Hiring managers for Medical Billing and Coding roles are not just seeking data entry specialists; they need meticulous professionals who directly impact an organization's financial health and regulatory compliance. The challenge is identifying candidates who can navigate complex coding systems, optimize revenue cycles, and minimize costly errors from resumes that often fail to quantify impact.Your resume must immediately demonstrate your proficiency in reducing denials, accelerating reimbursements, and ensuring HIPAA adherence, positioning you as an indispensable asset in a competitive healthcare landscape.
Key Takeaways
- Quantify your achievements: Always use numbers, percentages, or dollar amounts to show your impact on revenue, denial rates, or processing times.
- Prioritize certifications: Prominently display your CPC, CIC, COC, or other relevant certifications to establish immediate credibility.
- Tailor for ATS: Integrate specific coding systems (ICD-10-CM, CPT, HCPCS), EHR platforms, and compliance terms directly from job descriptions.
- Showcase software proficiency: List specific billing and coding software (e.g., Epic, Kareo, Cerner, NextGen) to demonstrate practical readiness.
- Highlight compliance and accuracy: Emphasize your understanding of HIPAA, OIG guidelines, and your commitment to clean claim submission.
Career Outlook
Average Salary: $45,000 - $65,000 annually (varies by experience, location, and certifications)
Job Outlook: Consistent growth driven by an aging population and increasing demand for healthcare services, ensuring stable career opportunities.
Professional Summary
Highly detail-oriented and certified Medical Billing and Coding Specialist with 7+ years of progressive experience optimizing revenue cycles, ensuring compliance, and accurately processing medical claims. Proven ability to reduce denial rates by up to 15% and improve claims processing efficiency using advanced knowledge of ICD-10, CPT, and HCPCS coding, coupled with proficiency in leading EHR/EMR systems like Epic and Cerner.
Key Skills
- ICD-10-CM
- CPT
- HCPCS Level II
- Revenue Cycle Management
- Denial Management
- EHR/EMR Systems (Epic, Cerner, Kareo, Practice Fusion)
- HIPAA Compliance
- Insurance Verification
- Medical Terminology
- Accounts Receivable
- Claim Submission
- Payer Relations
Professional Experience Highlights
- Managed full revenue cycle for a high-volume multi-specialty clinic, processing an average of 500+ claims weekly with a 98% first-pass resolution rate.
- Reduced claim denial rates by 12% within the first year by identifying common coding errors and implementing corrective action plans and staff training.
- Proficiently utilized Epic EMR system for patient registration, charge entry, claim submission, and denial management, ensuring seamless workflow.
- Conducted regular audits of patient accounts and coding practices to ensure compliance with HIPAA, CMS regulations, and payer-specific guidelines, preventing potential penalties.
- Processed and submitted medical claims to various insurance payers (Medicare, Medicaid, commercial) using Kareo software, maintaining an average of 95% clean claim submission rate.
- Managed accounts receivable, following up on unpaid claims, appealing denied claims, and resolving patient billing inquiries effectively.
- Applied ICD-10, CPT, and HCPCS codes to diagnoses and procedures for primary care services, ensuring accuracy and maximum reimbursement.
- Reconciled EOBs and posted payments accurately to patient accounts, identifying and resolving discrepancies in a timely manner.
- Assisted with patient registration, insurance verification, and eligibility checks prior to appointments, minimizing claim rejections.
- Supported the billing department by entering patient demographic and insurance information into Practice Fusion EMR system.
- Posted patient payments and adjustments, balancing daily batches for accurate financial reporting.
- Responded to patient billing questions and explained insurance benefits and out-of-pocket costs clearly.
Sarah Jenkins
Medical Billing And Coding Resume Example
Summary: Highly detail-oriented and certified Medical Billing and Coding Specialist with 7+ years of progressive experience optimizing revenue cycles, ensuring compliance, and accurately processing medical claims. Proven ability to reduce denial rates by up to 15% and improve claims processing efficiency using advanced knowledge of ICD-10, CPT, and HCPCS coding, coupled with proficiency in leading EHR/EMR systems like Epic and Cerner.
Key Skills
ICD-10-CM • CPT • HCPCS Level II • Revenue Cycle Management • Denial Management • EHR/EMR Systems (Epic, Cerner, Kareo, Practice Fusion) • HIPAA Compliance • Insurance Verification • Medical Terminology • Accounts Receivable
Experience
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Senior Medical Billing and Coding Specialist at Houston Medical Center ()
- Managed full revenue cycle for a high-volume multi-specialty clinic, processing an average of 500+ claims weekly with a 98% first-pass resolution rate.
- Reduced claim denial rates by 12% within the first year by identifying common coding errors and implementing corrective action plans and staff training.
- Proficiently utilized Epic EMR system for patient registration, charge entry, claim submission, and denial management, ensuring seamless workflow.
- Conducted regular audits of patient accounts and coding practices to ensure compliance with HIPAA, CMS regulations, and payer-specific guidelines, preventing potential penalties.
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Medical Biller/Coder at Lone Star Family Practice ()
- Processed and submitted medical claims to various insurance payers (Medicare, Medicaid, commercial) using Kareo software, maintaining an average of 95% clean claim submission rate.
- Managed accounts receivable, following up on unpaid claims, appealing denied claims, and resolving patient billing inquiries effectively.
- Applied ICD-10, CPT, and HCPCS codes to diagnoses and procedures for primary care services, ensuring accuracy and maximum reimbursement.
- Reconciled EOBs and posted payments accurately to patient accounts, identifying and resolving discrepancies in a timely manner.
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Billing Assistant at Gulf Coast Urgent Care ()
- Assisted with patient registration, insurance verification, and eligibility checks prior to appointments, minimizing claim rejections.
- Supported the billing department by entering patient demographic and insurance information into Practice Fusion EMR system.
- Posted patient payments and adjustments, balancing daily batches for accurate financial reporting.
- Responded to patient billing questions and explained insurance benefits and out-of-pocket costs clearly.
Education
- Associate of Applied Science in Health Information Technology - Houston Community College (2015)
- Certified Professional Coder (CPC) - AAPC (2016)
Why and how to use a similar resume
This resume is highly effective for a Medical Billing and Coding professional due to its clear, achievement-oriented structure and strategic use of industry-specific keywords and measurable results. The summary immediately establishes the candidate's expertise and impact. Each experience entry highlights tangible accomplishments, such as reducing denial rates and increasing revenue, demonstrating a direct contribution to financial health. The inclusion of specific EHR/EMR systems and coding methodologies (ICD-10, CPT, HCPCS) proves technical proficiency, while the dedicated skills section reinforces core competencies, making it easily scannable for recruiters.
- Quantifiable achievements: Metrics like '98% first-pass resolution rate' and 'reduced claim denial rates by 12%' provide concrete evidence of impact.
- Industry-specific keywords: Extensive use of terms like 'ICD-10,' 'CPT,' 'HCPCS,' 'Revenue Cycle Management,' and specific EHR systems (Epic, Cerner, Kareo) ensures ATS compatibility and demonstrates expertise.
- Clear career progression: The experience section shows a natural progression from Billing Assistant to Senior Specialist, indicating growth and increased responsibility.
- Compliance and regulatory focus: Emphasis on HIPAA and CMS compliance highlights a critical understanding of legal and ethical standards in healthcare billing.
- Comprehensive skill set: A balanced mix of technical (coding, software) and operational (denial management, RCM) skills showcases a well-rounded professional.
Jordan Smith
Medical Billing Specialist Resume Example
Summary: Highly accurate and results-driven Medical Billing Specialist with over 8 years of progressive experience in optimizing revenue cycles, managing complex claims, and ensuring compliance within fast-paced healthcare environments. Proven ability to reduce AR days, improve clean claim submission rates, and expertly navigate EMR/EHR systems to maximize reimbursement and minimize denials.
Key Skills
Revenue Cycle Management (RCM) • Denial Management & Appeals • ICD-10 & CPT Coding • EMR/EHR Systems (Epic, Athenahealth, Kareo) • Insurance Verification • Claim Submission & Follow-up • Accounts Receivable (AR) • Payment Posting & Reconciliation • HIPAA Compliance • Medical Terminology
Experience
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Senior Medical Billing Specialist at Horizon Health Systems ()
- Managed a diverse portfolio of over 500 patient accounts monthly, processing an average of 300 claims daily with a 98% clean claim submission rate using Epic EMR.
- Spearheaded denial management and appeals processes, successfully recovering over .5M in previously denied claims annually through meticulous follow-up and documentation.
- Reduced Accounts Receivable (AR) days by 15% through proactive follow-up with insurance carriers and effective patient collections strategies.
- Provided training and mentorship to junior billing staff on CPT, ICD-10, and HCPCS coding guidelines, ensuring team compliance and reducing coding errors by 10%.
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Medical Biller at Desert Bloom Pediatrics ()
- Processed and submitted medical claims to various commercial and government payers, including Medicare and AHCCCS, utilizing Athenahealth billing software.
- Performed daily payment posting, reconciliation, and charge entry, maintaining an average of 99.5% accuracy in patient accounts.
- Conducted thorough insurance verification and pre-authorization for all scheduled procedures, minimizing claim rejections and improving upfront collections by 20%.
- Managed patient inquiries regarding billing statements, payment plans, and insurance coverage, achieving high patient satisfaction scores.
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Billing Assistant at Acme Medical Group ()
- Supported billing department operations by accurately entering patient demographics, charges, and payments into Kareo EMR system.
- Assisted with claim scrubbing and submission, ensuring all necessary documentation was attached for timely processing.
- Managed and organized incoming Explanation of Benefits (EOBs) and Electronic Remittance Advices (ERAs), identifying payment variances.
- Handled patient calls regarding basic billing questions and directed complex inquiries to senior billing specialists.
Education
- Associate of Applied Science in Medical Billing and Coding - Phoenix College (2016)
- Certified Professional Biller (CPB) - AAPC (2016)
Why and how to use a similar resume
This resume is highly effective for a Medical Billing Specialist because it strategically emphasizes quantifiable achievements and industry-specific expertise. It moves beyond mere job descriptions to showcase tangible results in revenue cycle management, denial reduction, and claims processing. The clear, concise summary immediately positions the candidate as a seasoned professional, while the action-oriented bullet points demonstrate impact rather than just responsibility, making it easy for hiring managers to identify value.
- Quantifiable achievements are prominently featured, demonstrating direct impact on revenue and efficiency.
- Utilizes industry-specific keywords and software (e.g., Epic, ICD-10, denial management) which are critical for ATS scanning and hiring manager recognition.
- The professional summary provides a strong, concise overview of the candidate's core competencies and experience.
- Each work experience entry includes a minimum of five robust bullet points, showcasing a breadth and depth of responsibilities and accomplishments.
- The skills section is curated to highlight the most critical hard and soft skills, ensuring relevance and conciseness.
Eleanor Vance, CPC, CCS
Medical Coder Resume Example
Summary: Highly analytical and AAPC/AHIMA certified Medical Coder (CPC, CCS) with 8+ years of experience in multi-specialty healthcare environments. Proven ability to optimize revenue cycle, ensure compliance with coding guidelines, and reduce claim denials by consistently achieving 98%+ accuracy rates. Seeking to leverage expertise in ICD-10-CM, CPT, and HCPCS to contribute to a high-performing medical coding team.
Key Skills
ICD-10-CM • CPT • HCPCS Level II • Epic EMR • Cerner EMR • Athenahealth • Revenue Cycle Management • Medical Terminology • Compliance & Auditing • Claim Denials
Experience
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Medical Coder at St. Jude's Medical Center ()
- Accurately coded an average of 120+ complex inpatient and outpatient medical records daily using ICD-10-CM, CPT, and HCPCS Level II, maintaining a 99% accuracy rate.
- Reduced claim denial rates by 15% within the first year by identifying common coding errors and collaborating with billing to implement corrective actions.
- Utilized Epic EMR system extensively for charge capture, documentation review, and claim preparation, ensuring seamless data flow and compliance.
- Conducted internal audits on 50+ charts monthly, providing constructive feedback to providers and improving documentation quality by 20%.
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Junior Medical Coder at Lone Star Health Network ()
- Performed daily coding of physician office visits, diagnostic tests, and minor procedures across various specialties including cardiology and orthopedics.
- Achieved and maintained a consistent 98% coding accuracy rate for high-volume outpatient encounters, ensuring timely and correct claim submission.
- Collaborated closely with billing specialists to resolve coding discrepancies and facilitate clean claim processing, contributing to a 10% reduction in billing errors.
- Proficiently navigated Cerner EMR to abstract information, verify patient demographics, and ensure proper documentation for coding purposes.
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Medical Billing & Coding Assistant at Premier Family Practice ()
- Assisted lead coders with preliminary coding tasks, including charge entry and basic CPT/ICD-10-CM code assignment for routine office visits.
