Coding Consultant Resume Sample

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Ernie Bashirian
296 Schumm Ville,  Boston, MA
+1 (555) 799 6297

Work Experience


Senior Documentation & Coding Consultant
02/2017 - PRESENT
Chicago, IL
  • Typically works remotely, accessing work related tasks via VPN access
  • Reports to work as scheduled
  • Willing and able to travel when necessary, if applicable
  • Complies with all CIOX Health and HIM Division policies and procedures
  • Responsible for tracking continuing education credits to maintain professional credentials
  • Attends CIOX Health mandatory sponsored in-service and/or education meetings as required
  • Adheres to the American Health Information Management Association’s code of ethics
  • Complies with all IOD and HIM Division policies and procedures
  • Reviews medical records and assigns accurate codes for diagnoses and procedures
Medicare Risk Adjustment & Coding Consultant
02/2011 - 11/2016
San Francisco, CA
  • Assigns and sequences codes accurately based on medical record documentation
  • Assigns the appropriate discharge disposition
  • Abstracts and enters the coded data for hospital statistical and reporting requirements
  • Maintains 95% coding accuracy rate and 95% accuracy rate for APC assignment and maintains site designated productivity standards
  • Attend CIOX Health sponsored education meetings/in-services
  • Demonstrate initiative and judgment in performance of job responsibilities
  • Communicate with co-workers, management, and hospital staff regarding clinical and reimbursement issues
  • Function in a professional, efficient and positive manner
Clinical Coding Consultant
04/2008 - 08/2010
San Francisco, CA
  • Adhere to the American Health Information Management Association’s code of ethics
  • High complexity of work function and decision making
  • Willing and able to travel when necessary if applicable
  • Complies with all HIM Division Policies
  • One to five years of coding experience in a hospital and/or coding consulting role
  • Passing annual Introductory HIPAA examination and other assigned testing to be given annually in accordance with employee review
  • Assists providers in understanding the Medicare quality program as well as CMS - HCC Risk Adjustment program as it relates to payment methodology and the importance of proper chart documentation of procedures and diagnosis coding

Education


Keiser University - Daytona Beach Campus
2003 - 2007
Bachelor's Degree in Health Care

Professional Skills


  • Excellent oral & written communication skills (experience giving group presentations)
  • Excellent oral and written communication skills (experience giving group presentations)
  • Clinic or hospital experience and / or managed care experience
  • Clinic or hospital experience and/or managed care experience
  • Clinic or hospital experience and/or managed care experience
  • Clinic or hospital experience and / or managed care experience
  • Clinic or hospital experience and/or managed care experience

How to write Coding Consultant Resume

Coding Consultant role is responsible for insurance, reporting, training, travel, health, consulting, coding, analysis, education, compliance.
To write great resume for coding consultant job, your resume must include:

  • Your contact information
  • Work experience
  • Education
  • Skill listing

Contact Information For Coding Consultant Resume

The section contact information is important in your coding consultant 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
  • Email
  • Telephone number

Work Experience in Your Coding Consultant Resume

The section work experience is an essential part of your coding consultant 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 coding consultant responsibilities. It's meant to present you as a wholesome candidate by showcasing your relevant accomplishments and should be tailored specifically to the particular coding consultant position you're applying to. The work experience section should be the detailed summary of your latest 3 or 4 positions. Representative Coding Consultant resume experience can include:

  • Assist providers in understanding quality and CMS-HCC Risk Adjustment driven payment methodology and the importance of proper chart documentation of procedures and diagnosis coding
  • Utilizes analytics and identifies and target providers for Medicare Risk Adjustment training and documentation / coding resources
  • Assist providers in understanding quality and CMS - HCC Risk Adjustment driven payment methodology and the importance of proper chart documentation of procedures and diagnosis coding
  • Provides ICD - 10 - HCC coding training to providers and appropriate staff
  • Provides ICD10 - HCC coding training to providers and appropriate staff
  • Liaise with the CHKS clinical coding professional leads for any coding queries

