conducts reviews on records that have been identified as suspicious and / or potentially fraudulent, utilizing most current reference materials to include, but not limited to: Current Procedural Terminology (CPT), Internal Classification of Disease (ICD - 10) and Healthcare Common Procedure Coding System (HCPCs) guidelines
- Performs quality review audit of vendor coding. Communicates findings to vendor for correction. Maintains departmental tracking logs/databases
- Participates in Risk Adjustment Data Validation (RADV) audits required by CMS for ACA and MA Risk Plans. Assists in preparation and implementation of necessary internal controls for related entities consistent with CMS and State requirements
- Delivers audit results to provider/provider office. Communicates findings and works with provider office to educate on coding and documentation improvement opportunities
Education
National American University - Albuquerque Campus
2002 - 2007
Bachelor's Degree in Health Information Technology
Professional Skills
- Working knowledge of Risk Adjustment Data Validation
- Experience as a Medical Billing and Coding Specialist in the field
- Experience using coding software
- Clinical nursing experience in a hospital or office setting (RN or LPN)
- Experience in medical coding
- Teaching or related field experience
- Experience is mandatory in Medical Coding
How to write Medical Coding Resume
Medical Coding role is responsible for training, insurance, general, software, travel, reporting, auditing, medical, administrative, health.
To write great resume for medical coding job, your resume must include:
- Your contact information
- Work experience
- Education
- Skill listing
Contact Information For Medical Coding Resume
The section contact information is important in your medical coding 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 Coding Resume
The section work experience is an essential part of your medical coding 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 coding 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 coding position you're applying to.
The work experience section should be the detailed summary of your latest 3 or 4 positions.
Representative Medical Coding resume experience can include:
- Serves as a subject matter expert on AHA and ICD-CM coding guidelines for physicians and other patient care team members. Responds to coding inquiries from various internal departments. Collaborates on and supports various projects where coding expertise is required, such as corporate audits
- Attends continuing education classes to maintain coding proficiency and certification requirements. Maintains knowledge of AHA Coding Clinic and ICD-10-CM Official Guidelines for Coding and Reporting
- Clinical coding experience using ICD (International Classification of Diseases and Procedures) and CPT (American Medical Association Current Procedural Terminology) coding systems
- Experience or formal training in medical terminology
- Valid driver's license and proof of insurance with the ability to travel within the region up to 50% of the time
- Have had Physical Experience in an Office not Call Center
Education on a Medical Coding Resume
Make sure to make education a priority on your medical coding resume. If you’ve been working for a few years and have a few solid positions to show, put your education after your medical coding 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 Coding Resume
When listing skills on your medical coding 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 coding skills:
- Works effectively in achieving department tasks and goals
- Experience in providing effective written and verbal communications
- Experience working knowledge of the Healthcare Effectiveness Data and Information Set (HEDIS)
- Effective Communication, Listening and Professionalism
- Strong knowledge in Medical terminology, Anatomy, ICD-9-CM and ICD-10-CM coding guidelines
- Experience or formal training in anatomy and physiology
List of Typical Skills For a Medical Coding Resume
1
Skills For Supervisor, Physician Medical Coding Resume
- Coding professional certification (CPC) required within 18 months of hire
- Codes ancillary encounters utilizing ICD-10-CM diagnosis codes according to the guidelines in Coding Clinic for ICD-10-CM
- Provide timely and accurate answers to physician's in regards to coding and billing questions
- Medical Billing and Coding Instructor Diploma awarded by an accredited institution
- Reports inaccuracies found in coding software to HIM coding supervisor and any potential unethical and/or fraudulent activity per compliance policies
- Background in supporting risk adjustment management activities and clinical informatics
- Read and interpret governmental regulations related to correct coding requirements
- Optical Coding or Several Years in Medical
- Review the medical records, identify specific diagnoses and convert to ICD-9-CM or ICD-10-CM codes by following CMS, HHS & client specific guidelines
2
Skills For Medical Coding / QA Manager Resume
- Knowledge of health insurance contracting principles, reimbursement, terms, and conditions required
- Meets facility productivity and quality standards for ancillary coding
- Review and approve services as well as perform charge entry and ensure follow up of charges
- Ensure all services are documented and coded with correct diagnoses and procedure codes seek to attain proper documentation
- Maintain knowledge of CPT-4 and ICD-9/10-CM coding principles, governmental regulations, protocols and third-party requirements pertaining to billing and coding
