Certified Coding Specialist Resume Sample
Susanna Mraz
74626 Schuyler Stream,
Phoenix,
AZ
+1 (555) 520 0419
Work Experience
Certified Coding Specialist
10/2016
-
PRESENT
Los Angeles, CA
- Read and communicate effectively in English General computer knowledge and experience working with MS Office products Skilled in identifying and resolving problems Knowledge of Coding Guidelines and ability to apply them to Clinic Operations Knowledge of Health Insurance (Claims) processing and Clinic Operations
- Monitoring and working work queues/dashboard for assigned providers and specialties, to include coding, researching, correcting claims and trending of coding/billing behaviors
- Code all documented professional services provided in both clinic and other facilities
- Applies CPT-4, ICD-10-CM, HCPCS and modifiers following coding guidelines
- Adheres to official coding guidelines, AMA and CMS
- Expert in reviewing assigned providers/specialty areas and preparing educational communication, supporting documentation, etc. for provider and other Team coding/billing inquires
- Ensures coded services, provider charges and medical record documentation meet appropriate guidelines and standards
- Keeps abreast of coding guidelines and reimbursement reporting requirements
Certified Coding Specialist
11/2010
-
08/2016
Dallas, TX
- Fields coding questions and ensures review of patient complaints as well as insurance related inquires on behalf of assigned providers and specialties as needed
- Illustrate knowledge of healthcare industry in areas of coding, revenue cycle, claims and state specific insurance/laws
- Ensure timely charge review/processing of daily submissions
- Works collaboratively with Team to ensure monthly goals are met
- Provides feedback to physicians related to documentation issues and/or revenue opportunities
- Queries physicians when code assignments are not straightforward or documentation in the record in inadequate, ambiguous, or unclear for coding purposes
- Utilize appropriate application/methods to ensure all documented professional services are submitted timely
- Work on assigned coding projects and compile summary reports as needed
Education
University of Mount Union
2005 - 2009
Mba's Degree in Health
Professional Skills
- Assigns appropriate codes using Current Procedural Coding Expert and International Classification of Disease system
- Communicate with patients regarding coding questions/concerns
- Responds to fluctuating staffing needs as evidenced by flexibility in own work assignments and schedule
- Works with physicians/staff to resolve coding issues in the office
- Maintains professional licensure, utilizing local AAPC and AHIMA monthly chapter meetings
- Consults Knowledge Source or other references for coding information
- CCS (Certified Coding Specialist) Required
How to write Certified Coding Specialist Resume
Certified Coding Specialist role is responsible for insurance, research, reporting, auditing, training, finance, travel, health, general, compliance.
To write great resume for certified coding specialist job, your resume must include:
- Your contact information
- Work experience
- Education
- Skill listing
Contact Information For Certified Coding Specialist Resume
The section contact information is important in your certified 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 Certified Coding Specialist Resume
The section work experience is an essential part of your certified 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 certified 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 certified coding specialist position you're applying to.
The work experience section should be the detailed summary of your latest 3 or 4 positions.
Representative Certified Coding Specialist resume experience can include:
- Two years training or supervisory experience required
- One year of experience required with CCA (Certified Coding Associate)
- Two years of experience with at least one year in out patient coding required
- Identify/trend/summarize potential compliance, coding, billing concerns and bring forth a potential resolution
- Responsible for remaining up-to-date with knowledge of AHA ICD-9-CM/ICD-10-CM/PCS and AMA CPT-4 coding conventions, MS-DRG and APR-DRG principles and guidelines. Maintains a working knowledge of prospective payment systems as it relates directly to coding process
- Licensure/Certification: certified coding specialist through AHIMA or Certified Professional Coder through AAPC is required. Certified Risk Adjustment Coder (CRC) required within 1 year of hire
Education on a Certified Coding Specialist Resume
Make sure to make education a priority on your certified 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 certified 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 Certified Coding Specialist Resume
When listing skills on your certified 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 certified coding specialist skills:
- Certified Coding Specialist or Certified Professional Coder
- Certified Procedural Coder (CPC or Certified Coding Specialist – Physician (CCS-P.)(CCS)
- Quality is the cornerstone of Duke LifePoint, and it is the central focus of everything the organization and our hospital strive to achieve
- Reviews patient’s medical records
- Reviews all diagnostic procedures and assigns appropriate procedure codes
- Reviews reimbursement from third party payers to ensure payment through proper use of codes
List of Typical Skills For a Certified Coding Specialist Resume
1
Skills For Certified Coding Specialist Resume
- Serves as a resource for insurance carrier rules and changes
- Requests diagnosis from physicians when information is not recorded and obtains complete patient information