Education on a Coding Consultant Resume

Make sure to make education a priority on your coding consultant resume. If you’ve been working for a few years and have a few solid positions to show, put your education after your coding consultant 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 Coding Consultant Resume

When listing skills on your coding consultant 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 coding consultant skills:

  • CCS: Certified Coding Specialist Certification and two years of coding experience
  • Nursing/coding experience (surgical, hospital, clinic settings)
  • Conduct coding reviews to assess the overall effectiveness of clients’ coding systems
  • More than 2 years coding experience
  • Experience coding in health care facility
  • Experience working in a government, legal, law enforcement, investigations, healthcare, managed care and / or health insurance environment

List of Typical Experience For a Coding Consultant Resume

1

Experience For Medicare Risk Adjustment & Coding Consultant Resume

  • Supports the providers by ensuring documentation supports the submission of relevant ICD - 10 codes and CPTII procedural information in accordance with national coding guidelines and appropriate reimbursement requirements
  • Trains providers and other staff regarding documentation, billing, and coding and provides feedback to providers regarding documentation practices
  • Trains Providers and other staff regarding documentation, billing and coding and provides feedback to Providers regarding documentation practices
  • Provides ICD10 - HCC coding training to providers and appropriate staff (not including CEUs)
  • Provides mentorship and training to on-boarding coders
  • Reports statistics concerning coding accuracy levels
  • Utilizes analytics and identifies targeted providers for Medicare Risk Adjustment training and documentation/coding resources
  • Utilizes analytics and identifies and targets providers for Medicare Risk Adjustment training and documentation/coding resources
  • Utilize analytics and identifies targeted providers for Medicare Risk Adjustment training and documentation/coding resources
2

Experience For Provider Coding Consultant Resume

  • Assigns DRS's proficiently for high case mix index facilities and analyzes documentation for appropriate severity of illness and risk of mortality reporting
  • Develops and delivers Optum diagnosis coding tools to providers
  • Review Fraud and Abuse cases to mitigate fraudulent, wasteful, abusive, or erroneous billing
  • Reviews selected medical documentation to determine appropriate diagnoses, procedures codes and ICD-10 condition are coded per CMS coding guidelines
  • Coordinates documentation needs, query follow-up and final DRG assignment with the Clinical Documentation Specialist
  • Assists providers in understanding the CMS-HCC Risk Adjustment program as it relates to payment methodology and the importance of proper chart documentation of procedures and diagnoses coding
3

Experience For Clinical Coding Consultant Resume

  • Understands Medicare Stars quality program utilizing analytics and identifies targeted providers
  • Assists providers in understanding the MCAIP incentive program, Medicare Stars quality and CMS -HCC Risk Adjustment driven payment methodology, with importance of proper chart documentation of procedures and diagnosis coding
  • Supports providers by ensuring documentation requirements are met for the submission of relevant ICD-10 codes and CPTII procedural information in accordance with national coding guidelines and appropriate reimbursement requirements
  • Routinely consults with medical providers to clarify missing or inadequate record information to determine appropriate diagnostic and procedure codes
  • Ensures member encounter data (services and disease conditions) is being accurately documented and relevant procedural codes, as well as all relevant diagnosis codes, are captured
4

Experience For Healthcare Coding Consultant Resume

  • Provides thorough, timely, and accurate consultation on ICD-10 and/or CPTII codes to providers or practice teams
  • Refers inconsistent or incomplete patient treatment information/documentation to coding quality analyst, provider, supervisor, or individual department for clarification/additional information for accurate code assignment
  • Educates providers and staff on coding regulations and changes as they relate to Quality and Risk Adjustment to ensure compliance with state and federal regulations
  • Reviews selected medical documentation to determine appropriate diagnoses, procedures codes, and ICD-10 conditions are coded per CMS coding guidelines
  • Performs analysis and provides formal feedback to providers on regularly scheduled basis
5

