CARLYE WEGENAST
Zebulon
Summary
Dynamic Medical Coder with proven expertise at CSI Co. for Optimum Healthcare, excelling in medical coding compliance and documentation oversight. Recognized for meticulous attention to detail and effective communication, ensuring accurate claims processing and adherence to regulatory guidelines. Committed to continuous education and maintaining high ethical standards in all coding practices.
Overview
2
2
years of professional experience
1
1
Certification
Work History
Medical Coder
CSI Co. for Optimum Healthcare
Jacksonville
07.2023 - Current
- Validated accuracy of diagnosis codes as well as modifiers used on claims before final submission to payer and insurance companies.
- Provided support for coding queries raised by coders or staff members regarding specific cases or coding issues.
- Researched discrepancies between documentation and billing information in order to resolve any issues prior to submission.
- Reviewed patient medical records for accuracy, completeness and compliance with coding regulations.
- Performed audits on coded claims to ensure that all required data elements are included for accurate payment processing.
- Maintained confidentiality of patient information according to HIPAA regulations.
- Assigned additional diagnosis codes based on specific clinical findings (laboratory, radiology and, pathology reports as well as clinical studies) in support of existing diagnoses.
- Applied coding rules established by American Medical Association and Centers for Medicare and Medicaid Services for assignment of procedural codes.
- Maintained updated knowledge of coding requirements, which included continuing education and certification renewal.
- Read through patient health data, histories, physician diagnoses and treatments to gain understanding for coding purposes.
- Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements.
Intern
Skilled Nursing Facility
Raleigh
06.2025 - 06.2025
- Maintained positive working relationship with fellow staff and management.
- Worked closely with human resources to support employee management and organizational planning.
- Worked with management to gain hands-on experience in the management field.
Education
Health Information Management
DeVry University
Chicago, IL07-2025
DeVry University
Chicago, ILSkills
- Medical coding and compliance
- HIPAA regulations
- CPT and ICD-10 coding
- Attention to detail
- Problem solving
- Effective communication
- Quality assurance
- Record assessment
- Ethical standards
- Data verification
- Medical claims coding
- Regulatory guidelines
- Documentation oversight
- Continuing education
- Data security procedures
- Certified coding associate
Certification
- CCA Coding Certification
- Certified and Member of AHIMA
References
References available upon request.
Timeline
Intern
Skilled Nursing Facility
06.2025 - 06.2025
Medical Coder
CSI Co. for Optimum Healthcare
07.2023 - Current
Health Information Management
DeVry University
DeVry University
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