- Managed insurance verification and prior authorization processes for over 80 patients weekly, significantly expediting patient care and claim approval.
- Processed patient statements and handled collections for outstanding balances, contributing to a 5% improvement in accounts receivable.
- Utilized Athenahealth for patient scheduling, data entry, and basic claims submission, gaining foundational EMR experience.
Education
- Certified Professional Coder (CPC) - AAPC (2017)
- Certified Coding Specialist (CCS) - AHIMA (2018)
- Associate of Applied Science in Medical Billing and Coding - Austin Community College (2015)
Why and how to use a similar resume
This resume is highly effective for a Medical Coder because it immediately establishes Eleanor's critical certifications (CPC, CCS) and extensive experience in the professional summary. It then powerfully reinforces her expertise by quantifying achievements with specific metrics, such as "99% accuracy rate" and "reduced claim denial rates by 15%", demonstrating tangible value and direct impact on revenue. The inclusion of specific EMR systems like Epic and Cerner directly addresses common technical requirements, while detailed bullet points showcase a comprehensive understanding of complex coding guidelines, compliance, and revenue cycle optimization. Finally, the blend of essential hard skills (coding systems, EMRs) with crucial soft skills (attention to detail, analytical problem-solving) presents a well-rounded and highly capable candidate.
- Immediately highlights key certifications (CPC, CCS) and years of experience in the summary.
- Quantifies achievements with specific metrics (e.g., 99% accuracy, 15% denial reduction).
- Showcases proficiency in industry-standard EMR systems (Epic, Cerner, Athenahealth).
- Demonstrates a deep understanding of compliance, auditing, and revenue cycle optimization.
- Utilizes strong action verbs and industry-specific keywords throughout the experience section.
Sarah Thompson
Certified Professional Coder (CPC) Resume Example
Summary: Highly analytical and results-driven Certified Professional Coder (CPC) with over 7 years of experience in multi-specialty medical coding, compliance, and revenue cycle management. Proven expertise in ICD-10-CM, CPT, and HCPCS Level II coding, consistently achieving high accuracy rates and optimizing reimbursement for healthcare providers. Dedicated to maintaining strict compliance with evolving regulatory guidelines and enhancing financial integrity.
Key Skills
ICD-10-CM Coding • CPT & HCPCS Level II • E/M Coding • Revenue Cycle Management • Compliance & Auditing • Electronic Health Records (EHR) • Medical Terminology • Anatomy & Physiology • Denial Management • Data Analysis
Experience
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Certified Professional Coder (CPC) at Grand Canyon Medical Center ()
- Accurately coded an average of 150-200 complex inpatient and outpatient encounters daily across multiple specialties including cardiology, orthopedics, and general surgery, utilizing ICD-10-CM, CPT, and HCPCS Level II.
- Maintained a consistent coding accuracy rate of 98.5%, significantly contributing to clean claim submission and reducing denial rates by 15% within the first year.
- Collaborated with physicians and clinical staff to clarify documentation, ensuring complete and compliant medical records that supported appropriate code assignment and maximum reimbursement.
- Conducted regular internal audits of coded charts, identifying potential compliance risks and implementing corrective actions that aligned with OIG guidelines and payer requirements.
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Medical Coder Specialist at Desert Bloom Cardiology ()
- Managed all coding functions for a busy cardiology practice, including E/M, diagnostic testing, and procedural coding, resulting in an average monthly revenue capture of over $250,000.
- Identified and resolved coding discrepancies and claim rejections, improving first-pass resolution rates by 10% and accelerating payment cycles.
- Provided ongoing education to providers on documentation best practices for E/M services and complex procedures, ensuring accurate code assignment and mitigating audit risks.
- Utilized Greenway Health EHR and Practice Management software for efficient charge entry, claims processing, and denial management.
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Entry-Level Medical Coder at Valley Medical Billing Solutions ()
- Performed initial coding of physician office visits and minor procedures for various primary care practices using ICD-10-CM and CPT codes.
- Assisted senior coders with claim denials and appeals processes, learning effective strategies for resolution and prevention.
- Successfully completed comprehensive training on medical terminology, anatomy, physiology, and healthcare regulations (HIPAA, HITECH).
- Entered charges accurately into Meditech system, ensuring timely processing and reconciliation of patient accounts.
Education
- Certified Professional Coder (CPC) - AAPC (American Academy of Professional Coders) (2016)
- Associate of Science in Health Information Technology - Phoenix Community College (2016)
Why and how to use a similar resume
This resume is highly effective for a Certified Professional Coder (CPC) because it immediately highlights the candidate's professional certification and extensive experience in medical coding. It uses strong action verbs and quantifies achievements wherever possible, demonstrating clear impact on revenue cycle management, compliance, and operational efficiency. The strategic placement of industry-specific keywords and software names ensures it will pass through Applicant Tracking Systems (ATS) and resonate with hiring managers in the medical billing and coding field.
- Prominently features CPC certification, a critical credential for the role.
- Quantifies achievements with realistic metrics (e.g., '98% accuracy,' 'reduced denials by 15%') to showcase tangible impact.
- Leverages industry-specific keywords (ICD-10-CM, CPT, EHR, RCM) for ATS optimization and recruiter recognition.
- Employs a clear, chronological format with strong action verbs to describe responsibilities and accomplishments.
- Includes a 'Skills' section that balances essential hard skills with crucial soft skills, providing a comprehensive overview.
Jordan Smith
Certified Inpatient Coder (CIC) Resume Example
Summary: Highly skilled and AAPC Certified Inpatient Coder (CIC) with over 7 years of experience specializing in accurate ICD-10-CM/PCS and DRG assignment for complex inpatient encounters. Proven ability to optimize revenue integrity, ensure regulatory compliance, and reduce claim denials through meticulous documentation review and advanced encoder software proficiency.
Key Skills
ICD-10-CM/PCS • DRG Assignment • HIM Systems (Epic, Cerner) • 3M 360 Encompass • Optum EncoderPro • Clinical Documentation Improvement (CDI) • Auditing • Revenue Cycle Management • Regulatory Compliance • Attention to Detail
Experience
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Certified Inpatient Coder (CIC) at Stellar Healthcare System ()
- Accurately assigned ICD-10-CM/PCS codes and DRGs for an average of 30-40 complex inpatient cases daily, maintaining a 98.5% accuracy rate against internal and external audits, significantly impacting revenue capture.
- Collaborated closely with Clinical Documentation Improvement (CDI) specialists and physicians to clarify documentation, leading to an estimated $250,000 increase in appropriate reimbursement annually.
- Utilized 3M 360 Encompass and Epic EMR system to navigate patient records, abstract clinical data, and apply official coding guidelines for optimal coding outcomes.
- Identified and resolved coding discrepancies proactively, contributing to a 15% reduction in inpatient claim denials related to coding errors over two years.
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Inpatient Coder at Metropolitan Medical Center ()
- Coded inpatient medical records, including complex surgical and medical cases, applying ICD-10-CM/PCS guidelines with consistent 97% accuracy.
- Processed an average of 25-30 inpatient charts per day, consistently exceeding productivity benchmarks while upholding quality standards.
- Engaged with medical staff to improve documentation quality for proper code assignment, resulting in enhanced data integrity for hospital reporting.
- Proficiently used Cerner EMR and Optum EncoderPro to facilitate efficient and accurate coding processes.
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Medical Coder at Community Health Partners ()
- Performed medical coding for a mix of inpatient and outpatient encounters, focusing on ICD-10-CM and CPT coding standards.
- Reviewed patient medical records to extract relevant information for accurate code assignment across various specialties.
- Maintained a high level of coding accuracy, averaging 96% for all assigned cases, ensuring proper billing and reimbursement.
- Assisted with charge capture reconciliation and identified potential under-coding issues, supporting the revenue cycle team.
Education
- Associate of Science in Health Information Technology - Dallas Community College (2016)
Why and how to use a similar resume
This resume for a Certified Inpatient Coder (CIC) is highly effective due to its strategic focus on measurable achievements, industry-specific keywords, and clear demonstration of expertise. It immediately establishes the candidate's certification and extensive experience in the summary, followed by a chronological progression of roles that showcase increasing responsibility and impact. The consistent use of powerful action verbs combined with specific metrics quantifies the candidate's contributions to accuracy, compliance, and revenue optimization, making their value undeniable to potential employers.
- Quantifiable achievements (e.g., 98.5% accuracy, $250,000 increase) clearly demonstrate impact and value.
- Strong use of industry-specific keywords like ICD-10-CM/PCS, DRG, 3M 360 Encompass, and CDI showcases expert knowledge.
- Demonstrates progression in responsibility and complexity across multiple roles, highlighting career growth and adaptability.
- Highlights essential software proficiency (Epic, Cerner, 3M 360 Encompass), indicating readiness to integrate into various healthcare systems.
- Emphasizes compliance and regulatory adherence, crucial aspects of inpatient coding that mitigate financial and legal risks.
Jordan Smith
Certified Outpatient Coder (COC) Resume Example
Summary: Highly accomplished and AAPC-certified Outpatient Coder (COC) with 7+ years of experience specializing in complex E/M, surgical, and ancillary service coding across various specialties. Proven ability to maintain 98%+ coding accuracy, optimize revenue capture, and ensure strict compliance with federal regulations and payer guidelines. Adept at leveraging advanced coding software and EHR systems to streamline processes and minimize claim denials.
Key Skills
ICD-10-CM • CPT • HCPCS • E/M Coding • Medical Necessity • Payer Guidelines • Auditing • Compliance • Epic EHR • Cerner EHR
Experience
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Certified Outpatient Coder (COC) at Desert Bloom Medical Center ()
- Accurately coded an average of 60-70 complex outpatient charts daily, encompassing E/M, surgical procedures, infusions, and diagnostic services, maintaining a consistent 98.5% accuracy rate.
- Identified and implemented coding improvements that led to a 7% increase in appropriate revenue capture for high-volume service lines within the first year.
- Collaborated with physicians and clinical staff to improve documentation quality, resulting in a 12% reduction in coding-related denials.
- Conducted internal audits for compliance with ICD-10-CM, CPT, HCPCS, and payer-specific guidelines, providing actionable feedback to reduce coding errors.
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Outpatient Coder at Grand Canyon Specialty Clinics ()
- Coded for diverse specialties including Cardiology, Orthopedics, and Gastroenterology, ensuring accurate application of CPT, ICD-10-CM, and HCPCS codes for optimal reimbursement.
- Reviewed medical records and physician documentation to assign appropriate E/M levels, modifiers, and procedure codes, improving coding integrity.
- Resolved coding discrepancies and responded to payer denials by providing detailed documentation and coding rationale, recovering an average of 5,000 per quarter.
- Participated in monthly coding review meetings, contributing to the development of best practices and training materials for clinical staff.
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Medical Records Specialist & Junior Coder at Valley Vista Urgent Care ()
- Managed and organized patient medical records, ensuring completeness, accuracy, and confidentiality in compliance with HIPAA regulations.
- Assisted senior coders with reviewing basic outpatient charts and assigning appropriate ICD-10-CM and CPT codes under supervision.
- Processed patient demographics and insurance information, verifying eligibility and benefits to prevent claim rejections.
- Responded to physician queries regarding documentation requirements for accurate code assignment, facilitating improved record quality.
Education
- Certified Outpatient Coder (COC) - American Academy of Professional Coders (AAPC) (2016)
- Associate of Science in Health Information Technology - Phoenix College (2016)
Why and how to use a similar resume
This resume effectively showcases Jordan Smith's expertise as a Certified Outpatient Coder by prioritizing quantifiable achievements and industry-specific terminology. The strategic use of action verbs and metrics in each bullet point clearly demonstrates impact on revenue, efficiency, and compliance. The chronological layout highlights career progression, while a dedicated skills section quickly informs recruiters of key competencies and software proficiencies critical for the role.
- Features a concise professional summary that immediately highlights certification, years of experience, and key value propositions.
- Quantifiable achievements in the experience section (e.g., '98.5% accuracy rate', '7% increase in revenue capture', '12% reduction in denials') demonstrate tangible impact.
- Incorporates specific industry keywords and software (ICD-10-CM, CPT, HCPCS, Epic EHR, 3M 360 Encompass) to pass Applicant Tracking Systems (ATS) and resonate with hiring managers.
- Demonstrates clear career progression from Medical Records Specialist to Certified Outpatient Coder, showcasing growth and increasing responsibility.
- The 'Skills' section is curated to include only the most critical hard and soft skills, making it easy for recruiters to identify core competencies.
Jordan Smith
Revenue Cycle Specialist Resume Example
Summary: Highly analytical and results-driven Revenue Cycle Specialist with 6+ years of experience optimizing medical billing, collections, and denial management processes within diverse healthcare environments. Proven ability to reduce accounts receivable days, increase clean claim submission rates, and enhance revenue capture through meticulous attention to detail and expert application of ICD-10-CM, CPT, and HCPCS coding guidelines.