Experience For Certified Medical Coding Consultant Resume

  • Collaborates with providers, coders, facility staff, and a variety of internal and external personnel on wide scope of Risk Adjustment and Quality education efforts
  • Conduct confidential investigations, document relevant findings and report any illegal activities in accordance with all laws and regulations
  • Review claims, look for patterns of potential fraud, waste and / or abuse and interact with medical providers to request medical records for investigations
  • Conduct onsite provider claim and / or coding audits (utilizing appropriate personnel) to gather and analyze all necessary information and documents related to the investigation
  • Review claim and case history and compare medical documentation against procedural codes billed
6

Experience For Medicare Risk Adjustment & Coding Consultant Telecommute Resume

  • Update internal systems as needed
  • Interview patients when appropriate
  • Gather and analyze all necessary information and documents related to the investigation
  • Investigate, prevent payment when appropriate and resolve cases
  • Assists providers in understanding the Medical Condition Assessment Incentive Program and Medicare Stars quality and CMS - HCC Risk Adjustment driven payment methodology and the importance of proper chart documentation of procedures and diagnosis coding
  • Trains physicians and other staff regarding documentation and billing and coding, and provides feedback to physicians regarding documentation practices
7

Experience For Implementation & Coding Consultant Resume

  • Provides thorough, timely, and accurate consultation on ICD-10 and/or CPT 2 codes by providers or practice clinical consultants
  • Reviews selected medical documentation to determine if assigned diagnosis, procedures codes, and ICD-10 codes are appropriately assigned
  • Collaborates with doctors, coders, facility staff, and a variety of internal and external personnel on a wide scope of Risk Adjustment and Quality education efforts
  • Assist providers in understanding the CMS-HCC Risk Adjustment program as it relates to payment methodology and the importance of proper chart documentation of procedures and diagnoses coding. Understand Medicare Stars quality program utilizing analytics and identifies and targeted providers
  • Monitor Stars quality performance data for providers and promotes improved healthcare outcomes
8

Experience For RN Coding Consultant, K Sign on Bonus Resume

  • Assist providers in understanding the MCAIP incentive program, Medicare Stars quality and CMS -HCC Risk Adjustment driven payment methodology with importance of proper chart documentation of procedures and diagnosis coding
  • Supports the Providers by ensuring documentation requirements are met for the submission of relevant ICD -10 codes and CPTII procedural information in accordance with national coding guidelines and appropriate reimbursement requirements
  • Ensures member encounter data (services and disease conditions) is being accurately documented and relevant procedural codes as well as all relevant diagnosis codes are captured
  • Provides thorough, timely and accurate consultation on ICD-10 and/or CPTII codes to providers or practice teams
  • Collaborates with providers, coders, facility staff and a variety of internal and external personnel on wide scope of Risk Adjustment and Quality education efforts
9

Experience For Him-remote Inpatient Coding Consultant Resume

  • Routinely consult with medical providers to clarify missing or inadequate record information to determine appropriate diagnostic and procedure codes
  • Ensure member encounter data (services and disease conditions) is being accurately documented and relevant procedural codes as well as all relevant diagnosis codes are captured
  • Provide thorough, timely and accurate consultation on ICD-10 and/or CPTII codes to providers or practice teams
  • Refer inconsistent or incomplete patient treatment information/documentation to coding quality analyst, provider, supervisor or individual department for clarification/additional information for accurate code assignment
  • Train Providers and other staff regarding documentation, billing and coding and provides feedback to Providers regarding documentation practices
10

