Medical Biller And Coder Resume
Thousand Oaks, CA
SUMMARY:
Seeking a medical billing, collecting, or coding specialist position within the company. Experience in reconciling insurance and resolving patient accounts. Versatile quality assurance expert, enhancing productivity while minimizing quality risks. Able to visualize defects and recommend best practice solutions.
CORE COMPETENCIES:
Medical Billing Software MEDISOFT
Aging Report and Follow - up
CMS 1500/HCFA, UB04/UB92, ADA Forms
Entering Demographics
EHR systems MEDCIN
HIPAA/ CMS Compliant
HMO/ PPO/ IPA/ POS plans
Medical/Dental Terminology
Insurance verification
TAR forms/ Authorizations/ Referrals
Quality Mangement Systems
Supplier Quality Systems
FDA/ External & Internal audits
Appeal Letters/Correspondence
Posting Charges and Payments on Accout
ICD-9, ICD-10 CPT, HCPCS, and CDT Coding
Scheduling Appointments/ Printing Superbills
Typing 50 wpm/ 10 Key by touch
Medical Records
Contract Interpretation
Medicare/ Med-Cal guidelines
EOB/ EOMD Proficient/ Accounts Receivable
Regulatory Compliance
Six Sigma/ DMAIC
Cross-Functional Team Building
Continuous Improvement
PROFESSIONAL EXPERIENCE:
Confidential, Thousand Oaks, CA
Medical Biller and Coder
Responsibilities:
- Participated in 200-hour unpaid externship.
- Using Prime Clinical EHR software, posted charges and payments on accounts for time and accuracy.
- Submitted charge statements to Medicare, Medicaid, patients, and private health insurance providers.
- Under supervision, applied ICD-10 and CPT coding to health records under supervision.
- Performed follow-up on past due bills.
Confidential, El Segundo, CA
Facilities Technical Specialist
Responsibilities:
- Performed and tracked department root cause investigations targeting non-conformance resolution within 30 days.
- Coordinated efforts across multiple departments to gather supporting justification data to determine appropriate corrective and preventative actions.
- Created/revised Standard Operating Procedures (SOPs).
- Managed department personnel training.
Confidential, Thousand Oaks, CA
Senior Quality Operations Analyst
Responsibilities:
- Spearheaded Corrective Action Preventive Action (CAPA) management across entire facility including manufacturing and quality control (QC).
- Organized comprehensive root cause investigations targeting non-conformance resolution within 30 days.
- Advanced continuous improvement initiatives to prevent recurrences.
- Provided compliance to good manufacturing practices (GMP) regulations and assisted in documentation for area operations and support processes.
Quality Operations Analyst
Confidential
Responsibilities:
- Performed statistical trending on temperature-controlled equipment monitored by Confidential system.
- Participated in quality audits. Defended investigation outcomes during reviews by regulatory agency auditors.
- Sharpened manufacturing processes by uncovering compliance deficiencies after being recruited to audit Confidential vaccine operations.
QA Product Release Associate
Confidential
Responsibilities:
- Reviewed bulk manufacturing and final product batch records for GMP and compliance with FDA, product license, and SOP requirements.
- Exercised approval authority.
- Completed 100% of product release activities within established timelines.
- Broadened expertise by assisting with product complaint investigations.