The perfect resume will show the recruiter coding skills laced with a healthy … Performed computer assisted coding (CAC) using radiology information systems. Certified Medical Coder with one of the following active certifications and with a high degree of competency (CPC, CPC-A, CPC-H, or CPMA from AAPC; or CCA, Knowledge/experience with ICD-10 and CPT coding, This role requires travel within the general/local area, Support the Risk Adjustment Department in the review of provider medical records for compliant documentation and coding, Identify appropriate assignment of ICD - 10 Codes for Professional services, Coding and Documentation Education to our PCP Network, HCC education to our Provider and Specialist Network, Support the Coding Processors in the review of PCP completed attestation forms, 3+ years coding experience; outpatient or inpatient, CCS or CPC credentials through AHIMA or AAPC, Computer proficiency; can type, create, edit, search web browsers, toggle between multiple screens, use Word, Outlook, Excel and navigate in a Windows environment, Access to reliable transportation that will enable you to travel to Physician offices and company meetings, Accurately abstract information from the medial records into the appropriate coding systems, ensuring compliance with established guidelines, Enter and validate charges using appropriate tools and validates diagnoses with the medical documentation provided, Compare charges on accounts with the procedures coded and identifies any discrepancies. Every day you follow the right structure to help both people and machines read the same language. Together with averting the errors that are aforementioned, in addition, it is sensible… Read More » Create a resume in 5 minutes. A medical biller resume should show your ability to use medical codes to document patient diagnoses and treatments—but to put yours over the top, you should show how you’re detail-oriented … Medical Coder Resume Writing A resume is an important document you will need to have if you are looking for a job as medical coder. This education is being used by some of the top health systems in the country, You’re a key player in MedAssets-Precyse's Compliance Program, demonstrating knowledge of HIPAA Privacy and Security Regulation information, promoting confidentiality in handling patient information, Our coding colleagues work for MedAssets-Precyse, coding records for multiple clients where the hospital has outsourced either all or a part of the coding functions to MedAssets-Precyse. Heading: Here you write your complete name, complete address, a telephone number where you can be reached, and a professional e-mail address. Not every medical coder resume includes a professional summary, but that's generally because this section is overlooked by resume writers. Interpreted medical terminology (especially related to diagnostic radiology) in order to translate it into the coding software. Medical Coding Specialist Resume Examples & Samples Code medical records - Analyze medical record for Health Care Provider documentation to determine accurate MS-DRG, APC, ICD -10 diagnostic and … Get the job you want. Summary for a Medical Biller and Coder Resume The resume summary replaces the out-of-date resume objective. Writing tips, suggestions and more. Try Now! This could include Medical, Director/physician consultations, interpretation of state and federal mandates, applicable benefit language, medical and reimbursement policies and consideration of relevant clinical information, Performs clinical coverage review of post-service, pre-payment claims, which requires interpretation of state and federal mandates, applicable benefit language, medical & reimbursement policies, coding requirements and consideration of relevant clinical information on claims with aberrant billing patterns, Performs clinical coding review to ensure accuracy of medical coding and utilizes clinical expertise and judgment to determine correct coding & billing, Identifies aberrant billing patterns and trends, evidence of fraud, waste or abuse, and recommends providers to be flagged for review, Maintains and manages daily case review assignments, with a high emphasis on quality, Provides clinical support and expertise to the other investigative and analytical areas, Participates in training of new staff, and serves as a clinical resource to other areas within the clinical investigative team, 2+ years of current CPT/HCPCS coding experience (entering codes, auditing etc. ), Ability to work 8:00 am to 4:30 pm CST Monday through Friday and overtime as business needs require, Investigational and/or Auditing experience, Understanding of ICD-10 Coding in relation to DRGs, Travel up to three days per week to providers offices, Computer proficiency; can type, create, edit, search web browsers, toggle between multiple screens, use Word, Outlook and navigate in a Windows environment, Travel up to 3 days per week to providers offices, Managed Care / IPA / Health plan experience, Support the Risk Adjustment Department in the processing of attestations as well as coding and documentation education to our provider network, Travel up to 25% - Orange County and Long Beach,CA, CCS or CPC credentials through AHIM or AAPC, Travel up to 25% in Orange County and Long Beach, CA, Adjudication of claims with zero critical errors, Completion of claims in queue within specified time frame, Ability to work accurately and