Experience For Him-remote Provider Practice Coding Consultant Resume

  • Provide ICD10 - HCC coding training to providers and appropriate staff (not including CEUs)
  • Develop and deliver Optum diagnosis coding tools to providers
  • Review selected medical documentation to determine appropriate diagnoses, procedures codes and ICD-10 condition are coded per CMS coding guidelines
  • Assess adequacy of documentation and queries providers to obtain additional medical record documentation or to clarify documentation to ensure accurate and appropriate coding
  • Completes analysis of documentation, abstracting and code assignment by body system, organ, etiology and morphology according to the American Hospital Association Official ICD-9-CM and ICD-10 Coding Guidelines (Coding Clinic), CPT4/HCPCS Coding Guidelines, ASC groups, UHDDS Guidelines, HCFA methodology guidelines for coding, state and federal guidelines and hospital abstracting guidelines
  • Certified Risk Adjustment Coder or Certified Professional Coder with American Health Information Management Association or American Academy of Professional Coders with willingness to obtain required certification within first year in position - CRC or CPC whichever is not credentialed at time of hire. (CRC within 6 month of hire, CPC within 1 year of hire)

List of Typical Skills For a Coding Consultant Resume

1

Skills For Medicare Risk Adjustment & Coding Consultant Resume

  • Experience with claims processing systems
  • ) of experience coding in health care facility
  • Experience coding in health care facility
  • Experience coding performed at a health care facility
  • Good work ethic, desire to success, self-starter
  • Previous experience in Risk Adjustment and / or HEDIS / Stars
  • Previous experience in Risk Adjustment and/or HEDIS/Stars
  • Experience in Risk Adjustment and HEDIS/Stars
  • Experience in Risk Adjustment and HEDIS / Stars
2

Skills For Provider Coding Consultant Resume

  • Good work ethic, desire to succeed, self-starter
  • Experience in Risk Adjustment and HEDIS / Stars
  • Experience in management position in a provider primary care practice
  • To undertake clinical coding service on behalf of CHKS Coding and Financial Assurance to their Private Healthcare Providers
  • Visit client hospital sites on a regular (daily) basis to support coding during each month and for month end completeness
3

Skills For Clinical Coding Consultant Resume

  • To act as an ambassador for CHKS CFA by providing a professional coding service
  • Undertake remote coding from home as and when required
  • Coding performed at a health care facility
  • Travel regionally up to 75% (primarily day trips depending on region)
4

Skills For Healthcare Coding Consultant Resume

  • Knowledge of billing/claims submission and other related action
  • Knowledge of ICD10-CM coding
  • Deliver training materials designed to improve provider compliance
  • Adhere to the clinical coding conventions and procedures as defined by the World Health Organisation (WHO) and National Classifications Service
  • Clinically code the patient records from the medical record provided
5

Skills For Certified Medical Coding Consultant Resume

  • Develop long-term relationships
  • CRC certification or willingness to obtain certification within 120 days
  • Certified Professional Coder / CPC - A or willingness to obtain required certification within first year in position; equivalent certifications acceptable
  • Currently possess the CRC certification or willingness to be enrolled in CRC course within 120 days of hire and obtain certification within 6 months of hire
  • CRC certification or willingness to be enrolled in CRC course within within 120 days of hire and obtain certification within 6 months of hire
6

Skills For Medicare Risk Adjustment & Coding Consultant Telecommute Resume

  • Intermediate level of proficiency in MS Office (Excel (Pivot tables, excel functions), PowerPoint and Word)
  • Certified Risk Adjustment Coder AND/OR Certified Professional Coder with the American Academy of Professional Coders with the requirement to obtain both certifications, CRC and CPC, within first year in position - (CRC within 6 months of hire and CPC within 1 year of hire)
  • Certified Risk Adjustment Coder AND/OR Certified Professional Coder with the American Academy of Professional Coders, with the requirement to obtain both certifications, CRC and CPC, within first year in position (CRC within 6 months of hire, and CPC within 1 year of hire)
  • Advanced proficiency in MS Office (Excel, PowerPoint, and Word)
  • Demonstrate a level of knowledge and understanding of ICD10-CM and CPT coding principles consistent with certification by the American Academy of Professional Coders
7

