2419 Kincheloe Road
Beaverton, OR 97006
Job Objective Looking for an opportunity to put my skills and training to work for your company by acquiring the position of Medical Coding Auditor.
Medical Coding Auditor, August 2005 – Present
Group Health Cooperative, Beaverton, OR
- Scheduled and conducted multiple provider audits.
- Participated in performing coding focused CMS audits and investigations.
- Ensured support of medical coding controls.
- Provided individualized scorecard results and scheduled follow-up audits.
- Completed audit projects within time and budget.
- Ensured that the score cards and reports contain adequate evidence to support findings.
Medical Coding Auditor, May 2000 – July 2005
Universal American Corporation, Beaverton, OR
- Coordinated with state and federal agencies in support of robust partnership related to FWA investigations.
- Created reports using the company designated pre-payment tools.
- Identified potential fraud trends and performed appropriate analysis.
- Gathered relevant data to recognize national trends or schemes to proactively anticipate threats.
- Monitored and participated in AAPC Forum discussions.
- Maintained compliance with regulatory requirements.
Summary of Qualifications:
- Considerable experience with the principles and practices of medical coding
- Sound knowledge of CMS 1500 and UB04 data elements
- Good understanding of medical terminology
- Proficient with standard industry coding systems such as CPT, HCPCS , ICD-9, and Revenue Codes
- Ability to handle multiple projects and appropriately prioritize tasks to meet deadlines
- Excellent analytical and problem solving skills
- Superior communication skills, both verbal and written
Bachelor’s Degree in Health Information Management, Louisiana College, Pineville, LA