Key Skills
Revenue Cycle Management • Denial Management • Accounts Receivable • Medical Billing & Coding (ICD-10-CM, CPT, HCPCS) • Epic EMR, Athenahealth • Payer Relations • HIPAA Compliance • Claim Submission & Processing • Payment Posting • Analytical Problem-Solving
Experience
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Revenue Cycle Specialist at Desert Rose Medical Center ()
- Managed a diverse portfolio of payer accounts, consistently achieving an average collection rate of 98% and reducing AR days by 15% within the first year.
- Spearheaded denial management efforts for complex claims, resulting in a 20% reduction in denial rates and recovering over $250,000 in previously denied revenue annually.
- Proficiently utilized Epic EMR system for charge entry, claim submission (CMS-1500, UB-04), payment posting, and patient account follow-up, ensuring data integrity and compliance.
- Conducted thorough analysis of claim rejections and denials, identifying root causes and implementing corrective actions that improved clean claim submission rates by 18%.
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Medical Biller & Collector at Grand Canyon Pediatrics ()
- Processed an average of 300+ medical claims weekly for various commercial and government payers, maintaining a clean claim rate of 95%.
- Managed patient accounts receivable, performing collections activities and negotiating payment plans, which contributed to a 10% increase in patient self-pay collections.
- Verified patient insurance eligibility and benefits, accurately calculating patient financial responsibility (copays, deductibles, coinsurance) to minimize surprise billing.
- Resolved complex billing inquiries from patients and insurance companies, maintaining high levels of patient satisfaction and trust.
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Billing Assistant at Sunstone Family Practice ()
- Assisted with charge entry and payment posting, ensuring accurate and timely recording of financial transactions for over 100 patient encounters daily.
- Conducted initial review of medical documentation for coding accuracy (ICD-10-CM, CPT) under supervision, flagging discrepancies for senior billers.
- Managed patient registration and demographic data entry in Meditech system, ensuring accuracy for claim generation.
- Handled patient calls regarding billing statements and basic insurance questions, providing empathetic and clear explanations.
Education
- Associate of Science in Health Information Technology - Phoenix College (2017)
- Certified Professional Biller (CPB) - AAPC (2018)
Why and how to use a similar resume
This resume for a Revenue Cycle Specialist is highly effective due to its strategic blend of quantifiable achievements, industry-specific keywords, and a clear demonstration of progressive responsibility. The summary immediately establishes the candidate's core competencies and experience, while the experience section vividly illustrates impact through metrics, showing tangible contributions to revenue optimization and efficiency. The inclusion of specific EMR systems and coding standards directly addresses employer requirements, making the candidate an immediate strong fit for roles requiring technical proficiency and a results-oriented approach.
- Quantifiable achievements highlight direct impact on revenue and efficiency (e.g., "reduced AR days by 15%", "recovered over $250,000").
- Strong use of industry-specific keywords (e.g., "denial management," "ICD-10-CM," "Epic EMR," "CMS-1500") ensures ATS compatibility and demonstrates expertise.
- Clear career progression across three roles demonstrates increasing responsibility and a solid foundation of experience.
- Specific mention of EMR systems (Epic, Athenahealth, Meditech) shows practical, hands-on software proficiency critical for the role.
- Action-oriented verbs at the start of each bullet point (e.g., "Managed," "Spearheaded," "Conducted") convey initiative and measurable impact.
Jordan Smith
Patient Account Representative Resume Example
Summary: Highly motivated Patient Account Representative with 7+ years of progressive experience in medical billing, collections, and revenue cycle management. Proven ability to resolve complex billing inquiries, reduce Accounts Receivable (AR) days, and enhance patient financial satisfaction. Adept at utilizing Epic EHR and optimizing claims processing to maximize collections.
Key Skills
Revenue Cycle Management (RCM) • Patient Collections • Denial Management & Appeals • Insurance Verification • CPT & ICD-10 Coding • Epic EHR • HIPAA Compliance • Payer Relations • Medical Terminology • Customer Service
Experience
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Patient Account Representative at Texas Medical Center Hospital ()
- Managed a portfolio of over 500 complex patient accounts, consistently resolving billing discrepancies and increasing payment rates by 15% through proactive communication and negotiation.
- Reduced average Accounts Receivable (AR) days by 10% through diligent follow-up on outstanding balances and efficient resolution of insurance denials, utilizing Epic EMR and Waystar.
- Educated patients on insurance benefits, payment options, and financial assistance programs, leading to a 20% improvement in patient satisfaction scores related to billing inquiries.
- Processed and submitted over 200 claims weekly, ensuring compliance with CPT, ICD-10, and HIPAA regulations, resulting in a clean claim submission rate of 98%.
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Medical Biller & Collector at Houston Specialty Clinic ()
- Handled full-cycle medical billing and collections for a multi-specialty clinic, processing claims for various payers including Medicare, Medicaid, and commercial insurance.
- Reviewed and appealed denied claims, identifying root causes for rejections and implementing corrective actions that decreased denial rates by 12%.
- Managed patient collections, successfully recovering an average of 5,000 in outstanding patient balances each month through empathetic and effective communication strategies.
- Verified patient insurance eligibility and benefits, accurately calculating patient financial responsibility (co-pays, deductibles, co-insurance) at the point of service.
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Patient Service Representative at Heights Family Practice ()
- Provided exceptional front-desk support, managing patient registration, scheduling appointments, and overseeing check-in/check-out processes for a high-volume primary care office.
- Collected co-pays and outstanding balances at the time of service, improving point-of-service collection rates by 25% through clear communication of financial policies.
- Verified insurance information for all incoming patients, ensuring accuracy and mitigating future billing issues.
- Addressed patient inquiries regarding appointments, referrals, and basic billing questions, consistently achieving high patient satisfaction scores.
Education
- Associate of Applied Science in Medical Billing and Coding - Houston Community College (2016)
Why and how to use a similar resume
This resume effectively showcases a career progression in medical billing and patient accounts, highlighting a strong blend of technical expertise and interpersonal skills crucial for the role. It uses action-oriented verbs and quantifiable achievements to demonstrate impact, rather than just listing duties. The strategic inclusion of industry-specific keywords and software names ensures it will pass through Applicant Tracking Systems (ATS) and resonate with hiring managers in healthcare.
- Quantifiable achievements demonstrate direct impact on revenue cycle and patient satisfaction.
- Strategic use of industry keywords (e.g., CPT, ICD-10, Epic, AR Management) optimizes for ATS.
- Clear career progression from front desk to specialized account representative roles.
- Balanced presentation of both hard skills (software, billing codes) and soft skills (communication, problem-solving).
- Concise summary immediately highlights key qualifications and years of experience.
Jordan Smith
Claims Processor Resume Example
Summary: Highly analytical and results-oriented Claims Processor with 7+ years of experience in medical billing and coding, specializing in comprehensive claim adjudication and denial management. Proven ability to maintain high accuracy rates, optimize revenue cycles, and ensure strict compliance with payer regulations and HIPAA standards. Seeking to leverage expertise in a dynamic healthcare environment.
Key Skills
Claim Adjudication • CPT, ICD-10, HCPCS Coding • Denial Management • Revenue Cycle Management (RCM) • HIPAA Compliance • Electronic Medical Records (EMR) • Epic & Availity • Medical Terminology • Data Entry & Analysis • Attention to Detail
Experience
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Senior Claims Processor at Apex Healthcare Solutions ()
- Process an average of 200+ medical claims daily, including CPT, ICD-10, and HCPCS coding, maintaining a 98.5% accuracy rate for diverse specialties.
- Successfully managed a complex portfolio of claim denials and rejections, reducing outstanding AR by 15% within the first year through meticulous analysis and appeals.
- Utilized advanced features of Epic and Availity platforms for efficient claim submission, status tracking, and electronic remittance advice (ERA) reconciliation.
- Collaborated with providers and patients to gather necessary documentation, ensuring medical necessity and compliance with payer-specific guidelines.
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Claims Specialist at Metro Health Systems ()
- Adjudicated commercial and government claims, verifying patient eligibility, benefits, and prior authorizations to prevent billing discrepancies.
- Identified and resolved coding errors and discrepancies, leading to a 10% improvement in first-pass resolution rates for submitted claims.
- Communicated effectively with insurance companies to clarify policy details, negotiate settlements, and expedite claim processing, reducing turnaround time by an average of 2 days.
- Maintained strict adherence to HIPAA guidelines and industry regulations, ensuring data privacy and security in all claims-related activities.
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Medical Billing & Coding Assistant at Stellar Medical Clinic ()
- Prepared and submitted clean claims to various insurance carriers using Medisoft, resulting in a 95%+ acceptance rate on initial submission.
- Managed patient accounts, including posting payments, resolving billing inquiries, and explaining EOBs, enhancing patient satisfaction by 20%.
- Verified insurance coverage and benefits for incoming patients, reducing claim rejections due to eligibility issues by 12%.
- Assisted with medical coding tasks (ICD-10, CPT) under supervision, ensuring accurate documentation for services rendered.
Education
- Associate of Science in Health Information Technology - Houston Community College (2016)
Why and how to use a similar resume
This resume is highly effective for a Claims Processor as it strategically highlights both technical proficiency and impactful results. It uses strong action verbs and quantifiable achievements to demonstrate the candidate's value in a medical billing and coding context. The clear structure and keyword optimization ensure it will pass Applicant Tracking Systems (ATS) and resonate with hiring managers by showcasing direct contributions to revenue cycle management and compliance.
- Quantifiable achievements like "98.5% accuracy rate" and "reduced outstanding AR by 15%" provide concrete evidence of impact and efficiency.
- Specific industry software (Epic, Availity, Medisoft) and coding systems (CPT, ICD-10, HCPCS) are prominently featured, demonstrating technical readiness and familiarity with essential tools.
- The clear progression from 'Medical Billing & Coding Assistant' to 'Claims Specialist' to 'Senior Claims Processor' showcases career growth and increasing responsibility within the field.
- Emphasis on compliance (HIPAA, payer guidelines) and robust denial management directly addresses critical challenges and value propositions in claims processing.
- A concise, results-driven summary immediately articulates the candidate's core competencies and career objectives, positioning them as a strong and experienced professional.
Jordan Smith
Medical Reimbursement Specialist Resume Example
Summary: Highly analytical and results-driven Medical Reimbursement Specialist with 8+ years of experience in optimizing revenue cycle management, reducing denial rates, and ensuring compliance with complex payer regulations. Proven expertise in claim submission, appeal processing, and EOB analysis across diverse healthcare settings. Dedicated to maximizing reimbursement for healthcare providers through meticulous attention to detail and strong problem-solving abilities.
Key Skills
Denial Management & Appeals • Revenue Cycle Management (RCM) • CPT, ICD-10, HCPCS Coding • Payer Contract Negotiation • EOB Analysis • HIPAA Compliance • Medical Billing Software (Epic, Athenahealth, Kareo) • Accounts Receivable (A/R) Management • Insurance Verification & Authorization • Claim Submission & Follow-up
Experience
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Senior Medical Reimbursement Specialist at Methodist Health System ()
- Spearheaded denial management and appeals processes, successfully recovering over $250,000 in previously denied claims annually by identifying root causes and implementing corrective actions.
- Reduced denial rates by an average of 18% across multiple service lines through proactive analysis of EOBs, payer contracts, and coding discrepancies (CPT, ICD-10, HCPCS).
- Managed a portfolio of high-value accounts, ensuring timely and accurate claim submission for complex procedures and services using Epic EMR system.
- Collaborated cross-functionally with clinical staff, coders, and patient financial services to resolve billing issues and improve overall revenue cycle efficiency.
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Reimbursement Coordinator at Dallas Orthopedic & Sports Medicine ()
- Managed end-to-end medical billing and reimbursement processes for a high-volume orthopedic clinic, handling an average of 300 claims per week.
- Processed and submitted claims to commercial, Medicare, and Medicaid payers, ensuring 98% first-pass resolution rate through meticulous verification and authorization.
- Conducted thorough analysis of Explanation of Benefits (EOBs) to identify payment variances, underpayments, and denials, initiating appeals as necessary.
- Maintained up-to-date knowledge of payer-specific billing requirements, CPT/ICD-10 coding guidelines, and HIPAA regulations to ensure full compliance.
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Medical Billing Specialist at Premier Family Medical Group ()
- Performed daily charge entry, payment posting, and reconciliation for a busy primary care practice with 10+ providers.
- Managed patient accounts, including balance inquiries, payment arrangements, and collections, achieving a 90% success rate in patient collections.
- Verified patient insurance eligibility and benefits prior to appointments, minimizing claim rejections and patient financial surprises.
- Addressed and resolved billing inquiries from patients and insurance companies promptly and professionally.
