Certified Professional Coder with experience in E/M

1. CMC, CPC, ICD 10 Proficient.
Amanda Wagner
7396 Ellicott Rd
Lockport, NY 14094
716-364-3813
Awags81@yahoo.com
Objective: Seeking a position where I can utilize my extensive knowledge of medical terminology,
anatomy and physiology.
Work Experience:
12/2015-Present-McKesson
-Emergency Room Coding
- Abstract information from medical record and assign the appropriate ICD 10 and CPT codes.
-Coding using the MMIS system
-ICD10 using Encoder Pro reference
-Full time remote coding.
06/2015-12/2015-Medical Coder-Practice First
-Emergency Room & Urgent Care coding
-98% Error rate with 22 chart per hour average
-Adhere to the audit worksheets for correct coding
-Assures codes are supported by provider documentation and initiate queries based on other clinical
documentation for accurate and reliable data collection and reimbursement
-End of week chart return -correcting charts that were missing data and or documentation and coding
for timely filing.
-Responsible to maintain knowledge of official coding conventions and rules established by the AMA
and CMS for assignment of diagnostic and procedural codes by maintaining CEU's.
01/2014-06/2015-Lead Medical Coder- Team Health (Exigence of Team Health)
-Assign CPT, HCPC & ICD 9 codes for clinician services for proper billing and reimbursement
-Obtain insurance referrals and verify coverage
-View charts and provide one to one or group educational feedback to clinicians
-Gather data and prepare information reports to the Division Director of Medical Billing
-Maintain up to date knowledge of health care billing laws, rules and regulations.
-Helping other medical coders keep up to date with their sites
-End of month accounting reports
-Resolving any coding issues
-Helping billing resolve issue with their denials
-Monthly coding audits.

2. -Supervises day to day activities of all coding staff.
09/2011-01/2014-Exigence of Team Health
Certified Medical Coder
-Assigns CPT procedure codes for clinician services and ICD 9 on all medical record types to highest
level to assure appropriate billing and reimbursement
-Input charges for all Urgent Care sites, clinical and inpatient centers on a daily basis
-Post all co-payments, self-payments and reconcile on a daily basis
-Assigns modifiers
-File claims to the appropriate insurance company
-Send refund to both patient and insurance carriers if there is an over payment
-Interacts with clinician and other clinic/corporate department to assure compliance and billing
practices
9/06-9/2011 Catholic Health Systems
Service Representative
Registered patients in AS400 system
-Completed and updated patient and insurance demographics
-Insurance eligibility via Epace, Healthy net and HMO websites
-Entered CPT and ICD 9 codes for Internal Medicine, Pediatrics, Surgical and OB/GYN
-Ensured correct documentation was in patient’s charts
-Verified level of service by cross reference of patients charts and encounters documentation
-Responsible for encounter forms being submitted with the correct CPT and ICD 9 code for the
assigned provider/service timely, accurately and coding process and procedures
-Researched and resolved claims that were incomplete or unable to bill
-Answered patient billing questions
-Helped patients establish insurance through Fidelis or Medicaid and Medicare
-Responsible for all Workers Compensation and No Fault Claims
-Completed all C4 forms for Workers Compensation on the NY state website
-Obtained all documentation for Workers Compensation from patient’s chart, patients employer or
patients lawyer
-Delegated work assignments between service representatives while I attended HMO meetings or
completed end of billing reports
02/2006-09/2006 American Home Patient
Accounts Receivable
-Follow up collection and allocation of payments
-Processed DME claims and denials using the MESTA system
-Carry out billing, collection and reporting activates according to specific deadlines
-Followed timely filing procedures per insurance
-Answered inbound customer service calls from patients and providers
-Processing and verifying patient account data and reviewing and posting all 1st and 3rd payments
-Analyzed billing and other records to ensure that all provider credentials and other medical
terminology data is accurately entered and identified and resolved problem accounts by working
collaboratively with facility health staff, billing staff and insurance companies
01/2005-02/2006 North American Administrators

3. Claims Analyst
-Reviewed all medical and surgical billing for reasonable and necessary changes
-Examine coding procedure
-Provided 2nd review of bills on which providers and patient’s question of payments authorized.
-Entered Deductibles and co pays using the Eldorado System
-Processed Flexible spending accounts in conjunction with IRS guidelines
-Analyzed and correctly adjudicated claims
-Customer Service and provider phone calls
-Evaluated claims referred for medical management and made recommendations for follow up, further
investigation or documentation as necessary
Additional Information:
Able to type 72wrds/per min. Computer applications such as Lotus Notes, PowerPoint, Microsoft ME,
Excel, Adobe, Publisher, Outlook, Word and Access. Medical billing software such as AS400, Medent,
WNY healthy net, Med host, Epaces, Sorian and Maternal Manager Medical coding software such as
Clinical EMR, Allscrips. Knowledge of procedures to Medical Billing CPT/ICD 9 Codes, Benefit
Codes, HIPAA, Pre-Certifications, Pre- existing Medical necessities, Federal Guidelines and Rules and
Regulations (IRS). SPD’s, Deductibles co-pay, out of pockets, In Net, Out of Net. Calendar Year
Maximums and Lifetime. Also handled Utilization management, stop loss carrier, and over payments. I
am also knowledgeable of the medical terminology. I have worked with all medical insurances and the
providers and TPA’s as well. New York state Workers Compensation and No Fault Insurance
Biller/Coder. Frequently contact with numerous Workers Compensation lawyers and New York State
Comp Board.
Knowledge of health care standards appropriate to specific claim.
Knowledge of medical, pharmaceutical, and other health services, practices, and
Terminology and medical reimbursement policies, procedure and standards.
Knowledge of the Workers' Disability Compensation Act.
Ability to analyze health services utilization data.
Ability to conduct interviews with health care professionals, technicians, and/or
Recipients.
Ability to understand and apply complex policies, procedures and legal statutes.
Ability to maintain records, and prepare reports and correspondence related to the work.
Ability to write reports using health care and medical terminology.
Ability to maintain confidentiality of information.
Coding for OB/Gyn, Pediatrics, Internal Medicine, Pain management, Urgent Care.
Coding for all HMO’s, TPA’s, private government and Medicare.
Full knowledge of Stark Law and PQRI
Encourages team work and motivates both teams and individuals
Excellent knowledge of health care billing procedures, documentation and standards
Certifications:
Certified Profession Coder-AAPC
Certified Medical Coder – Practice Management Institute