A Clinical Coding Specialist is a professional medical coder who extracts precise information from documentation, test results, and reports and assigns the appropriate codes for creating claims to be paid by insurance carriers. Some of the most common duties are listed on the Clinical Coding Specialist Resume as – coding patient information for preexisting conditions; selecting the correct procedure codes for patient care, noting proper diagnosis codes, working with healthcare providers and billing services; managing other medical facility records, and organizing medical reports.
Some of the primary skills necessary for a career as a Clinical Coding Specialist include – strong knowledge of medical coding and medical terminologies, familiarity with clinical medical billing and healthcare systems, and the ability to ensure accuracy of health information data. One of the most common requirements for this post includes a degree in the healthcare domain. However, some employers might also hire those with relevant certification in medical or clinical coding.
Objective : Driven Clinical Coding Specialist with 2 years of focused experience in accurately coding and billing for healthcare services. Proficient in ICD-10 and CPT coding, ensuring compliance with industry standards. Adept at data abstraction and enhancing coding efficiency through detailed analysis and collaboration with healthcare providers.
Skills : Medical Coding Proficiency, Icd-10 Coding Expertise, Data Analysis Skills, Icd-10 Coding
Description :
Assign and sequence medical codes based on comprehensive medical record documentation, adhering to official coding guidelines.
Conduct thorough reviews of policy guidelines and coding definitions to ensure compliance.
Accurately assign ICD-10, CPT, and HCPCS codes for diagnoses and procedures.
Address encoder edits and payer edits during the data abstraction process prior to finalizing coding and billing.
Assist in resolving identified payer edit issues in collaboration with administrative entities.
Review outpatient encounters to ensure accurate coding of diagnoses, procedures, and modifiers using ICD-10 and CPT coding systems.
Maintain updated knowledge of coding guidelines and regulations to support compliance and efficiency.
Experience
0-2 Years
Level
Entry Level
Education
AAS HIT
Junior Clinical Coding Specialist Resume
Objective : Dedicated Junior Clinical Coding Specialist with 2 years of experience in coding and billing for healthcare services. Skilled in ICD-10 and CPT coding, ensuring accuracy and compliance with regulations. Committed to data abstraction and enhancing coding practices through collaboration and continuous improvement initiatives.
Skills : Microsoft Office Suite (excel, Word, Powerpoint), Healthcare Software Proficiency, Revenue Cycle Management, Problem Solving, Time Management
Description :
Code outpatient medical records for accurate reimbursement and analysis.
Abstract clinical data to assign appropriate diagnosis and procedure codes, ensuring compliance with APC group assignments.
Review and resolve NCCI and CCI coding edits to maintain billing integrity.
Analyze and rectify coding edits for the billing department to minimize claim denials.
Interpret local and national coverage policies to address medical necessity edits effectively.
Engage in team meetings and ongoing coding education to enhance professional development.
Monitor coding trends to identify areas for improvement and implement best practices.
Experience
0-2 Years
Level
Junior
Education
AAS HIT
Clinical Coding Specialist Resume
Headline : Accomplished Clinical Coding Specialist with 7 years of extensive experience in medical coding and billing. Well-versed in ICD-10 and CPT coding standards, ensuring compliance and accuracy in documentation. Proven ability to enhance coding processes and improve efficiency through meticulous data analysis and collaboration with healthcare teams.
Skills : Healthcare Coding Software, Coding Compliance Management, Adaptability, Training And Mentoring, Project Management, Statistical Analysis
Description :
Abstracts vital information from medical records, assigning precise ICD-10 codes for accurate reimbursement.
Identifies and assigns exception codes when documentation is insufficient, ensuring compliance with regulations.
Adheres to HIPAA laws and maintains patient confidentiality throughout the coding process.
Conducts thorough reviews of medical records to capture codes with the highest specificity in alignment with CMS guidelines.
Performs audits of medical records to identify omitted diagnoses for claims submission.
Facilitates prospective reviews and reconciliations for targeted claims, evaluating coverage limitations.
Submits reviewed claims to the Claims Department for final adjudication and processing.