Education
- Associate of Science in Health Information Technology - Dallas County Community College (2016)
- Certified Professional Coder (CPC) - AAPC (2017)
Why and how to use a similar resume
This resume is highly effective for a Medical Reimbursement Specialist because it immediately establishes a strong professional brand through a focused summary. It leverages quantifiable achievements and industry-specific keywords throughout the experience section, demonstrating tangible impact on revenue cycle management and compliance. The clear structure, combined with a targeted skills section, ensures that applicant tracking systems (ATS) and hiring managers can quickly identify relevant qualifications and expertise in a high-demand field.
- Quantifiable achievements: Each bullet point, especially in the experience section, includes metrics (e.g., 'reduced denial rates by 18%', 'recovered $250K') that demonstrate tangible value and impact.
- Industry-specific keywords: The resume is rich with terms like CPT, ICD-10, EOBs, HIPAA, denial management, payer contracts, and specific software (Epic, Athenahealth, Kareo), optimizing it for ATS.
- Strong professional summary: A concise 3-sentence summary immediately highlights core competencies, years of experience, and key areas of expertise relevant to the role.
- Clear and logical structure: The resume follows a standard, easy-to-read format, with distinct sections for personal info, summary, experience, education, and skills, ensuring quick navigation.
- Comprehensive skill set: The 'Skills' section provides a targeted list of both hard and soft skills crucial for a Medical Reimbursement Specialist, showcasing a well-rounded candidate.
Jordan Smith
Health Information Technician (HIT) Resume Example
Summary: Highly skilled and certified Health Information Technician with over 6 years of progressive experience in managing patient health information, ensuring data accuracy, and maintaining HIPAA compliance. Proficient in advanced EHR systems, medical coding (ICD-10-CM, CPT), and optimizing revenue cycle processes to enhance operational efficiency and patient data integrity.
Key Skills
EHR Systems (Epic, Cerner) • ICD-10-CM & CPT Coding • HIPAA Compliance • Data Integrity & Analytics • Revenue Cycle Management • Medical Terminology • Health Information Management • Medical Billing Software (Kareo) • Attention to Detail • Problem-Solving
Experience
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Health Information Technician at Grand Canyon Medical Center ()
- Managed daily processing of 150+ patient records, maintaining a 99.7% accuracy rate in data entry and record maintenance within Epic EHR system.
- Ensured strict adherence to HIPAA regulations and organizational policies, successfully passing all quarterly internal compliance audits.
- Collaborated with billing and coding departments to resolve complex claim denials, contributing to a 10% reduction in outstanding accounts receivable.
- Conducted comprehensive chart audits for coding accuracy (ICD-10-CM, CPT), identifying and correcting discrepancies to prevent revenue loss.
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Health Information Specialist at Desert Bloom Clinic ()
- Processed an average of 100 patient charts daily, ensuring complete and accurate documentation in the Cerner EHR system.
- Assisted with CPT and ICD-10 coding verification for outpatient services, contributing to a 5% increase in clean claim submissions.
- Managed secure storage and retrieval of sensitive patient data, responding to over 75 record requests per week from patients and external providers.
- Implemented a new electronic document scanning protocol for legacy paper records, converting over 5,000 charts to digital format.
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Medical Records Clerk at Pinnacle Orthopedics ()
- Organized and filed over 200 patient charts weekly, ensuring systematic and accessible record-keeping for a busy orthopedic practice.
- Ensured secure storage and retrieval of confidential patient data, adhering strictly to privacy protocols.
- Assisted with patient registration and appointment scheduling, verifying demographic and insurance information with 98% accuracy.
- Managed incoming and outgoing faxes and mail related to patient records, ensuring timely communication with external entities.
Education
- Associate of Science in Health Information Technology - Phoenix College (2017)
Why and how to use a similar resume
This resume effectively showcases Jordan Smith's expertise as a Health Information Technician by combining a clear, concise summary with detailed, accomplishment-driven experience entries. It strategically uses industry-specific keywords and software names, making it highly discoverable by Applicant Tracking Systems (ATS) and immediately conveying relevance to hiring managers. The inclusion of quantifiable achievements provides concrete evidence of impact and value.
- The professional summary immediately highlights key qualifications and years of experience relevant to the HIT role.
- Each experience entry features strong action verbs and quantifiable metrics, demonstrating tangible contributions and results.
- Specific industry software (Epic, Cerner, Kareo) and coding standards (ICD-10-CM, CPT) are prominently listed, proving technical proficiency.
- Emphasis on HIPAA compliance, data integrity, and revenue cycle management directly addresses critical responsibilities of an HIT.
- Clear career progression across three roles illustrates increasing responsibility and breadth of experience.
Sophia Rodriguez
Billing Coordinator Resume Example
Summary: Highly detail-oriented and results-driven Billing Coordinator with 7+ years of progressive experience in medical billing and revenue cycle management within diverse healthcare environments. Proven ability to streamline claims processing, reduce denial rates by up to 20%, and optimize collections through expert application of CPT, ICD-10, and advanced billing software, ensuring robust financial health for providers.
Key Skills
Medical Billing Software (Epic, Cerner, Kareo, Waystar) • CPT & ICD-10 Coding • Revenue Cycle Management • Claims Processing • EOB Analysis • Denials & Appeals • Accounts Receivable • HIPAA Compliance • Data Entry • Patient Collections
Experience
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Billing Coordinator at Lonestar Health Systems ()
- Managed the full revenue cycle for a multi-specialty clinic, processing an average of 800 claims monthly with a 98% first-pass resolution rate.
- Reduced claim denial rates by 15% within the first year by identifying common errors, implementing pre-submission audits, and providing targeted staff training.
- Spearheaded the integration of a new claims scrubbing software (Waystar), leading to a 10% increase in billing efficiency and a 5% reduction in A/R days.
- Successfully recovered over $250,000 in outstanding claims by meticulously appealing denied claims and liaising with insurance companies and patients.
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Medical Biller at Gulf Coast Pediatrics ()
- Processed and submitted over 1,200 claims weekly to various commercial and government payers, ensuring compliance with HIPAA and payer-specific guidelines.
- Analyzed Explanation of Benefits (EOBs) to identify payment discrepancies, underpayments, and denials, initiating corrective actions promptly.
- Managed patient accounts receivable, including collections calls, payment plan setups, and resolving complex billing inquiries, improving patient satisfaction by 20%.
- Performed charge entry and payment posting with 99% accuracy, reconciling daily deposits and maintaining precise financial records using Kareo.
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Billing Assistant at Coastal Family Practice ()
- Supported the billing department by accurately entering patient demographics, insurance information, and charges into the EMR system (Cerner).
- Verified patient insurance eligibility and benefits for all scheduled appointments, reducing front-desk errors by 10%.
- Posted patient and insurance payments to accounts, ensuring daily reconciliation matched bank deposits.
- Followed up on basic denied claims, identifying reasons for denial and initiating initial resubmission or appeal processes.
Education
- Associate of Science in Health Information Technology - Houston Community College (2016)
Why and how to use a similar resume
This resume for a Billing Coordinator is highly effective due to its strategic focus on quantifiable achievements and industry-specific expertise. It immediately establishes the candidate as a results-driven professional by highlighting metrics like denial rate reduction and collection amounts in the summary and experience sections. The clear progression through roles, from assistant to coordinator, demonstrates a strong career trajectory and increasing responsibility. The inclusion of specific software names and coding standards (CPT, ICD-10) signals immediate readiness for the technical demands of the role, while the concise skill section acts as a quick reference for key competencies.
- Quantifiable achievements: Metrics like "15% reduction in claim denial rates" and "recovered over $250,000" provide concrete evidence of impact.
- Industry-specific keywords: Use of terms like "revenue cycle management," "CPT," "ICD-10," "EOB analysis," and specific software (Epic, Waystar) demonstrates deep industry knowledge.
- Clear career progression: The chronological order of roles, starting from Assistant to Coordinator, shows growth and increasing responsibility in the field.
- Strong professional summary: It quickly highlights years of experience, key skills, and major achievements, setting a strong first impression.
- Relevant skills section: A focused list of 12 critical hard and soft skills provides a quick overview of the candidate's core competencies for the role.
Alex Chen
Coding Auditor Resume Example
Summary: Highly analytical and detail-oriented Coding Auditor with 8+ years of progressive experience in medical billing and coding, specializing in compliance, risk adjustment, and revenue cycle optimization. Proven ability to conduct comprehensive audits, identify coding discrepancies, and implement corrective actions to ensure regulatory adherence and maximize reimbursement.
Key Skills
ICD-10-CM/PCS • CPT & HCPCS Level II • E/M Auditing • CMS/OIG Compliance • Risk Adjustment (HCC) • Revenue Cycle Management • EHR Systems (Epic, Cerner) • Optum360 / EncoderPro • Data Analysis • HIPAA Regulations
Experience
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Coding Auditor at Apex Healthcare Solutions ()
- Led comprehensive audits of inpatient and outpatient medical records, CPT, HCPCS, and ICD-10-CM coding, ensuring 100% compliance with CMS, OIG, and commercial payer regulations.
- Identified and mitigated coding inaccuracies, reducing denial rates by 18% and recovering over 50,000 in potential lost revenue annually.
- Developed and delivered targeted coding education programs for clinical staff and coders, improving coding accuracy scores by an average of 15% across departments.
- Utilized auditing software such as Optum360 and EncoderPro to streamline audit processes, increasing audit throughput by 25% while maintaining high accuracy.
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Senior Medical Coder at Commonwealth Medical Group ()
- Served as a lead coder for multi-specialty practices, specializing in complex surgical procedures and E/M services, maintaining an average accuracy rate of 98%.
- Managed a portfolio of over 500 charts monthly, translating physician documentation into accurate ICD-10-CM, CPT, and HCPCS codes for billing and reporting.
- Mentored junior coders on complex coding guidelines and payer-specific rules, contributing to a team-wide 10% improvement in coding efficiency.
- Reviewed and appealed denied claims, successfully overturning 70% of denials related to coding errors, recovering approximately $75,000 annually.
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Medical Coder at Baystate Health System ()
- Accurately assigned ICD-10-CM, CPT, and HCPCS codes for a high volume of outpatient encounters, including primary care, urgent care, and specialty clinics.
- Reviewed patient medical records to extract relevant information for coding and billing purposes, ensuring medical necessity and proper sequencing.
- Collaborated with physicians and clinical staff to clarify documentation discrepancies, improving initial claim submission accuracy by 12%.
- Maintained up-to-date knowledge of coding guidelines, payer policies, and industry changes through continuous professional development.
Education
- Bachelor of Science in Health Information Management - Northeastern University (2016)
Why and how to use a similar resume
This resume effectively showcases Alex Chen's expertise as a Coding Auditor by employing a results-oriented approach. It strategically highlights quantitative achievements and specific industry tools, demonstrating a clear impact on revenue optimization, compliance, and operational efficiency. The progressive career trajectory from Medical Coder to Senior Medical Coder and then to Coding Auditor illustrates increasing levels of responsibility and specialized knowledge, making the candidate highly attractive for a senior auditing role.
- Quantifies achievements with specific metrics (e.g., 'reduced denial rates by 18%', 'recovered over 50,000') to demonstrate tangible impact on revenue and compliance.
- Uses industry-specific keywords and software (ICD-10-CM, CPT, HCPCS, E/M Auditing, Optum360, Epic, Cerner) highly relevant to a Coding Auditor role, signaling expertise.
- Highlights crucial compliance expertise with references to CMS, OIG, and HIPAA, which are non-negotiable for a regulatory-focused position.
- Showcases clear progressive career growth, building a strong foundational understanding in coding before transitioning to the specialized auditing function.
- Emphasizes both technical auditing skills and valuable soft skills like training, collaboration, and analytical thinking, presenting a well-rounded professional profile.
Jordan Smith
Denial Management Specialist Resume Example
Summary: Highly analytical and results-driven Denial Management Specialist with 8+ years of experience optimizing revenue cycles and minimizing claim denials in fast-paced healthcare environments. Proven expertise in identifying root causes, implementing effective appeal strategies, and leveraging advanced billing software to recover over $2M in previously denied claims and reduce denial rates by an average of 15%. Seeking to apply comprehensive knowledge of medical coding, payer policies, and A/R management to enhance financial performance.
Key Skills
Denial Management • Revenue Cycle Management • Medical Billing & Coding (ICD-10-CM, CPT, HCPCS) • Payer Negotiations & Appeals • A/R Management • EHR Systems (Epic, Meditech, Athenahealth) • Claim Submission & Follow-up • Compliance & Regulations • Data Analysis & Reporting • Problem-Solving
Experience
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Denial Management Specialist at Apex Healthcare Solutions ()
- Led denial resolution efforts for complex claims, recovering an average of $80K per month and reducing the overall denial rate by 18% within the first year.
- Developed and implemented a new appeals process for Medicare and Medicaid denials, increasing successful appeal rates by 25% and accelerating cash flow.