- Determines and records other required medical information
- Enhances professional growth and development through in-service meetings, education, programs, conferences, etc
- Abstracts and assigns ICD-9-CM and ICD-10-CM codes from patient records
- Consults with peers on new or unfamiliar diagnosis/procedures
- Assures information is available for peer review and Medicare review
- Participates in department’s efforts to enhance productivity as directed by supervisor
- Demonstrates courteous behavior through polite and respectful communication with all co-workers, physicians and visitors as evidenced by observation and feedback from others
2
Skills For Certified Coding Specialist Resume
- Promotes a professional image of the department
- Completion of a Coding and Billing Program that is accredited by American Academy of Professional Coders (AAPC) or American Health Information Management Association (AHIMA)
- Read and communicate effectively in English General computer knowledge and experience working with MS Office products
- Registered Health Information Administrator or Registered Health Information Technician
- Certified Coder with either AAPC or AHIMA
3
Skills For Certified Coding Specialist Resume
- Certified Coding Specialist (CCS) or Certified Professional Coder (CPC) or Registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT)
- Also required are: demonstrated excellent interpersonal, and verbal and written communication skills; strong presentation skills; and strong organizational, analytical, and problem-solving skills
- Skilled in identifying and resolving problems Knowledge of Coding Guidelines and ability to apply them to Clinic Operations Knowledge of Health Insurance (Claims) processing and Clinic Operations
- Maintains daily productivity and turnaround times as outlined in Department’s Performance Improvement plan (attachment A)Responsible for remaining up-to-date with knowledge of AHA ICD-9-CM/ICD-10-CM/PCS and AMA CPT-4 coding conventions, MS-DRG and APR-DRG principles and guidelines
- Maintains daily productivity and turnaround times as outlined in Department’s Performance Improvement plan
- O Codes and abstracts diagnosis and procedure information from patient medical records according to AHA ICD-9-CM/ICD-10-CM/PCS and AMA CPT-4 coding conventions, UHDDS and CMS guidelines and regulations. Utilizes the 3M Encoder to verify and assign AHA ICD-9-CM/ICD-10-CM/PCS and AMA CPT-4 codes, and MS-DRG/APR-DRG assignment
- Assists with daily operations and resolving issues and billing/coding discrepancies. Coordinates staff assignments to meet workload demands as indicated by volume statistics
4
Skills For Certified Coding Specialist Resume
- Serves as a liaison to Health Information Management (HIM) managers and other departments to resolve coding issues, including coding inaccuracies and denial processing
- Assists team members with issues requiring immediate attention including resolving inconsistencies in documentation
- Adhere to internal department policies and procedures to ensure efficient work processes. Actively participate in periodic coding meetings and shares ideas and suggestions for operational improvements
- Demonstrate proficiency on billing system functionality, computer applications and resources essential to completing the coding process
- Respond to audit findings by providing documentation references and copies of record to Coding Manager to assist in preparing a facility response
5
Skills For Certified Coding Specialist Resume
- Responsible for assigning PQRS codes and assists in the development of templates and processes to obtain the appropriate documentation
- Supervises staff including assignments and Kronos approval and sign offs, as well as, assist with recruitment
- Assign appropriate diagnosis codes for all out patient encounters utilizing current classification systems
- Extract required information from source documentation and enter into encounter and abstracting system
- Maintain up to date knowledge of coding guidelines and reimbursement report guidelines
- Assign appropriate diagnosis codes for all outpatient encounters and inpatient encounters utilizing current classification systems
6
Skills For Certified Coding Specialist Resume
- Assists in training of new personnel
- Complete work assignments in a timely manner and adhere to department charge lag goals and understand the workflow of the department
- Investigate, resolve and analyze edits and denials and provide reports for process improvement, as necessary
- Make forward progress within the training period toward meeting coding accuracy standards of the department within the first year of employment. Meet appropriate coding productivity standards within the time frame established by management staff
- Perform staff coding audit, monitors performance and completes summary reports for management
- Actively practice behaviors associated with SH Service Excellence expectations. Smile at and greet everyone enthusiastically, treat everyone with respect, dignity and C.A.R.E. Be an ambassador for Susquehanna Health. Provide the best C.A.R.E. for our patients no matter what
7
Skills For Certified Coding Specialist Resume
- Assume responsibility for personal development and education
- Follow specific guidelines to ensure appropriate code assignment and optimal reimbursement
- Initiate a physician query when documentation in the record is inadequate, ambiguous or unclear for coding purposes and an accurate code assignment can not be applied
- Know and follow all organizational/departmental policies/procedures
- Review records and provide codes to support medical necessity requests for specific tests as identified by Finance
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