Debra Downham
Winston-Salem
Summary
An administrative support professional with medical skills, knowledge and education.
Medical coding professional with extensive experience in accurately coding patient records and ensuring compliance with healthcare regulations. Known for strong focus on team collaboration and achieving results, adaptable to changing needs. Skilled in utilizing coding software and maintaining detailed documentation, with reputation for reliability and precision.
Overview
16
16
years of professional experience
Work History
Medical Coder II
Advocate Health
03.2016 - Current
- Increased coding accuracy by diligently reviewing medical documentation and applying appropriate codes.
- Resourcefully used various coding books, procedure manuals, and on-line encoders.
- Reviewed patient charts to better understand health histories, diagnoses, and treatments.
- Applied official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services to assign diagnostic codes.
- Reviewed, analyzed, and managed coding of diagnostic and treatment procedures contained in outpatient medical records.
- Reviewed outpatient records and interpreted documentation to identify diagnoses and procedures.
- Correctly coded and billed medical claims for Pulmonary, Nephrology, Gen Medicine, Internal Medicine, Medicare Wellness Visits, Transitional Care Management, Family Medicine and EKGS
- Maintained a high level of productivity while consistently meeting deadlines for claim submissions.
- Ensured compliance with industry regulations and guidelines by staying up-to-date on the latest coding changes.
- Enhanced team efficiency with regular training sessions on new coding updates and best practices.
- Collaborated with physicians to obtain necessary documentation, improving claim approval rates.
- Supported the implementation of electronic health record systems, simplifying the coding process.
- Monitored changes in coding regulations to provide recommendations for compliance.
- Verified signatures and checked medical charts for accuracy and completion.
- Interacted with physicians and other healthcare staff to ask questions regarding patient services.
- Maintained up-to-date knowledge of coding guidelines and regulations, ensuring compliance across all coding activities.
- Maintained accuracy, completeness, and security for medical records and health information.
- Input data into computer programs and filing systems.
Charge Entry Operator-Internal Medicine Coding and Billing Dept.
Wake Forest Baptist Medical Center
01.2011 - 03.2016
- Create batches for all paper encounter forms into Wake One.
- Manual charge entry for Pulmonary Function Test and Home Health.
- File reports as necessary.
Certified Patient Service Representative, Internal Medicine Dept.
Wake Forest Baptist Medical Center
12.2009 - 01.2011
- Performed all front desk check-in, check out responsibilities.
- Answer phone.
- Provided excellent customer service to patients and medical staff.
- Verified patient insurance eligibility and entered patient information into system.
- Greeted and assisted patients with check-in procedures.
- Processed payments using cash and credit cards, maintaining accurate records of transactions.
- Followed document protocols to safeguard confidentiality of patient records.
Education
Certified Professional Coding Certification - Medical Coding
Forsyth Technical Community College
Winston-Salem, NC12-2015
Skills
- ICD-10 & CPT coding
- Medical terminology
- Medical billing
- EPIC and Microsoft Office
- Queue management
- Medical filing
- Clinical data entry
- Medicare insurance regulations
Timeline
Medical Coder II
Advocate Health
03.2016 - Current
Charge Entry Operator-Internal Medicine Coding and Billing Dept.
Wake Forest Baptist Medical Center
01.2011 - 03.2016
Certified Patient Service Representative, Internal Medicine Dept.
Wake Forest Baptist Medical Center
12.2009 - 01.2011
Certified Professional Coding Certification - Medical Coding
Forsyth Technical Community College
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