- Analyzed denial trends using Epic EMR and Athenahealth billing systems to identify systemic issues and collaborate with coding and front-desk teams on preventative measures.
- Managed a portfolio of high-value denied claims, successfully overturning over .2M in previously lost revenue through meticulous documentation and payer negotiation.
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Denial Resolution Specialist at Elite Medical Billing Services ()
- Processed and appealed denied medical claims across multiple specialties, consistently achieving a 90%+ success rate for Level 1 appeals.
- Identified common denial reasons such as lack of medical necessity, coding errors, and timely filing limits, implementing targeted corrective actions.
- Utilized Meditech and Kareo billing software to track claim statuses, document communications, and generate detailed denial reports for management.
- Collaborated closely with physicians and clinical staff to gather necessary documentation and medical records to support complex appeals.
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Medical Biller & Claims Processor at Green Valley Family Practice ()
- Managed end-to-end medical billing processes, including charge entry, claim submission, payment posting, and initial denial investigation for a high-volume practice.
- Successfully submitted over 1,500 claims monthly to various commercial and government payers, maintaining a clean claim submission rate of 98%.
- Reviewed and verified patient demographics, insurance information, and service codes (ICD-10-CM, CPT) to ensure accuracy prior to billing.
- Addressed basic claim rejections and denials, performing necessary corrections and resubmissions to minimize delays in payment.
Education
- Associate of Science in Health Information Technology - Houston Community College (2016)
Why and how to use a similar resume
This resume is highly effective for a Denial Management Specialist because it strategically emphasizes quantifiable achievements and industry-specific expertise. The summary immediately positions the candidate as a results-driven professional, while each experience entry clearly outlines responsibilities with strong action verbs and specific metrics. The inclusion of relevant software and coding systems demonstrates a practical, hands-on understanding crucial for the role, and the clear career progression showcases increasing responsibility and skill development in denial prevention and revenue recovery.
- Quantifiable achievements are prominently featured, demonstrating clear impact on revenue and efficiency.
- Strategic use of industry-specific keywords (e.g., ICD-10-CM, CPT, Epic, Athenahealth) ensures ATS compatibility and recruiter recognition.
- Clear career progression across three roles illustrates increasing responsibility and depth of expertise.
- Highlights proficiency in critical medical billing and EHR software essential for the modern healthcare landscape.
- The summary provides a concise yet powerful overview, setting the stage for the detailed accomplishments below.
Jordan Smith
Charge Entry Specialist Resume Example
Summary: Highly accurate and results-driven Charge Entry Specialist with 7+ years of experience in medical billing and revenue cycle management. Proven ability to process high volumes of medical charges, ensure coding compliance, and significantly contribute to reducing claim denials and maximizing reimbursement. Adept at utilizing various EMR/EHR systems and dedicated to maintaining data integrity and financial efficiency.
Key Skills
CPT & ICD-10 Coding • Charge Entry & Posting • Denial Management • Payment Posting • EMR/EHR Systems (Epic, Kareo, Waystar) • Medical Terminology • HIPAA Compliance • Revenue Cycle Management • Data Accuracy • Problem-Solving
Experience
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Charge Entry Specialist at Apex Medical Solutions ()
- Processed an average of 300+ charges daily across multiple specialties (cardiology, orthopedics, general surgery) with a consistent 99.5% accuracy rate.
- Applied CPT, ICD-10, and HCPCS codes, along with appropriate modifiers, ensuring compliance with payer-specific guidelines and regulations.
- Identified and resolved charge entry discrepancies and coding errors, preventing potential claim rejections and reducing the denial rate by 15%.
- Collaborated with clinical staff and coders to clarify documentation, ensuring accurate and complete charge capture for complex procedures.
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Medical Biller at Harmony Health Services ()
- Managed end-to-end medical billing processes for a busy multi-specialty clinic, handling an average of $250,000 in monthly claims.
- Submitted electronic and paper claims to various commercial and government payers using Kareo and Optum 360 systems.
- Performed regular follow-up on unpaid and underpaid claims, appealing denials and recovering an average of 5,000 in previously denied revenue per quarter.
- Verified patient insurance eligibility and benefits, communicating financial responsibilities to patients pre-service to minimize bad debt.
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Billing Assistant at Precision Billing Associates ()
- Assisted with charge entry, payment posting, and patient statement generation for over 50 healthcare providers.
- Reconciled daily deposits and posted payments from EOBs and patient payments with 100% accuracy.
- Managed incoming patient calls regarding billing inquiries, resolving discrepancies and explaining complex billing statements.
- Organized and maintained patient records and billing documentation, ensuring easy retrieval for audits and inquiries.
Education
- Associate of Science in Medical Billing and Coding - Dallas Community College (2016)
Why and how to use a similar resume
This resume for a Charge Entry Specialist is highly effective because it strategically blends quantifiable achievements with industry-specific terminology and a clear career progression. It immediately highlights the candidate's core competencies and impact on revenue cycle management, making it appealing to both human recruiters and Applicant Tracking Systems (ATS). The structured format ensures readability and allows key information to be quickly identified.
- Quantifiable Achievements: Each experience entry includes metrics demonstrating impact, such as 'maintained 99.5% accuracy' or 'reduced denial rate by 15%', which proves value.
- Industry-Specific Keywords: Incorporates essential terms like CPT, ICD-10, EMR/EHR, clearinghouses, and denial management, optimizing it for ATS and showcasing expertise.
- Clear Career Progression: The chronological order of roles, from Billing Assistant to Charge Entry Specialist, illustrates growth and increasing responsibility within medical billing.
- Targeted Skills Section: The 'Skills' section is concise and focuses on the most critical hard and soft skills relevant to the role, such as 'Data Accuracy' and 'Revenue Cycle Management'.
- Professional Summary: Provides a strong, concise overview of the candidate's experience, key strengths, and value proposition right at the beginning.
Jordan Smith
Payment Poster Resume Example
Summary: Highly accurate and results-driven Payment Poster with over 7 years of experience in medical billing and revenue cycle management. Proficient in processing high volumes of EOBs, ERAs, and EFTs across diverse practice management systems, consistently achieving 98%+ accuracy rates. Adept at identifying and resolving discrepancies, managing denials, and ensuring timely cash application to optimize financial performance and minimize AR days.
Key Skills
Payment Posting (Manual & Electronic) • EOB/ERA Interpretation • EFT Processing • Denial Management • Account Reconciliation • Revenue Cycle Management • Epic Systems • AdvancedMD • Kareo • CPT/ICD-10 Coding
Experience
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Senior Payment Poster at Desert Bloom Medical Group ()
- Processed an average of 250+ insurance and patient payments daily, including EOBs, ERAs, and EFTs, ensuring timely and accurate cash application for over $5M in monthly revenue.
- Achieved a consistent 99% accuracy rate in payment posting, significantly reducing unapplied cash and reconciliation errors across 15+ specialty departments.
- Identified and resolved complex payment discrepancies, underpayments, and overpayments, collaborating with billing specialists to appeal denials and recover revenue.
- Managed daily reconciliation of posted payments to bank deposits and clearinghouse reports, streamlining month-end closing procedures by 15%.
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Payment Poster at Canyon View Billing Services ()
- Posted 150+ patient and insurance payments daily for multiple healthcare clients, including surgical centers and primary care clinics, using AdvancedMD and Kareo.
- Interpreted Explanation of Benefits (EOBs) and Electronic Remittance Advices (ERAs) to accurately apply payments, adjustments, and write-offs.
- Identified denial reasons and communicated findings to the claims team, contributing to a 10% reduction in re-worked claims.
- Maintained meticulous records of all payment transactions, ensuring audit readiness and supporting efficient financial reporting.
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Billing Assistant at Valley Medical Clinic ()
- Supported the billing department by performing initial payment posting for co-pays, deductibles, and self-pay accounts.
- Verified patient insurance eligibility and benefits, reducing claim rejections due to incorrect information by 8%.
- Processed charge entry for daily services, ensuring correct CPT and ICD-10 coding were applied before claim submission.
- Managed patient accounts, updating demographics and financial information in the practice management system.
Education
- Medical Billing and Coding Certificate - Phoenix College (2016)
- Associate of Applied Science in Health Information Technology - Glendale Community College (2015)
Why and how to use a similar resume
This resume is highly effective for a Payment Poster role because it immediately establishes the candidate's proficiency in critical revenue cycle management functions. It leverages a strong professional summary and quantifies achievements within each experience entry, demonstrating not just responsibilities but measurable impact on financial operations. The strategic inclusion of industry-specific software and terminology ensures it's optimized for Applicant Tracking Systems (ATS) and resonates with hiring managers seeking specialized expertise.
- Quantifiable achievements throughout demonstrate direct impact on financial efficiency and accuracy.
- Strategic use of industry keywords (EOB, ERA, Epic, AdvancedMD) ensures ATS compatibility and relevance.
- Clear career progression showcases increasing responsibility and mastery of payment posting processes.
- Dedicated skills section highlights both essential hard skills (software, medical codes) and crucial soft skills (accuracy, problem-solving).
- A concise professional summary provides an immediate overview of the candidate's value and experience.
Sophia Rodriguez
Senior Medical Biller Resume Example
Summary: Results-driven Senior Medical Biller with over 8 years of experience in optimizing revenue cycle management, reducing claim denials, and ensuring compliance for multi-specialty clinics. Proven ability to lead billing operations, mentor teams, and implement process improvements that consistently enhance financial performance and operational efficiency. Adept at navigating complex payer regulations and utilizing advanced EMR/EHR systems.
Key Skills
Revenue Cycle Management (RCM) • Denial Management & Appeals • CPT, ICD-10-CM, HCPCS Coding • Medical Billing Software (Epic, Cerner, Kareo, AdvancedMD) • Accounts Receivable (AR) Management • Insurance Verification & Authorization • HIPAA Compliance • Electronic Health Records (EHR) • Payer Relations • Process Improvement
Experience
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Senior Medical Biller at Precision Health Solutions ()
- Oversee the end-to-end medical billing process for a large multi-specialty practice, handling 1,000+ claims weekly across various payers.
- Led denial management and appeals, successfully recovering over $500,000 in previously denied claims annually and maintaining an appeal success rate of 90%.
- Mentored and trained a team of 4 junior medical billers, improving overall team productivity by 20% within the first year.
- Implemented new billing software features and streamlined workflows, reducing average claim processing time by 15% and increasing clean claim submission rates to 98%.
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Medical Biller at United Medical Group ()
- Managed the full revenue cycle for a busy internal medicine clinic, processing an average of 500 claims per week.
- Reduced Accounts Receivable (AR) days by 10% through proactive follow-up with insurance companies and patient collections efforts.
- Identified and resolved complex coding discrepancies (CPT, ICD-10-CM, HCPCS), significantly minimizing claim rejections and improving first-pass resolution rates.
- Collaborated directly with physicians and clinical staff to improve documentation practices, leading to enhanced billing accuracy and reduced audit risks.
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Billing Specialist at Community Care Clinic ()
- Processed patient demographics, insurance verification, and prior authorizations with 99% accuracy.
- Submitted electronic and paper claims to various insurance carriers, including Medicare, Medicaid, and commercial plans.
- Handled patient inquiries regarding billing statements, balances, and insurance coverage, resolving an average of 30+ calls daily.
- Maintained a high level of accuracy (98%) in data entry and claim submission, contributing to timely reimbursements.
Education
- Associate of Science in Medical Office Administration - Dallas Community College (2015)
- Certified Professional Biller (CPB) - AAPC (2016)
Why and how to use a similar resume
This resume is highly effective for a Senior Medical Biller because it strategically combines quantifiable achievements with industry-specific keywords and software proficiencies. It clearly demonstrates a career progression, highlighting increasing responsibilities and leadership roles. The use of strong action verbs at the beginning of each bullet point, coupled with specific metrics, showcases a direct impact on revenue optimization, efficiency, and compliance, which are critical for senior-level billing positions. The inclusion of both hard skills (e.g., specific EMR/EHR systems, coding sets) and relevant soft skills (e.g., team leadership, process improvement) paints a comprehensive picture of a well-rounded and highly capable professional.
- Quantifiable achievements and metrics clearly demonstrate financial impact and efficiency gains.
- Strong incorporation of industry-specific keywords (CPT, ICD-10, RCM, denial management) ensures ATS compatibility.
- Demonstrates clear career progression and increasing levels of responsibility, ideal for a 'Senior' role.
- Highlights leadership and mentoring capabilities, crucial for senior positions.
- Showcases proficiency in essential medical billing software and EMR/EHR systems, indicating readiness for advanced tools.
Jordan Smith
Lead Medical Coder Resume Example
Summary: Highly accomplished Lead Medical Coder with 8+ years of progressive experience in complex medical coding, auditing, and team leadership within fast-paced healthcare environments. Proven ability to maintain 98%+ coding accuracy, reduce claim denials by up to 15%, and optimize revenue cycle management while ensuring strict compliance with all regulatory guidelines. Certified Professional Coder (CPC) and Certified Coding Specialist (CCS) with expertise in CPT, ICD-10-CM, and HCPCS.
