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Your Name

Physician Services

Fairview, TN

your.email@example.com
111-222-3333
www.your-website.com

Summary

I have experience in the ever changing business of Health Care Organizations. I have over ten years of experience in every aspect of physician practices and additional years combined of combined expertise at a large Medical Center and in the Corporate Health Care Environment. I am a committed, reliable, career oriented leader with excellent communication skills. I can lead and manage a Physician Practice by creating a workplace of excellence for staff, with a focus on increasing profitability for the group, which will allow the Physicians an opportunity to confidently focus on providing excellent healthcare to our patients.

Work Experience

Physician Services

LifePoint Hospitals, INC, Brentwood, TN

2011Current

Provide leadership, oversight and support to multiple physician practices 
* Provide both long and short term guidance and solutions to LifePoint physicians practices, regional and senior directors that include operations in coding, billing, insurance collections, cash posting and balancing, collection agency administration and refunds 
* Analyze aged trial balances of each practice and provide regular reports on Accounts Receivable 
* Identify business practices of each clinic that need correction or improvement, support findings when necessary and provide recommendations and solutions 
* Orient and train personnel on the billing systems and the company's billing and collections policies 
* Instrumental in decreasing bad debt for the practices. To date have collected almost two million dollars. 
* Corrects system errors within the billing systems 
* Credentialed physicians as needed 
* Coded and billed when clinics did not have adequate staffing 
* Serves as a resource for clinics that have coding and/or billing questions 
* Travels to clinics when necessary and will provide regional and senior directors with solutions to billing and coding issues and provide solutions, and training if necessary

Team Lead Coding/Billing

HealthMark Partners, INC, Nashville, TN

2009 2011

Completed audits of all coders and billers. Required them to maintain and accuracy rate of 95% or higher 
* Trained staff on billing systems, coding, billing and collections processes 
* Ensured all charge information entered was accurate through monthly audits 
* Set monthly financial goals for each ASC for staff to reach with collections 
* Coded and billed claims as needed 
* Accounts Receivable management 
* Served as a resource for coding and billing concerns for multiple ASCs 
* Traveled to surgical centers to train and audit staff

Office Coordinator

Spectrum Pain Clinics, Franklin, TN

2009 2009

Coded, billed and filed all encounters daily 
* Performed follow up on all outstanding accounts for both insurance and patients balances 
* Performed monthly processing of patient statements 
* Responsible for collection agency administration 
* Corrected all rejections from the clearinghouse and identified trends in billing errors 
* Responsible for posting all revenue for the clinic 
* Served as a resource for patients that were financially struggling or were not insured to ensure a payment arrangement was agreed upon that met the needs of the patient and the practice

Coding/Billing Coordinator

Cogent Healthcare, Brentwood, TN

2008 2009

Reviewed medical record documentation and assigned CPT and ICD-9 codes to all billable encounters while adhering to compliance with published regulations and guidelines 
* Interacted with physicians and other patient care providers regarding billing and documentation policies, procedures and guidelines 
* Served as a resource for physicians and other patient care providers for clarification of conflicting, ambiguous, or non-specific documentation 
* Researched, analyzed and responded to inquiries regarding compliance, coding, denials, and billable services 
* Ensured strict confidentiality of patient financial records 
* Attended coding conferences, workshops, and in-house sessions to receive updated coding information 
* Contacted insurance companies and patients to collect balances as needed 
* Corrected insurance claims to ensure company received proper reimbursement 
* Posted any revenue to accounts as needed

Coding Specialist

Retina Vitreous Associates, Nashville, TN

2006 2008

Responsible for all encounter form to chart audits 
* Worked insurance denials and rebilled 
* Worked with insurance companies to ensure payment of all outstanding claims was received in a timely manner 
* Daily amounts billed averaged 200K 
* Educated physicians and staff regarding medical record documentation and guidelines 
* Researched all encounters from the previous year and rebilled with missed charges to Medicare. Recuperated thousands of dollars worth in lost revenue 
* Appealed claims as needed 
* Posted insurance payments as needed

Coding Specialist

Outpatient Imaging Affiliates, Franklin, TN

2005 2006

Responsible for coding all encounters for three centers 
* Average records coded daily was 400 
* Daily amounts billed averaged over 500K 
* Trained and supervised three other CPCs 
* Served as a resource for coding and billing questions 
* Worked denial for insurance companies as needed

QA Coding Specialist

HealthSpring USA, LLC, Nashville, TN

2004 2005

Responsible for audits of modifiers 25 and 59 to ensure providers were billing appropriately 
* Conducted education sessions for providers that were identified through audits for misuse of modifiers 
* Proficient on medical record documentation 
* Audited all high tech radiology claims for medical necessity and proper billing 
* Proficient in Medicare guidelines and NCCI edits 
* Average monthly savings for HealthSpring was 70K

Coding Specialist

Vanderbilt University Medical Center, Nashville, TN

2000 2004

Responsible for concurrent coding for Cardio-Thoracic Surgery, General Surgery, NICU and Newborn Nursery 
* Provided education for interns, residents and fellows regarding medical record documentation 
* Maintained coding accuracy of 95% 
* Instrumental in identifying problem areas within the group and lowered turnaround time from 10 days to 7 days 
* Responsible for identifying deficiencies in medical record documentation 
* Analyzed medical records for Internal Medicine, Hematology/Oncology and Cardiology services

Education

information technology

Volunteer State Community College, Gallatin, TN

19992001

Middle Grades Education

Western Kentucky University, Bowling Green, KY

19961999

College Preparatory in Evaluation and Management Coder

St Cecilia Academy, Nashville, TN

19921996

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