Medical Coding Specialist Resume Examples

Certified medical coding specialist with 9 years coding outpatient and inpatient records, currently a coding specialist for a 420-bed regional hospital. Codes about 110 outpatient and emergency charts a day at 97% accuracy on external audits, cut the coding-related denial rate from 6.8% to 2.1%, and recovered $1.3M in missed charges through a charge capture review. Holds the CPC and CCS credentials and codes to the record, not to the bill.

Coding Denial Reduction. Built a monthly denial report by payer, reason code, and code set from Epic data, found 4 root causes including modifier 25 misuse and outdated LCD rules, and fixed them through coder education and 12 new encoder edits, which cut coding-related denials from 6.8% to 2.1% in 18 months.

Outpatient Charge Capture Review. Reviewed 4,000 outpatient surgery and infusion charts against the charge description master, finding missed drug administration and supply charges, which recovered $1.3M within timely filing limits and added 8 charge capture checks to the daily workflow.

Emergency Department E/M Guide. Wrote a 10-page guide for emergency department E/M leveling with 25 worked examples and a query template for physicians, which raised audit agreement on emergency levels from 88% to 97% for a team of 9 coders.

• Member of a local AAPC chapter, attending 10 monthly education meetings a year for continuing units.
• Volunteer at a free community clinic, helping set up coding and charge entry for about 40 visits a week.
• Mentor 2 students a year from a health information technology programme through their coding practicum.

• Serve as the go-to coder for emergency department questions for a hospital coding team of 9.
• Lead a monthly coding education session covering guideline updates and audit findings for 14 coders.
• Chapter officer for a local AAPC chapter of about 120 members, organising speakers for 2 years.