Key Skills
CPT Coding • ICD-10-CM Coding • HCPCS Level II • E/M Coding • Medical Auditing • Compliance & Regulations • Revenue Cycle Management • Denials Management • Epic EMR • Cerner EMR
Experience
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Lead Medical Coder at Apex Healthcare Solutions ()
- Led a team of 5 medical coders, overseeing daily operations, quality assurance, and professional development to ensure high performance and adherence to coding standards.
- Achieved and maintained a consistent 98.8% coding accuracy rate across multiple specialties (Surgery, Cardiology, E/M), significantly reducing audit flags and rework.
- Developed and implemented new training modules for complex E/M coding and modifier usage, improving team proficiency by 20% within six months.
- Conducted weekly coding audits on complex cases, providing constructive feedback and education that reduced coding-related claim denials by 15% ($75,000 annually).
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Senior Medical Coder at Unity Medical Center ()
- Coded high volumes of inpatient and outpatient records (averaging 100+ charts/day) using ICD-10-CM, CPT, and HCPCS Level II codes with a consistent 98% accuracy.
- Specialized in complex surgical and procedural coding, resolving intricate coding discrepancies and ensuring appropriate reimbursement.
- Mentored junior coders, providing guidance on difficult cases and contributing to a 5% improvement in their individual coding accuracy rates.
- Managed the appeals process for denied claims, successfully overturning 70% of coding-related denials through detailed documentation review and payer communication.
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Medical Coder at Metro Health Services ()
- Accurately assigned CPT, ICD-10-CM, and HCPCS codes for a diverse range of medical services including office visits, laboratory, and radiology procedures.
- Utilized Epic EMR and Optum360 Encoder software daily to ensure efficient and precise code assignment and data entry.
- Maintained up-to-date knowledge of coding guidelines, payer policies, and industry changes through continuous professional development.
- Collaborated effectively with physicians and clinical staff to clarify documentation, ensuring complete and accurate medical records for coding.
Education
- Associate of Science in Health Information Technology - Dallas Community College (2016)
- Certified Professional Coder (CPC) - AAPC (2016)
- Certified Coding Specialist (CCS) - AHIMA (2018)
Why and how to use a similar resume
This resume is highly effective for a Lead Medical Coder because it strategically highlights leadership, deep technical expertise, and quantifiable achievements. It immediately establishes the candidate as a seasoned professional with a proven track record in driving accuracy, compliance, and revenue optimization. The use of specific coding terminology, software, and metrics demonstrates a strong command of the field, appealing directly to an ATS and hiring managers looking for a high-impact leader.
- Quantifiable achievements in each experience entry demonstrate direct impact on revenue, efficiency, and accuracy.
- Clear progression from Medical Coder to Lead Medical Coder showcases career growth and increasing responsibility.
- Integration of specific industry software (Epic, Cerner, Optum360) and coding systems (CPT, ICD-10-CM, HCPCS) ensures ATS compatibility.
- Emphasis on leadership, auditing, training, and compliance directly aligns with the responsibilities of a Lead Medical Coder.
- A concise professional summary immediately positions the candidate as an expert with relevant certifications and experience.
Sarah Jenkins
Medical Billing Supervisor Resume Example
Summary: Highly accomplished Medical Billing Supervisor with 8+ years of progressive experience in revenue cycle management, claims processing, and denial resolution. Proven ability to lead and develop high-performing billing teams, reduce accounts receivable days, and ensure compliance with complex healthcare regulations. Seeking to leverage expertise to optimize billing operations and maximize revenue for a dynamic healthcare organization.
Key Skills
Revenue Cycle Management • Claims Processing (CMS-1500, UB-04) • Denial Management & Appeals • CPT/ICD-10 Coding • HIPAA Compliance • EHR Systems (Epic, Cerner) • Team Leadership & Training • Accounts Receivable (A/R) Management • Payer Relations • Medical Terminology
Experience
-
Medical Billing Supervisor at Desert Bloom Medical Group ()
- Managed a team of 8 medical billing specialists, overseeing daily operations, performance reviews, and professional development.
- Reduced average Accounts Receivable (A/R) days by 18% through proactive denial management strategies and enhanced claims scrubbing protocols.
- Implemented a new electronic claims submission process, resulting in a 98% clean claim submission rate and a 15% decrease in rejections.
- Developed and delivered comprehensive training programs on CPT/ICD-10 coding updates, payer-specific requirements, and HIPAA compliance for all billing staff.
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Senior Medical Biller at Grand Canyon Health ()
- Processed high volumes of complex medical claims across multiple specialties, including surgical, diagnostic, and primary care.
- Identified and resolved root causes of denial trends, recovering over $250,000 in previously denied claims annually.
- Mentored and provided technical guidance to junior billers, improving team efficiency and reducing individual error rates by 20%.
- Managed patient billing inquiries and appeals, maintaining a 95% satisfaction rate through clear communication and effective problem-solving.
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Medical Biller at Valley View Clinic ()
- Performed accurate charge entry and claims submission for a busy multi-specialty clinic using Cerner EMR.
- Verified patient insurance eligibility and benefits, proactively communicating out-of-pocket costs to patients.
- Posted payments, adjustments, and refunds, ensuring precise ledger reconciliation and adherence to financial policies.
- Managed Accounts Receivable follow-up, identifying unpaid claims and pursuing timely reimbursement from insurance carriers.
Education
- Associate of Science in Health Information Technology - Phoenix College (2016)
Why and how to use a similar resume
This resume is highly effective for a Medical Billing Supervisor because it immediately establishes the candidate's leadership capabilities and proven track record in optimizing revenue cycles. It leverages strong action verbs and quantifiable achievements to demonstrate impact, rather than just listing responsibilities. The inclusion of specific industry software and compliance knowledge reassures hiring managers of the candidate's technical proficiency and understanding of the regulatory landscape. The clear, chronological format makes it easy to digest, and the targeted skills section reinforces their suitability for supervisory roles in medical billing.
- Quantifiable achievements: Metrics like 'reduced A/R days by 18%' and '98% clean claim submission rate' provide concrete evidence of success.
- Industry-specific keywords: Terms such as 'CPT/ICD-10 coding', 'denial management', 'revenue cycle management', and 'EHR systems (Epic, Cerner)' resonate directly with hiring managers in the medical billing field.
- Demonstrated leadership: Bullet points explicitly show team management, training, and process improvement initiatives, crucial for a supervisor role.
- Clear career progression: The experience section outlines a logical advancement from Medical Biller to Senior Medical Biller to Supervisor, illustrating growth and increasing responsibility.
- Relevant skill set: The 'Skills' section is concise and highlights the most critical hard and soft skills, making it easy for recruiters to identify key competencies.
Jordan Smith
Coding Manager Resume Example
Summary: Highly accomplished and certified Coding Manager with 8+ years of progressive experience in medical billing and coding, specializing in compliance, revenue cycle optimization, and team leadership. Proven track record of improving coding accuracy, streamlining processes, and achieving significant revenue enhancements through strategic management and advanced analytical skills. Adept at fostering high-performing teams and navigating complex regulatory landscapes.
Key Skills
ICD-10-CM • CPT • HCPCS • Revenue Cycle Management • Compliance & Auditing • EHR Systems (Epic, Cerner) • Team Leadership • Process Optimization • Data Analysis • Payer Relations
Experience
-
Coding Manager at Texas Health Medical Group ()
- Led a team of 15 medical coders, overseeing daily operations, performance management, and professional development, resulting in a 98% coding accuracy rate.
- Implemented robust internal audit protocols, reducing coding-related denial rates by 18% and recovering an average of $20,000 monthly in previously denied claims.
- Managed comprehensive ICD-10-CM, CPT, and HCPCS coding for multi-specialty practices, ensuring strict adherence to federal and state regulations.
- Spearheaded the integration of a new Computer-Assisted Coding (CAC) software, boosting team productivity by 15% and reducing coding turnaround time by 2 days.
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Lead Medical Coder at Baylor Scott & White Health ()
- Provided expert coding for complex surgical procedures and professional services across various specialties including Cardiology, Orthopedics, and Oncology.
- Conducted regular quality assurance reviews on junior coders' work, identifying areas for improvement and contributing to a department-wide 5% increase in coding accuracy.
- Served as a primary resource for clinical staff and physicians, clarifying documentation requirements to support accurate code assignment and maximize reimbursement.
- Assisted in the successful completion of external audits by CMS and private payers, maintaining a 99% compliance score and avoiding potential penalties.
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Medical Coder at Methodist Health System ()
- Performed high-volume coding of inpatient and outpatient records using ICD-10-CM, CPT, and HCPCS Level II coding systems with an average of 60 encounters per day.
- Maintained a consistent coding accuracy rate of 97% or higher, consistently exceeding departmental benchmarks.
- Identified and resolved coding-related claim denials, working closely with the billing team to resubmit corrected claims and recover revenue.
- Utilized Epic EMR system for documentation review and code assignment, ensuring data integrity and compliance with HIPAA regulations.
Education
- Bachelor of Science in Health Information Management - University of Texas at Dallas (2016)
- Certified Professional Coder (CPC) - AAPC (2016)
- Certified Coding Specialist (CCS) - AHIMA (2017)
Why and how to use a similar resume
This resume is highly effective for a Coding Manager role because it strategically highlights leadership, compliance expertise, and quantifiable achievements in revenue cycle management. It demonstrates a clear career progression, showcasing increasing responsibility and mastery of complex medical coding systems and team oversight. The use of specific industry keywords, software, and metrics makes the candidate's impact tangible and directly relevant to the demands of a senior coding position, positioning them as a results-driven leader.
- Showcases strong leadership and team development skills crucial for a managerial role.
- Emphasizes compliance, audit success, and risk mitigation, key concerns for medical organizations.
- Quantifies achievements in revenue optimization and efficiency improvements, demonstrating financial impact.
- Integrates industry-specific software (EHR, CAC) and coding systems (ICD-10-CM, CPT, HCPCS) to establish expertise.
- Presents a clear career trajectory with increasing responsibilities, validating readiness for a Coding Manager position.
Sarah Thompson
Clinical Documentation Improvement (CDI) Specialist Resume Example
Summary: Highly accomplished and certified Clinical Documentation Improvement (CDI) Specialist with 7+ years of experience enhancing documentation accuracy, optimizing Case Mix Index (CMI), and ensuring regulatory compliance. Proven ability to collaborate with physicians and interdisciplinary teams to improve patient care quality, reduce claim denials, and maximize revenue integrity through precise ICD-10-CM/PCS coding and DRG validation.
Key Skills
Clinical Documentation Improvement (CDI) • ICD-10-CM/PCS Coding • DRG Validation • HCC Coding • Physician Query Development • EMR Systems (Epic, Cerner) • Compliance & Regulatory Adherence • Data Analysis & Reporting • Interdisciplinary Collaboration • Medical Terminology & Anatomy
Experience
-
Senior Clinical Documentation Improvement (CDI) Specialist at Golden Gate Health System ()
- Led CDI initiatives for complex service lines (Cardiology, Oncology), increasing Case Mix Index (CMI) by an average of 3.5% annually through targeted physician education and concurrent documentation reviews.
- Developed and implemented a new query template system in Epic, resulting in a 15% improvement in physician query response rates and enhanced documentation specificity.
- Conducted comprehensive reviews of inpatient medical records for accuracy and completeness, identifying and clarifying over 30 documentation discrepancies per week to support accurate DRG assignment and HCC capture.
- Provided ongoing education to 50+ attending physicians and residents on compliant documentation practices, ICD-10-CM/PCS guidelines, and the impact of documentation on quality metrics and reimbursement.
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Clinical Documentation Improvement (CDI) Specialist at Bayview Community Hospital ()
- Performed concurrent and retrospective chart reviews for medical necessity and appropriate documentation, ensuring accurate reflection of patient severity of illness and risk of mortality.
- Authored physician queries for ambiguous, conflicting, or incomplete documentation, leading to improved specificity for principal diagnoses, secondary diagnoses, and procedures.
- Facilitated physician engagement sessions on the importance of documentation for quality reporting, length of stay, and appropriate resource utilization.
- Utilized Cerner EMR to track and report CDI metrics, contributing to a 2% increase in overall CMI within the first year of the CDI program's implementation.
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Registered Nurse (RN) Case Manager at Coastal Medical Center ()
- Managed a caseload of 15-20 patients daily, coordinating care plans, discharge planning, and resource utilization across multiple hospital units.
- Collaborated with physicians, social workers, and allied health professionals to ensure optimal patient outcomes and efficient transitions of care.
- Reviewed patient charts for medical necessity of admission and continued stay, applying InterQual and Milliman criteria to support appropriate levels of care.