- Conduct reviews of records to ensure compliance with guidelines and governmental requirements
- Ensure maximum efficiency and reimbursement for services
- Acceptable certifications: RHIA, RHIT, CPC, CCS, CC
3
Skills For Medical Coding Quality Consultant Resume
- Review medical records, interpret and apply L&I payment policies, rules, laws and procedural coding guidelines (CPT®, HCPCs, local codes) in order to determine whether a provider's services were documented and billed appropriately
- Communicate analytical findings and directives to healthcare providers through the issuance of audit reports and legal orders
- Lead post audit discussions and negotiations with providers and/or attorneys to achieve resolution
- Work with the state's Attorney General's office in preparation of court hearings and provide testimony at court hearings related to audit findings
- Perform quality assurance reviews of audits performed by other team members
- Provide consultative services to department staff and medical provider's regarding laws, rules and payment policies which affect payment to healthcare providers
- Assures the final diagnoses and procedures as stated by the physician are valid and complete
4
Skills For Field Based Medical Coding Quality Consultant Resume
- Demonstrated proficiency in computerized data entry required
- Assigns and sequences ICD-10-CM/CPT/HCPCS codes to diagnoses and procedures for documented information
- Ensures adherence to HIPAA
- Ensures adherence to norms specified by the company and the client
- Ensures strict adherence to compliance and work ethics
- Able to be Flexible to work longer hours if needed
5
Skills For Medical Coding Spec Senior Resume
- Can work as an Individual but have Team Mind Set
- Flag reports/send queries to the provider for documentation deficiency
- Certification like CPC/CIC/COC/CCS/CRS from AAPC/AIHMA is mandatory
- Current CPC or CCS
- Certified Coding Specialist (CCS) through the American Health Information Management Association (AHIMA) or Certified Professional Coder (CPC)/(CPC-H) through AAPC
- Total Quality Management (TQM) concepts, techniques, process and outcome measurements experience
6
Skills For Medical Coding Quality Analyst Resume
- Proof of education and immunizations Required
- Updates knowledge and skills by reviewing quarterly Coding Clinic and completing semi-annual quiz, attending company coder training as required, and reviewing coding newsletters
- E/M CPT, Radiology or HCC coding experience encouraged
- The coder needs to be proficient in ICD-10-CM coding guidelines
- Optical Coding for Insurance payments
7
Skills For Medical Coding / Audit Supp Specialist Resume
- Mentoring others
- CPC (AAPC) or CCS (AHIMA)Certification required
- In a health insurance field
- American Academy of Professional Coders (AAPC)
Related to Medical Coding Resume Samples
Coding Auditor Resume Sample
Work Experience
• Audits external vendors’ coding based on medical record reviews
• Works on additional risk adjustment audit requests (i.e. outside auditors’ requests)
• Develops and maintains an education calendar and individual continuing education and orientation record for each member of ...
Professional Skills
• Excellent written and communication skills...
• Demonstrated organizational, problem-solvi...
• Strong communication skills - ability to t...
Medical Coder Resume Sample
Work Experience
• 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
• Tr...
Professional Skills
• One year clinical experience to include ge...
• Demonstrated proficiency working with Epic...
• Strong computer skills; understanding of R...
Medical Coding Specialist Resume Sample
Work Experience
• Codes, abstracts and analyzes inpatient and/or outpatient medical records using International Classification of Diseases, Tenth Revision (ICD-10). Always coding to the highest level of specificity
• Identifies coding error (e.g., incorrect primary diagnosis, MCC’s, CC’s, and procedure codes) and re...
Professional Skills
• + Strong critical thinking and problem sol...
• Experience in general computer skills and ...
• Leadership skills to develop team concepts...
Analyst / Senior Quantitative Analyst Resume Sample
Work Experience
• Chartered Financial Analyst (CFA), Financial Risk Manager (FRM) designation
• Monitor the effectiveness of models in use and continually update model parameters with actual results and changing trends
• Create, enhance and maintain models and model parameters for various mode...
Professional Skills
• Hands on experience with credit risk model...
• Other programming/software familiarity: st...
• Excellent interpersonal and communications...
Full Stack .NET Developer Resume Sample
Work Experience
• Design and development of software applications (primarily web based) used in various areas of the bank (such as Loans processing, Treasury, Middle Office etc.)
• Unit and Integration Testing – planning, execution and evaluation
• Production Release preparation and coordinati...
Specialist, BI Resume Sample
Work Experience
• Understands logical and physical data models, data modeling methodologies
• Experience in data reporting and visualization area with atleast 2-3 years’ experience on Tableau development
• Experience as BI/DW consultant
• Intelligence, analytical mindset...
Professional Skills
• Attention to detail and strong interperson...
• Strong skills and experience with scriptin...
• Strong project management skills including...