Experience
5-7 Years
Level
Senior
Education
B.S. in HCA
Lead Clinical Coding Specialist Resume
Headline : Detail-oriented Clinical Coding Specialist with over 5 years of experience in accurately coding medical records using ICD-10, CPT, and HCPCS systems. Proven track record of ensuring compliance with regulations and improving coding accuracy. Strong analytical skills and a commitment to maintaining patient confidentiality while optimizing revenue cycle processes.
Skills : Data Quality Review, Analytical Thinking, Cross-functional Collaboration, Advanced Medical Terminology, Clinical Documentation Improvement, Effective Communication Skills
Description :
Conducted thorough data quality reviews on outpatient and inpatient records to validate ICD-10 and CPT codes, ensuring compliance with MS-DRG standards.
Monitored documentation for compliance with coding regulations and reporting requirements.
Analyzed clinical documentation for quality and completeness, optimizing code selection and maximizing reimbursement.
Trained healthcare professionals on coding guidelines and documentation techniques to enhance accuracy.
Advanced from coder-in-training to a full-time coding specialist due to performance excellence.
Coded Ancillary, ED, and Series Accounts efficiently, maintaining high productivity standards.
Consistently exceeded productivity goals through effective time management and organizational skills.
Experience
5-7 Years
Level
Consultant
Education
BSHIM
Clinical Coding Specialist Resume
Summary : Experienced Clinical Coding Specialist with over 10 years of expertise in precise medical coding and billing across diverse healthcare environments. Proficient in ICD-10, CPT, and HCPCS coding, ensuring compliance and accuracy. Committed to enhancing coding workflows and improving reimbursement processes through data analysis and collaboration with clinical teams.
Skills : Expertise In Icd-10 And Cpt Coding, Critical Thinking, Team Collaboration, Communication Skills, Confidentiality Practices, Medical Billing Software
Description :
Coded inpatient and outpatient accounts with a focus on accuracy and compliance.
Conducted retrospective chart reviews for HCC risk adjustment to ensure proper diagnosis coding.
Coded various service types across multiple healthcare facilities.
Ensured optimal coding for emergency room visits, maximizing reimbursement using CPT and ICD codes.
Provided training and feedback to physicians on documentation practices to enhance billing accuracy.
Maintained up-to-date knowledge of coding standards, receiving certifications in ICD-9 and ICD-10.
Collaborated with clinical staff to improve coding efficiency and accuracy through data analysis.
Experience
7-10 Years
Level
Management
Education
BSHIM
Senior Clinical Coding Specialist Resume
Headline : Accomplished Clinical Coding Specialist with 7 years of comprehensive experience in medical coding, specializing in ICD-10 and CPT coding. Proven expertise in ensuring compliance and accuracy while enhancing coding workflows. Adept at leveraging data analysis to optimize documentation processes and foster collaboration with healthcare teams for improved outcomes.
Skills : Certified Coding Specialist, Expertise In Medical Billing And Denials, Idx Software Proficiency, Ingenix Encoder Proficiency
Description :
Ensured optimal diagnosis codes were utilized for each service date, enhancing accuracy in documentation.
Abstracted HCC codes from medical charts for risk adjustment, contributing to improved patient care.
Strictly adhered to coding guidelines, maintaining compliance with regulatory standards.
Coded and abstracted Emergency Room records for a pediatric facility, ensuring precision in documentation.
Maintained accounts receivable below industry standards by optimizing coding accuracy and efficiency.
Conducted regular audits to identify areas for coding improvement, fostering a culture of continuous learning.
Collaborated with healthcare providers to enhance coding practices, resulting in a more streamlined workflow.
Experience
5-7 Years
Level
Management
Education
BSHIM
Clinical Coding Specialist Resume
Summary : With a decade of experience in clinical coding, I excel in accurately translating medical documentation into precise codes. My expertise spans ICD-10, CPT, and HCPCS coding, ensuring compliance and maximizing reimbursement. I am dedicated to enhancing coding processes through rigorous data analysis and effective collaboration with healthcare teams, ultimately improving patient care and operational efficiency.