- Educated patients and families on post-discharge care, medication management, and available community resources to prevent readmissions.
Education
- Master of Science in Nursing (MSN) - University of California, San Francisco (2016)
- Bachelor of Science in Nursing (BSN) - California State University, East Bay (2013)
Why and how to use a similar resume
This resume is highly effective for a Clinical Documentation Improvement (CDI) Specialist because it strategically highlights a blend of clinical expertise, coding knowledge, and strong communication skills—all critical for success in this role. It uses action-oriented language and quantifiable achievements to demonstrate impact on revenue integrity, compliance, and physician engagement. The structure is clean and easy to read, allowing hiring managers to quickly grasp the candidate's qualifications and value proposition.
- Quantifiable achievements showcase direct impact on Case Mix Index (CMI), query rates, and denial reduction, which are key performance indicators for CDI.
- Specific mention of EMR systems (Epic, Cerner) and coding classifications (ICD-10-CM/PCS, DRG, HCC) demonstrates technical proficiency and industry-specific knowledge.
- The 'Summary' section provides a concise yet powerful overview, immediately positioning the candidate as an experienced and results-driven professional.
- Inclusion of both a clinical background (RN) and CDI certifications (CCDS, CDIP) validates the comprehensive skill set required for effective documentation improvement.
- The 'Skills' section is focused on the most critical hard and soft skills, making it easy for ATS systems and human readers to identify relevant competencies.
Jordan Vance
Health Information Management (HIM) Specialist Resume Example
Summary: Highly detail-oriented and certified Health Information Management (HIM) Specialist with over 7 years of experience in optimizing data integrity, ensuring regulatory compliance (HIPAA, HITECH), and enhancing revenue cycle efficiency. Proficient in advanced coding (ICD-10, CPT), EHR systems (Epic, Cerner), and adept at leveraging health data for improved patient outcomes and operational excellence.
Key Skills
ICD-10-CM/PCS Coding • CPT/HCPCS Coding • EHR Systems (Epic, Cerner) • HIPAA & HITECH Compliance • Data Integrity & Analysis • Revenue Cycle Management • Medical Terminology • Clinical Documentation Improvement (CDI) • Release of Information (ROI) • Audit & Quality Assurance
Experience
-
Health Information Management Specialist at Desert Bloom Medical Center ()
- Managed comprehensive health record documentation for over 500 patient encounters weekly, ensuring 98% accuracy in data capture and integrity within Epic EHR.
- Performed advanced ICD-10 and CPT coding for diverse specialties, improving billing accuracy and reducing claim denials by 15% through meticulous review and physician query.
- Ensured strict adherence to HIPAA, HITECH, and other regulatory standards, successfully passing two internal compliance audits with zero deficiencies.
- Collaborated with clinical and administrative teams to streamline documentation workflows, resulting in a 10% reduction in average record completion time.
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Medical Coder & Auditor at Grand Canyon Health Network ()
- Conducted daily coding and auditing of patient records, identifying and correcting discrepancies to maintain a 99% coding accuracy rate across multiple service lines.
- Analyzed denied claims and implemented corrective actions, recovering approximately $20,000 in previously lost revenue annually.
- Provided feedback and education to providers on documentation best practices, leading to a 5% improvement in CPT specificity and ICD-10 capture.
- Participated in quarterly compliance reviews, contributing to the development of updated coding policies and procedures.
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Health Information Technician at Sonora Regional Hospital ()
- Maintained and organized physical and electronic health records for over 300 patients daily, ensuring quick retrieval and secure storage.
- Processed requests for Release of Information (ROI) in accordance with HIPAA regulations, handling an average of 50 requests per week with 100% compliance.
- Performed data entry and abstracting for various health initiatives, supporting clinical research and quality improvement projects.
- Assisted in the transition from paper-based records to an electronic health record (EHR) system, contributing to a seamless data migration.
Education
- Bachelor of Science in Health Information Management - Arizona State University (2016)
Why and how to use a similar resume
This resume for a Health Information Management (HIM) Specialist is highly effective due to its strategic focus on quantifiable achievements and industry-specific expertise. It immediately establishes the candidate's proficiency in critical areas like coding, compliance, and EHR systems through a strong professional summary. Each experience entry is packed with action verbs and metrics that demonstrate tangible impact, showcasing not just responsibilities but concrete contributions to efficiency, accuracy, and revenue optimization. The clear progression through relevant roles highlights a growing mastery of HIM principles, while the dedicated skills section reinforces key technical competencies vital for the modern healthcare landscape.
- Quantifiable achievements demonstrating impact on efficiency and revenue.
- Strategic use of industry-specific keywords (ICD-10, CPT, Epic, HIPAA).
- Clear career progression showcasing increasing responsibility and expertise.
- Strong emphasis on regulatory compliance and data integrity.
- Proficiency in critical EHR systems and health IT tools.
Jordan Smith
Medical Records Coder Resume Example
Summary: Highly accurate and certified Medical Records Coder with over 7 years of experience in multi-specialty healthcare environments. Expert in ICD-10-CM, CPT, and HCPCS coding, committed to ensuring compliance, optimizing revenue cycles, and maintaining data integrity within various EHR systems including Epic and Cerner. Proven ability to reduce claim denials and improve coding efficiency by up to 15%.
Key Skills
ICD-10-CM & CPT Coding • HCPCS Level II • EHR Systems (Epic, Cerner, Meditech) • Revenue Cycle Management • HIPAA Compliance • Medical Terminology • Anatomy & Physiology • Claim Denial Management • Auditing & Compliance • Attention to Detail
Experience
-
Senior Medical Records Coder at Capitol City Medical Center ()
- Accurately coded an average of 60-70 complex inpatient and outpatient medical records daily using ICD-10-CM, CPT, and HCPCS Level II codes, maintaining a 98.5% accuracy rate.
- Collaborated with physicians and clinical staff to clarify documentation, reducing coding discrepancies by 10% and improving claim submission efficiency.
- Utilized Epic EHR system extensively for comprehensive record review, charge capture, and claims processing, ensuring compliance with payer-specific guidelines.
- Conducted internal audits on a quarterly basis, identifying coding errors and providing actionable feedback, which contributed to a 5% reduction in denial rates.
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Medical Coder Specialist at Sierra Health Group ()
- Managed coding for a high-volume multi-specialty clinic (cardiology, orthopedics, general surgery), processing 50+ claims per day with 98% accuracy.
- Implemented new internal coding guidelines for specific surgical procedures, resulting in a 7% decrease in coding-related rejections.
- Reviewed and appealed denied claims, successfully recovering over $20,000 in reimbursements annually by providing detailed documentation and coding rationale.
- Proficiently used Cerner and Meditech EHR platforms for patient record management, charge entry, and report generation.
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Junior Medical Coder at Valley Billing Solutions ()
- Reviewed and assigned appropriate ICD-10-CM and CPT codes for routine primary care and diagnostic service claims, processing an average of 40 records daily.
- Assisted senior coders with documentation analysis and query generation to ensure complete and accurate medical record information.
- Performed data entry and maintained patient confidentiality in accordance with HIPAA regulations within a proprietary billing software.
- Learned and applied complex coding rules and regulations under direct supervision, quickly adapting to evolving industry standards.
Education
- Associate of Science in Health Information Technology - Sacramento City College (2016)
- Certified Professional Coder (CPC) - AAPC (2016)
Why and how to use a similar resume
This resume effectively showcases Jordan Smith as a highly competent Medical Records Coder by employing a results-oriented approach. It strategically highlights industry-specific certifications, a strong command of coding systems like ICD-10-CM and CPT, and proficiency in leading EHR platforms. The use of quantifiable achievements throughout the experience section demonstrates tangible value, while the clear progression through roles illustrates increasing responsibility and expertise. This structure immediately communicates the candidate's technical prowess, commitment to compliance, and direct impact on revenue optimization, making it highly appealing to hiring managers in healthcare.
- Quantifiable achievements and metrics (e.g., '98.5% accuracy rate,' 'recovered over $20,000') clearly demonstrate impact.
- Strategic inclusion of industry keywords (ICD-10-CM, CPT, HCPCS, Epic, Cerner, HIPAA) ensures ATS compatibility and relevance.
- Clear career progression from Junior to Senior Coder illustrates growth and increasing responsibility.
- Emphasis on compliance, revenue cycle optimization, and denial management directly addresses key concerns for healthcare providers.
- Balanced showcase of both technical coding expertise and valuable soft skills like communication and mentorship.
Jordan Smith
Certified Risk Adjustment Coder (CRC) Resume Example
Summary: Highly skilled and AAPC Certified Risk Adjustment Coder (CRC) with 6+ years of experience specializing in Hierarchical Condition Categories (HCCs) and Medicare Advantage plans. Proven track record in achieving 98%+ coding accuracy, optimizing RAF scores, and ensuring stringent compliance with CMS guidelines to drive significant revenue capture and minimize audit risk.
Key Skills
Risk Adjustment Coding (CRC) • ICD-10-CM • Hierarchical Condition Categories (HCC) • Medicare Advantage • Auditing & Compliance • Electronic Health Records (Epic, Cerner) • Data Analysis • Claim Denials Management • Attention to Detail • Analytical Thinking
Experience
-
Certified Risk Adjustment Coder at Zenith Healthcare Systems ()
- Accurately coded an average of 150+ patient charts daily, identifying chronic conditions and assigning appropriate HCCs to optimize risk adjustment factor (RAF) scores for Medicare Advantage plans.
- Achieved a consistent coding accuracy rate of 98%+, significantly contributing to compliant revenue capture and minimizing audit risks.
- Collaborated with clinical documentation improvement (CDI) specialists and providers to clarify documentation discrepancies, resulting in a 15% reduction in query response time.
- Utilized advanced knowledge of ICD-10-CM guidelines and CMS regulations to ensure comprehensive and compliant coding practices.
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Senior Medical Coder (Risk Adjustment Focus) at Meridian Health Partners ()
- Reviewed and coded over 120 complex medical records daily for various payer types, with a growing emphasis on risk adjustment coding.
- Conducted internal audits on 50 charts monthly, identifying coding errors and providing actionable feedback to junior coders, improving team accuracy by 10%.
- Managed a portfolio of high-risk patient charts, ensuring thorough documentation and accurate HCC assignment, impacting over 10,000 patient lives.
- Developed and delivered training modules on updated ICD-10-CM guidelines and risk adjustment best practices to a team of 8 coders.
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Medical Coder at Unity Medical Group ()
- Coded primary care and specialty outpatient encounters using ICD-10-CM and CPT codes, maintaining an average daily volume of 80 charts.
- Ensured compliance with all federal and state coding regulations, including HIPAA and OIG guidelines.
- Assisted with the implementation of a new EHR system (Epic), providing peer support and testing functionalities.
- Processed and submitted claims efficiently, contributing to a 99% clean claim submission rate.
Education
- Certified Risk Adjustment Coder (CRC) - AAPC (2019)
- Certified Professional Coder (CPC) - AAPC (2017)
- Associate of Science in Health Information Technology - Dallas Community College (2017)
Why and how to use a similar resume
This resume effectively highlights a Certified Risk Adjustment Coder's expertise by leading with a strong summary that immediately establishes the candidate's core competencies and certifications. The experience section uses action verbs and quantifiable achievements to demonstrate impact on revenue, accuracy, and compliance. The clear progression through roles, coupled with specific industry keywords and software familiarity, positions the candidate as a highly capable and experienced professional in the risk adjustment coding domain.
- Quantifiable achievements demonstrate direct impact on revenue and accuracy.
- Specific industry keywords (HCC, RAF, Medicare Advantage) are strategically integrated.
- Clear career progression showcases increasing responsibility and expertise.
- Inclusion of relevant software (Epic, Cerner) indicates technical proficiency.
- Strong emphasis on compliance and auditing capabilities, crucial for risk adjustment.
Jordan Smith
Certified Professional Medical Auditor (CPMA) Resume Example
Summary: Highly analytical and results-driven Certified Professional Medical Auditor (CPMA) with 7+ years of experience in healthcare compliance, revenue integrity, and risk mitigation. Proven expertise in performing comprehensive audits, identifying coding discrepancies, and implementing corrective actions that optimize revenue and ensure adherence to federal and state regulations. Adept at leveraging data analytics to enhance audit processes and provide actionable insights.
Key Skills
Medical Auditing • CPT/ICD-10-CM/HCPCS • E/M Audits • HCC Risk Adjustment • Compliance & Regulatory Adherence • Revenue Cycle Management • Data Analysis • EHR Systems (Epic, Cerner, AthenaHealth) • HIPAA • AAPC Guidelines
Experience
-
Certified Professional Medical Auditor (CPMA) at Desert Peak Health System ()
- Led comprehensive external and internal medical audits across multiple specialties (e.g., E/M, Surgery, Radiology), identifying and resolving coding errors to recover over .2M in potential revenue losses annually.
