Leslie Mejia
SAN FRANCISCO
Summary
Dynamic medical billing and coding professional with expertise in ICD-10 coding and HIPAA compliance, previously at Anchor Drugs Pharmacy. Achieved significant reductions in claim denials through meticulous verification and effective communication with healthcare providers, enhancing patient satisfaction and optimizing reimbursement rates. Proven ability to manage patient accounts and resolve disputes efficiently.
Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.
Overview
23
23
years of professional experience
Work History
Medical Biller and Coder
Anchor Drugs Pharmacy
06.2008 - Current
- Correctly coded and billed medical claims for Durable Medical Equipment.
- Reduced claim denials through meticulous verification of patient eligibility and coverage benefits prior to claim submission.
- Worked closely with physicians to accurately assign ICD-10 diagnostic codes for optimal reimbursement rates from insurance companies.
- Processed insurance company denials by auditing patient files, researching procedures, and diagnostic codes to determine proper reimbursement.
- Reviewed patient charts to better understand health histories, diagnoses, and treatments.
- Resourcefully used various coding books, procedure manuals, and on-line encoders.
- Contributed to team efficiency by maintaining organized records of patient accounts, billing statements, and payment statuses.
- Expedited payment processing by promptly addressing any discrepancies or issues raised by insurance carriers.
- Interacted with physicians and other healthcare staff to ask questions regarding patient services.
- Assisted patients with understanding their insurance coverage and financial responsibilities, fostering positive relationships and trust between the practice and its clients.
- Maintained high levels of customer satisfaction through prompt resolution of disputes related to charges on patient accounts or insurance claims.
- Communicated with insurance companies to research and resolved coding discrepancies.
- Followed up with medical staff regarding missing information in patient records.
- Input data into computer programs and filing systems.
Medical Coder
Wall Medical Group
01.2003 - 08.2009
- Increased coding accuracy by diligently reviewing medical documentation and applying appropriate codes.
- Applied official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services to assign diagnostic codes.
- Reviewed, analyzed, and managed coding of diagnostic and treatment procedures contained in outpatient medical records.
- Reviewed outpatient records and interpreted documentation to identify diagnoses and procedures.
- Maintained a high level of productivity while consistently meeting deadlines for claim submissions.
- Collaborated with physicians to obtain necessary documentation, improving claim approval rates.
- Monitored changes in coding regulations to provide recommendations for compliance.
- Verified signatures and checked medical charts for accuracy and completion.
- Kept coding team informed of changes in coding standards and healthcare regulations through monthly newsletters.
- Improved reimbursement rates with accurate and timely submission of medical codes for various treatments and diagnoses.
- Improved patient privacy protection by strictly adhering to HIPAA regulations during coding and billing process.
- Verified accuracy of patient information in medical records.
- Communicated effectively with staff, patients, and insurance companies by email and telephone.
Education
Graduate Certificate - Medical Billing And Coding
Bryman College
CA10-2003
Skills
- HIPAA compliance
- Payment posting
- Insurance verification
- ICD-10 proficiency
- CMS-1500 form completion
- Patient account management
- Medicare and medicaid billing
- Claim submission
- Diagnostic coding
- Appeals processing
- Procedural coding
- Medical coding expertise
- Commercial insurance billing
- Workers' compensation billing
- Denial management
- CPT coding
- Disability claims process
- Medical billing procedures
- Data entry
- Claims processing
- HCPCS level II coding
- Medical billing
- Medical terminology
- Insurance claims analysis
- Medical claims coding
- Document management
- Insurance coding (ICD-9 and CPT)
- Data security procedures
- Patient data compilation
- Data entry and management
- Attention to detail
- Customer service
- Doctor communication
- Billing procedures
- Patient information verification
- Insurance billing
- ICD-10 coding
- Word processing software
- Patient rights
- Medical history recording
- Records maintenance
- Past due account management
Timeline
Medical Biller and Coder
Anchor Drugs Pharmacy
06.2008 - Current
Medical Coder
Wall Medical Group
01.2003 - 08.2009
Graduate Certificate - Medical Billing And Coding
Bryman College
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