efficiently at all times, including those of high processing volume, Ability to multi-task and manage time efficiently under the pressure of deadlines, Sensitivity to the confidential nature of the data and proprietary company information, Good Leadership skills (Leader without Title), Review and assign accurate medical codes for diagnoses, procedures, and services performed by physicians and other qualified healthcare providers in the office or facility setting (eg, inpatient hospital), Develop policy and work with Managed Care and Medical Affairs on trends that require payor interaction, Update education through online information as well as courses available in order to maintain strong coding skills and knowledge of legal compliance standards, Create and maintain reports for coder use in tracking productivity, denials, level of service changes made by coders, and to comply with internal audit standards, Reviews all physician documentation to ensure compliance with third party and regulatory guidelines, Proficiency across a wide range of services, including evaluation and management, anesthesia, surgery, radiology, pathology, and medicine, Understanding of how to integrate medical coding and payment policy changes into a practice's reimbursement processes, Knowledge of anatomy, physiology, and medical terminology necessary to correctly code provider diagnosis and services, ICD-10-CM Official Guidelines for Coding and Reporting, CPT® coding guidelines and parenthetical notes, Services covered under Medicare Parts A, B, C and D, Ability to apply the above skills and knowledge in audit settings and educate on findings, Minimum of 2+ years knowledge of medical coding guidelines and regulations including compliance and reimbursement – allowing a CPC to better handle issues such as medical necessity, claims denials, bundling issues, and charge capture, Maintain thorough knowledge of coding policies and procedures, and medical terminology/technology, Is able to determine benefit and coverage based on TRICARE policy and UHCMV guidelines, Consistently meet established productivity, schedule adherence, and quality standards while maintaining good attendance, Attend and participate in Prior Authorization List (PAL) Committee and Episode of Care (EOC) Committee and collaborate with PGBA on ensuring coding in CRT is consistent with PGBA processing of referrals/authorizations, Work closely with Utilization Management team to ensure timely updates of CRT for change orders and contract modifications, Work closely with IT developers on enhancements and releases, Able to recode authorization/referral requests to ensure TRICARE coverage and consistency in claims payment (unlisted codes, etc), Assist with annual review of Prior Authorization List and support coding changes as required, 1+ years of experience in a medical office or similar setting, in a medically related role such as customer service, administrative support, medical care or clerical related role, or an Associate's Degree (or higher), Certified Medical Coder ( CPC, etc) with current certification, Graduate of an Accredited Medical Coding School, Ability to navigate a PC to open applications, send emails, and conduct data entry, Ability to create, copy, edit, send and save using Microsoft Word, Excel, and Outlook, Ability to obtain favorable adjudication following submission of Department of Defense eQuip Form SF86, Associate's Degree (or higher) or some college, Certified Medical Coder with either CPC or CCS with high degree of competency in this are, 1-2 years prior coding experience in a medical office or hospital environment, Evaluates the medical record for procedures and diagnoses documented in the medical record and accurately assigns ICD-10, HCPCSs, Modifiers, and CPT codes, based on National Coding Guidelines, Assists in the identification and recommendation of system edits, Code within timeframes established by Allina hosptial coding standards, Will be reviewing provider dictation and charge entry done by business ops personnel to make certain that correctCPT codes are billed and appropriate diagnoses assigned in accordance with Provider dictation, Reports for coder use are created and maintained in both business software applications and are used for tracking productivity, denials, and level of service changes made by coders, Update education through online information as well as courses available to them in order to maintain strong coding skills and knowledge of legal compliance standards, Knowledge of Medicare/CMS requirement and Allina Policy; will perform the job in accordance with Allina’s Standards of Business Conduct, which include principles of legal compliance, ethics and integrity, confidentiality, protection of assets and avoidance of conflict of interest and inappropriate business relationships, Certified as a professional coder (CPC or CCS-P), 1+ year of medical record coding and record review experience, Knowledge of ICD-10 and experience working in a managed care health plan organization, Enjoy the benefits and learning experience of being exposed to different HIM environments, Be an active participant in client and MedAssets-Precyse staff meetings, training and conference calls, often using online technology, Learning is a daily part of your role with MedAssets-Precyse – keep your coding knowledge base current with Precyse University, available to all coding colleagues. Reviewed patients’ medical records, and translated them to universally accepted industry standard code; Coordinated with the medical coding team to convert doctor’s verbal descriptions into numeric or alpha-numeric data using ICD 10-CM, CPT & HTCPS Every day you follow the right structure to help both people and machines read the same … Below is one example of a sample resume for an entry level position in medical billing and coding. Use the medical billing and coding specialist resume sample as a guide, or use the resume builder for a customized resume in minutes, no writing needed. Start your resume with a professional profile—a catchy opening paragraph that summarizes your proudest career gigs. An optimized Medical Coder resume will get you shortlisted by showing your prowess in both medical and IT fields. It will help you showcase your skills and things you’ve learnt on courses or during internships. Travel could be up to 50%, Must have reliable transportation with valid driver’s license and insurance, Strong written and verbal communication skills; strong work analytical, organizational and time management skills are required, Professional demeanor and appearance, strong work ethic, reliable, resourceful, enthusiastic, team player with a positive attitude, Comprehensive knowledge of Microsoft Word and Excel and Access, Bachelor’s Degree in Business or a related field, Prior Coding experience, preferably in a medical office, Extensive knowledge of multiple types of Current Procedural Terminology and Healthcare Common Procedure coding systems, Knowledge and experience in a health care environment/managed care, Review medical records, patient medical history and physical exams, physician orders, progress notes, consultation reports, diagnostic reports, operative and pathology reports, and discharge summaries in order to verify whether a) the diagnosis codes are supported by the documentation and agree with ICD 10 Guidelines for Coding and Reporting, Review all medical record documentation for HEDIS and STARs capture and closure. 09/2005 – 03/2012. Medical Coder Resume Summary. Improve your career with expert tips and strategies. But one thing is certain—the recruiters want to know what you’ve learnt and where you’ve learnt it. Medical Billing Resume Medical billers are primarily responsible for handling all aspects related to medical billing and payments. Communicated with insurance companies regarding the updates in invoices. or B.A. Felicia … Want to save time and have your resume ready in 5 minutes? Speaks in a positive, professional manner about co-workers, physicians, and the facility, Attends meetings as required and strives to improve the quality of meetings by taking an active role in meeting topics. If you have the space to include it, you should. Here’s how to write a medical coder resume that proves you’re a perfect fit for the position. See 20+ resume templates and create your resume here. Even with the high demand for medial coding specialists, your resume still needs to wow your future employer. Go for a resume objective if you target entry-level positions. You will see on our medical coder resume sample that many templates … When listing skills on your medical coder resume, remember always to be honest about your level of ability. The resume that follows is a superb example for a Medical Coder resume and would guide you towards writing a resume of your own caliber. Easily Editable & Printable. Protect the security of medical records to ensure that confidentiality is maintained, Participate in inter-rater reliability testing/peer review exercises, as requested, Experience with commercial claims and/or medical/surgical products or Medicare advantage or Medicare fee for service program coverage, the Common Procedure Coding System (HCPCS), International Classification of Diseases (ICD-9, ICD-10) information, Knowledge of coding International Classification of Diseases, 9th Revision (ICD-9) codes, Understands and applies appropriate Centers for Medicare & Medicaid Services (CMS) guidelines to coding, Knowledge of anatomy, physiology and medical terminology, Excellent verbal, math and written communication skills, ------------------------------------------------------------------------------------, Responsible for conducting non-routine audits, documenting & communicating findings and recommendations, explaining regulatory requirements, and overseeing the corrective actions for audits, Conduct risk assessments and preparation of work plans, Develop an understanding of the operations, system processes and procedures used in areas being audited, Review and test for compliance with institutional policies and procedures, applicable laws and regulations through the inspection of physical operations, processes, retrieval and review of documents and investigation of irregularities and errors, Compile information and/or prepare reports and analyses setting forth results of compliance audits with appropriate recommendations; perform subsequent audits to ensure complete and appropriate corrective action, Develop recommended corrective actions to address issues detected, Actively participates in exit conferences, providing clarification and supporting information necessary, Bachelors degree and coding certifications REQUIRED**, Assists the Business Office and external agencies in clarification of coding regarding reimbursement issues. 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