Skills For Implementation & Coding Consultant Resume

  • Previous experience in management position in a provider primary care practice
  • RN, LPN or certified coder
  • An intermediate level of knowledge with Local, State & Federal laws and regulations pertaining to health insurance (Medicare, Medicare Advantage, Medicare Part D, Medicaid, Tricare, Pharmacy and / or commercial health insurance)
  • HS diploma / GED or higher
  • Certified Risk Adjustment Coder AND/OR Certified Professional Coder with the American Academy of Professional Coders, with the requirement to obtain both certifications (CRC and CPC) within first year in position; CRC within 6 months of hire and CPC within 1 year of hire
  • Experience in Risk Adjustment
  • Experience coding in healthcare facility
8

Skills For RN Coding Consultant, K Sign on Bonus Resume

  • Intermediate level of proficiency in MS Office - Excel (pivot tables, excel functions), PowerPoint, and Word
  • Travel approximately 50% regionally
  • Intermediate level of proficiency in MS Office - Excel (pivot tables, functions), PowerPoint, and Word
  • Certified Risk Adjustment Coder AND/OR Certified Professional Coder with the American Academy of Professional Coders with the requirement to obtain both certifications, CRC and CPC, within first year in position (CRC within 6 months of hire, and CPC within 1 year of hire) OR CMBS (Certified Medical Billing Specialist)
  • Certified Risk Adjustment Coder AND / OR Certified Professional Coder with the American Academy of Professional Coders with the requirement to obtain both certifications, CRC and CPC, within first year in position (CRC within 6 months of hire and CPC within 1 year of hire)
  • Travel regionally approximately 75%
9

Skills For Him-remote Inpatient Coding Consultant Resume

  • Provides thorough, timely and accurate consultation on ICD - 10 and / or CPT 2 codes by providers or practice clinical consultants
  • Reviews selected medical documentation to determine if assigned diagnosis, procedures codes and ICD - 10 codes are appropriately assigned
  • Supports the providers by ensuring documentation supports the submission of relevant ICD - 10 codes and CPT2 procedural information in accordance with national coding guidelines and appropriate reimbursement requirements
  • Reviews selected medical documentation to determine if assigned diagnosis, procedures codes and ICD - 10 codes are appropriately assigned Assesses adequacy of documentation and queries providers to obtain additional medical record documentation or to clarify documentation to ensure accurate and appropriate coding
  • Refers inconsistent or incomplete patient treatment information / documentation to coding quality analyst, provider, supervisor or individual department for clarification / additional information for accurate code assignment
  • Provides thorough, timely and accurate consultation on ICD-10 and / or CPT 2 codes by providers or practice clinical consultants
10

Skills For Him-remote Provider Practice Coding Consultant Resume

  • Provides thorough, timely and accurate consultation on ICD -10 and / or CPT 2 codes by providers or practice clinical consultants
  • Facilitates and/or performs an audit of the providers’ medical chart to ensure appropriate documentation exists to support the diagnoses submitted appropriately
  • Assists providers in understanding quality and CMS-HCC Risk Adjustment driven payment methodology and the importance of proper chart documentation of procedures and diagnosis coding
  • Ensure completeness of coding, continually striving to maintain timeliness, accuracy and consistency of clinical coding when undertaking the remote coding service
  • To follow locally defined variations as appropriate to meet the agreed weekly/monthly clinical coding deadlines as set by the client, ensuring the number of episodes are completed as outlined within the contract without comprising data quality
  • Assists providers in understanding the CMS-HC Risk Adjustment program as it relates to payment methodology and the importance of proper chart documentation of procedures and diagnosis coding
  • Assist providers in understanding the Medical Condition Assessment Incentive Program and Medicare Stars quality and CMS - HCC Risk Adjustment driven payment methodology and the importance of proper chart documentation of procedures and diagnosis coding
  • Supports the providers by ensuring documentation supports the submission of relevant ICD -10 codes and CPTII procedural information in accordance with national coding guidelines and appropriate reimbursement requirements

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