Stacey Gordon (Resume 1)2016
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908 Cedartree Lane Apt 12, Claymont, DE 19703 484-574-4831 Email: greeneyes12242003@yahoo
STACEY D. GORDON, CPC
908 Cedartree Lane Apt 12, Claymont, DE 19703 484-574-4831 Email: firstname.lastname@example.org
SUMMARY: Dependable and enthusiastic HIM professional with almost 3 years experience in the Health Information Management profession. Same-Day-Surgery facility coder for orthopedic trauma, sports and oncology. Extensive experience with Medicare billing. Self-motivated, organized, works well independently.
EDUCATION AND CERTIFICATIONS: Associates Degree Community College of Philadelphia, 2002 CPC (Certified Professional Coder) ICD-10 Proficient, American Academy of Professional Coders
EXPERIENCE:5/13 - PresentUniversity of Pennsylvania Philadelphia, PAHIM Coding Specialist789 bed, Level I Trauma and Academic Facility Code same day surgeries in the Orthopedic Surgery Department for Trauma, Sports, and Oncology in the Epic System. Verify all surgeries are billed in Epic Verify Insurance information, and obtain Referrals and Authorizations Review and correct warnings and errors, authorization and referral denials, procedure and diagnosis denials, transfers, and Refund patients. Manually Write Off denied charges. Extensive Accounts Receivable Management of outstanding insurance claims involving detailed coding review and follow-up of CPT 4 and ICD9-CM codes assigned to surgical procedures. Review of operative reports and assign ICD9/CPT codes for accurate coding reimbursement utilizing Med Assets for compliance/bundling issues Electronic Medical Record via EPIC to determine and assign appropriate CPT 4/ICD-9/HCPCs codes. Abstract and charge information into Epic. Resolve all billing edits.
6/10 5/13SpecialtyCare Springfield, PAAccounts Receivable Representative Code surgical codes and ICD-9 codes, and Daily Balancing of each Charge Entry Batch Reconcile Aging Reports for Blue Cross Blue Shield, Workman Compensation Claims, and Auto Claims Prepare claim appeals, adjustments, and reconciliations Verify CPT & ICD-9 Codes and Insurance payments, and prepare Refund Requests Help Management with questions regarding Procedure Codes and help with Special Projects Correct Claim errors and resubmit to Insurance Company Verify patients demographics and secondary insurance Contact Insurance companies to resolve discrepancies Negotiate Payment Proposals with Insurance Company Assist co-worker with helping to resolve Insurance issues Attain payments for procedure codes formerly being denied
11/09 2/12Bath&Body Works Springfield, PASales Associate (Part-Time)
8/09 6/10Genesis Healthcare Kennett Square, PAMedicare Billing Specialist Code & Review Medicare Claims in the FISS System and billed appropriate party Contacted Medicare Provider Services to resolve discrepancies Reconciled the Aging Report Prepared claim appeal spreadsheet made adjustments and reconciliations Contacted Hospice and Skilled Nursing facilities to reconcile billing overlaps Corrected CPT & ICD-9 and Claim Errors, and validated for Medicare billing Verified patients demographics and secondary insurance Reviewed patients ADR file
11/07 7/09HCR Manorcare Fitzgerald Mercy Yeadon, PAMedicare Billing Manager Code and Billed Medicare and performed collections duties Reviewed Census Report to bill inpatient, outpatient, and discharged patients Billed claims in the PCC system (HCR Manor Care Specific) Reviewed Medicare Claims in the FISS System and billed as necessary Verified Commercial claims and verified insurance payments Reviewed Bad Debt and Cash Logs and escalated to management Reviewed Aging Report to determine collection priorities Contacted Medicare Provider Services to resolve discrepancies, and Corrected CPT & ICD-9 Errors Posted Medicare, Private, and Commercial Insurance payments into PCC system Reconciled the Aging Report Submitted monthly spreadsheet to report cash payments and adjustments Managed six people
9/04 11/07Dr. Gary V. Gordon, MD FACP Wynnewood, PABookkeeper Posted private and insurance payments Made referral verifications, Insurance verifications, and co-pays Processed bills daily, and Corrected CPT & ICD-9 Errors Third party billing and MRI authorizations Remicade, Orencia, and Rituxin Reports Approved and tallied monies each day C&S System and Navinet System knowledge
OTHER PROFESSIONAL EXPERIENCE:Working knowledge of the following technologies: EPIC, Gift Rap, Rehab Optima, PCC System, Navinet, FISS, C&S, SoftDent, NextGen, HealthTec Microsoft Office Word, Excel and Outlook
PROFESSIONAL ASSOCIATIONS: American Academy of Professional Coders Upland Pennsylvania Chapter