Skills : Icd-10 Coding Proficiency, Cpt Coding Expertise, Attention To Detail, Cpt Coding, Hcpcs Coding, Medical Terminology
Description :
Utilized advanced coding techniques to ensure compliance with ICD-10 and CPT standards.
Conducted comprehensive audits to verify accuracy and integrity of diagnosis coding.
Developed and implemented coding policies to improve efficiency and communication with clinical staff.
Performed detailed retrospective and prospective coding audits for enhanced reimbursement accuracy.
Managed patient billing processes, ensuring timely submission to insurance companies.
Maintained accurate and secure medical records to protect patient privacy.
Trained new staff on coding best practices and compliance regulations.
Experience
10+ Years
Level
Executive
Education
BS HIM
Associate Clinical Coding Specialist Resume
Objective : Detail-oriented Clinical Coding Specialist with over 5 years of experience in accurately coding medical diagnoses and procedures. Proficient in ICD-10, CPT, and HCPCS coding systems, ensuring compliance with regulations. Strong analytical skills and a commitment to maintaining high standards of data integrity. Excellent communication abilities, collaborating effectively with healthcare teams to optimize patient care and billing processes.
Skills : Epic Systems For Medical Coding, Abstracting Data, Medical Billing, Coding Software, Health Information Management, Patient Privacy Laws
Description :
Conducted thorough reviews of clinical documentation to ensure accurate coding.
Collaborated with healthcare providers to enhance coding accuracy and compliance.
Performed clinical validation audits to capture all relevant coding based on CMS guidelines.
Utilized coding software and tools to maintain efficiency in coding tasks.
Participated in training sessions to stay updated on coding standards and regulations.
Analyzed coding trends to identify areas for improvement within the coding team.
Assisted in the development of coding policies and procedures to align with industry standards.
Experience
0-2 Years
Level
Entry Level
Education
AAS-HIT
Clinical Coding Specialist Resume
Objective : Accomplished Clinical Coding Specialist with 5 years of experience in medical coding and billing across diverse healthcare settings. Proficient in ICD-10, CPT, and HCPCS coding, ensuring compliance and accuracy. Known for enhancing coding efficiency through meticulous data analysis and collaboration with clinical teams, ultimately driving improved patient care and operational success.
Skills : Data Entry Skills, Time Management And Organization, Interpersonal Skills, Conflict Resolution, Analytical Skills, Organizational Skills
Description :
Coded Inpatient and Outpatient encounters in accordance with ICD-10 and CPT guidelines using MEDITECH, ensuring accuracy and compliance.
Conducted bill holds reconciliation to align with hospital standards, facilitating timely revenue cycle management.
Communicated effectively with physicians and various departments to clarify documentation and coding requirements.
Managed retrospective and prospective coding queues for major insurance providers, enhancing operational efficiency.
Abstracted clinical data from electronic health records, ensuring precise coding for optimal billing outcomes.
Reviewed diverse chart types for accurate diagnosis coding, focusing on maximizing reimbursement and compliance.
Coded complex Interventional Radiology procedures, maintaining high standards of accuracy and compliance.
Experience
2-5 Years
Level
Junior
Education
AAS-HIM
Clinical Coding Specialist Resume
Summary : Dedicated Clinical Coding Specialist with a proven track record in medical coding and billing. Expertise in utilizing coding software and electronic health records to enhance accuracy and efficiency. Strong understanding of healthcare regulations and payer requirements. Committed to continuous education and staying updated on coding guidelines to optimize reimbursement processes.
Skills : Data Management Software, Medical Coding Compliance, Adaptable To Coding Systems, Precision In Medical Coding, Coding Audits
Description :
Reviewed and analyzed outpatient and inpatient medical record documentation to optimize coding accuracy and reimbursement.
Conducted HCC Medicare Risk Adjustment audits to ensure precise coding of patient records.
Specialized in coding for ancillary services, labs, radiology, emergency room, and infusion center encounters.
Trained as a reimbursement analyst, supporting patient accounting requests and reconciling unpaid claims.
Assigned codes in compliance with AHA guidelines, CMS regulations, and hospital policies.
Utilized physician query processes to clarify documentation for accurate code assignment.
Participated in quality reviews aimed at continuous performance improvement in coding practices.
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