- Developed and implemented targeted educational programs for 75+ providers and coding staff, resulting in a 15% reduction in audit deficiencies and improved documentation quality within 12 months.
- Ensured strict compliance with CMS, OIG, HIPAA, and AAPC guidelines, successfully navigating three external payer audits with zero major findings.
- Utilized advanced data analytics tools (e.g., OptumInsight, Epic reporting) to proactively identify high-risk coding patterns and implement preventative strategies, mitigating compliance exposure by 20%.
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Senior Medical Coder & Auditor Analyst at Grand Canyon Medical Group ()
- Performed pre-bill and post-bill audits on over 500 claims monthly, identifying and correcting coding errors (CPT, ICD-10-CM, HCPCS) that improved clean claim submission rates from 88% to 96%.
- Collaborated with physicians and clinical staff to improve documentation practices, leading to enhanced specificity and accuracy in medical records for appropriate code assignment.
- Assisted in the preparation for RAC and OIG audits, conducting internal reviews of high-volume services and providing recommendations for risk reduction strategies.
- Trained 10+ new coders on payer-specific guidelines and coding best practices, significantly reducing their error rates within the first three months.
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Medical Billing and Claims Specialist at Sonora Valley Hospitals ()
- Processed and submitted an average of 300+ medical claims daily, ensuring accuracy and timely submission to maximize reimbursement.
- Managed denial resolution and appeals processes, successfully overturning 75% of denied claims through meticulous documentation review and payer communication.
- Interpreted Explanation of Benefits (EOBs) and applied payments, reconciling patient accounts and identifying discrepancies.
- Maintained up-to-date knowledge of payer policies, government regulations, and industry changes impacting medical billing and claims processing.
Education
- Bachelor of Science in Health Information Management - Arizona State University (2017)
Why and how to use a similar resume
This resume is highly effective for a Certified Professional Medical Auditor (CPMA) because it immediately establishes the candidate's core qualification and expertise through the prominent title and a strong, keyword-rich summary. It effectively quantifies achievements in revenue recovery, compliance adherence, and operational efficiency across multiple roles, demonstrating a clear impact on organizational financial health and risk management. The strategic use of industry-specific keywords, software, and regulatory bodies throughout the experience section ensures it will pass through Applicant Tracking Systems (ATS) and resonate with hiring managers seeking a high-caliber auditor.
- Quantifies impact on revenue recovery and risk mitigation, showcasing clear value.
- Highlights direct experience with critical regulatory compliance (CMS, OIG, HIPAA, AAPC).
- Showcases expertise in specific coding systems (CPT, ICD-10-CM, HCPCS) and audit types (E/M, HCC).
- Demonstrates capability in provider education and process improvement, key aspects of an auditor's role.
- Includes relevant EHR systems and data analysis tools, indicating technical proficiency.
Jordan Smith
Medical Coding Analyst Resume Example
Summary: Highly analytical and detail-oriented Medical Coding Analyst with 7+ years of experience specializing in ICD-10-CM, CPT, and HCPCS coding across diverse specialties. Proven track record of optimizing revenue cycles, significantly reducing claim denials by up to 15%, and ensuring stringent compliance with healthcare regulations. Expert in Epic and Cerner EHR systems, dedicated to enhancing coding accuracy and operational efficiency.
Key Skills
ICD-10-CM Coding • CPT Coding • HCPCS Level II • E/M Coding Guidelines • Revenue Cycle Management • Claims Denial Management • EHR Systems (Epic, Cerner, Kareo) • Medical Terminology • HIPAA Compliance • Data Analysis
Experience
-
Medical Coding Analyst at Baylor Scott & White Health ()
- Analyzed complex medical records and assigned accurate ICD-10-CM, CPT, and HCPCS Level II codes for inpatient and outpatient services, maintaining a consistent 98.5% accuracy rate.
- Managed a daily volume of 75+ charts, identifying and resolving coding discrepancies to ensure compliance with CMS guidelines and payer-specific requirements, mitigating audit risks.
- Reduced claim denial rates by 12% within the first year by proactively auditing documentation and providing targeted feedback to clinical departments, recovering over $250,000 in potential lost revenue.
- Collaborated with physicians and clinical staff to improve documentation quality, leading to enhanced specificity in coding and a 10% increase in clean claim submission rates.
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Senior Medical Coder at Optum360 (for various healthcare clients) ()
- Performed high-volume, multi-specialty coding (e.g., Cardiology, Orthopedics, General Surgery) for 20+ client facilities, consistently exceeding productivity benchmarks by 10%.
- Successfully resolved an average of 50-60 coding-related inquiries and appeals per week, recovering over 50,000 in underpaid or denied claims annually.
- Provided expert guidance on complex coding scenarios and regulatory updates (e.g., E/M guideline changes) to a team of junior coders, fostering a culture of continuous learning and accuracy.
- Developed and delivered training sessions on coding best practices and documentation improvement for clinical staff, resulting in a 5% reduction in physician query rates.
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Medical Billing & Coding Specialist at Prime Care Clinic ()
- Processed and submitted medical claims to various insurance carriers (Medicare, Medicaid, commercial payers), achieving a first-pass resolution rate of 95%.
- Assisted with charge entry and payment posting, reconciling accounts and identifying discrepancies to ensure accurate financial records and prevent revenue leakage.
- Reviewed patient demographic and insurance information for accuracy, preventing common billing errors that lead to claim rejections and delays.
- Managed accounts receivable, diligently following up on unpaid claims and appeals, and reducing outstanding balances by an average of 10% monthly.
Education
- Associate of Applied Science in Health Information Technology - Dallas County Community College (2017)
- Certified Professional Coder (CPC) - AAPC (2017)
- Certified Coding Specialist (CCS) - AHIMA (2018)
Why and how to use a similar resume
This resume is highly effective for a Medical Coding Analyst because it immediately establishes the candidate's core competencies and quantifiable achievements. It uses a clear, reverse-chronological format that highlights career progression and increasing responsibility. The strategic placement of industry-specific keywords and software names throughout the summary, experience, and skills sections ensures it will pass through Applicant Tracking Systems (ATS) and resonate with hiring managers. The consistent use of metrics demonstrates a results-oriented professional, crucial for roles impacting revenue cycle management.
- Quantifiable achievements (e.g., "98.5% accuracy rate," "reduced claim denial rates by 12%") demonstrate tangible impact and value.
- Specific industry keywords (ICD-10-CM, CPT, HCPCS, Epic, Cerner, Revenue Cycle Management) are integrated naturally, optimizing for ATS.
- Strong action verbs at the start of each bullet point showcase proactive contributions and responsibilities.
- Demonstrates progressive career growth, indicating increasing expertise and leadership capabilities.
- Highlights critical compliance and regulatory knowledge (CMS, HIPAA, OIG), essential for ethical coding practices.
Good vs Bad Resume Examples
Professional Summary
❌ Avoid:
Experienced Medical Biller and Coder seeking a challenging position where I can use my skills to contribute to a healthcare organization.
✅ Do This:
Certified Professional Coder (CPC) with 7+ years of experience optimizing revenue cycle management and ensuring 99% clean claim submission. Successfully reduced denial rates by 18% through proactive auditing and payer communication, recovering over 50K in potential lost revenue.
Why: The 'good' example immediately highlights a key certification (CPC), quantifies years of experience, and, most importantly, provides specific, measurable achievements (99% clean claim rate, 18% denial reduction, 50K recovered). The 'bad' example is vague, lacks any metrics or specific skills, and could apply to almost any professional role.
Work Experience
❌ Avoid:
Responsible for submitting medical claims and following up on denied claims.
✅ Do This:
Optimized claims processing workflow, resulting in a 15% reduction in average turnaround time and improving reimbursement rates by 5% within one fiscal year.
Why: The 'good' example starts with a power verb ('Optimized') and uses clear metrics (15% reduction, 5% improvement) to demonstrate a tangible impact. The 'bad' example is a task-based description of duties, failing to convey any achievement or the candidate's personal contribution to success.
Skills Section
❌ Avoid:
Skills: Microsoft Office, Teamwork, Communication, Organization, Data Entry.
✅ Do This:
Hard Skills: ICD-10-CM/PCS, CPT, HCPCS, Epic, Kareo, Cerner, HIPAA Compliance, Revenue Cycle Management, Denial Appeals, Medical Terminology, Anatomy & Physiology. Soft Skills: Analytical Thinking, Attention to Detail, Problem-Solving, Communication, Adaptability.
Why: The 'good' list is highly specific to Medical Billing and Coding, featuring essential coding systems, relevant EHR software, and critical compliance knowledge. It also includes pertinent medical knowledge. The 'bad' list is generic; while those skills are valuable, they don't immediately signal expertise in the specialized field of Medical Billing and Coding and are often assumed.
Best Format for Medical Billing And Coders
For most Medical Billing and Coding professionals, the Reverse-Chronological format is highly recommended. This format clearly displays your career progression and emphasizes recent, relevant experience, which is what hiring managers primarily seek. It's also the most ATS-friendly format, making it easier for automated systems to parse your information.A Functional resume might be considered for career changers or those with significant gaps, but it often raises red flags for employers and ATS alike, as it de-emphasizes chronological work history. If you're new to the field, combine a strong 'Skills' section with any relevant internships or transferable experience in a reverse-chronological layout.
Essential Skills for a Medical Billing And Coding Resume
A balanced skills section demonstrates both your technical prowess and your ability to thrive in a professional healthcare environment. Hard skills prove your capability to perform the core functions of the role, while soft skills highlight your professionalism and fit within a team. Both are critical for success in this detail-oriented, compliance-driven field.Highlighting specific coding systems, software, and compliance knowledge directly addresses employer needs. Soft skills like analytical thinking and attention to detail are paramount for accuracy and problem-solving in complex billing scenarios.
Technical Skills
- ICD-10-CM/PCS Coding
- CPT/HCPCS Coding
- EHR Systems (Epic, Cerner, Kareo)
- Revenue Cycle Management
- HIPAA Compliance
- Denial Management
Soft Skills
- Attention to Detail
- Analytical Thinking
- Problem-Solving
- Ethical Judgment
Power Action Verbs for a Medical Billing And Coding Resume
- Coded
- Processed
- Audited
- Managed
- Optimized
- Reduced
ATS Keywords to Include
Include these keywords in your resume to pass Applicant Tracking Systems:
- ICD-10-CM
- CPT Coding
- HIPAA Compliance
- Revenue Cycle Management
- Denial Management
- EHR Systems
Frequently Asked Questions
What certifications are most important for a Medical Billing And Coding resume?
The most recognized certifications are the Certified Professional Coder (CPC), Certified Inpatient Coder (CIC), and Certified Outpatient Coder (COC) from AAPC, and the Certified Coding Specialist (CCS) and Certified Coding Specialist–Physician-based (CCS-P) from AHIMA. Prioritize those relevant to your career path (e.g., outpatient vs. inpatient coding).
How should I list my proficiency with EHR systems on my resume?
Create a dedicated 'Technical Skills' or 'Software Proficiency' section. List specific systems by name (e.g., 'EHR Systems: Epic, Cerner, Kareo, NextGen'). If you have advanced experience, mention specific modules or functions you're proficient in (e.g., 'Epic: Resolute Professional Billing, Cadence Scheduling').
I'm entry-level with no experience. How do I make my resume stand out?
Focus on your education, certifications, and any relevant externships or volunteer work. Highlight transferable skills like attention to detail, analytical abilities, and computer literacy. Emphasize your knowledge of medical terminology, anatomy, and coding guidelines acquired through your training. Consider adding a 'Projects' section if you completed extensive coding exercises during your program.
How do I describe HIPAA compliance experience on my resume?
Integrate it into your work experience bullet points or a dedicated 'Compliance' section. For example: 'Ensured 100% adherence to HIPAA regulations and OIG guidelines across all billing and coding processes' or 'Conducted regular audits to maintain strict HIPAA compliance, safeguarding patient data integrity.'
What's the best way to show my knowledge of ICD-10-CM and CPT coding?
List them explicitly in your 'Skills' section. In your 'Work Experience,' use bullet points that demonstrate their application: 'Applied ICD-10-CM and CPT codes with 98% accuracy for multi-specialty claims' or 'Reviewed physician documentation to assign appropriate CPT modifiers, maximizing clean claim rates.'
Should I include soft skills on my resume for this role?
Absolutely. While hard skills are crucial, soft skills like attention to detail, analytical thinking, problem-solving, and communication are highly valued. They demonstrate your ability to work accurately, identify discrepancies, resolve complex billing issues, and interact effectively with colleagues and payers.
How can I quantify my achievements if my role was primarily task-based?
Think about the impact of your tasks. Did your accuracy reduce errors? Did your efficiency speed up processes? 'Processed 150+ claims daily with a 99% accuracy rate,' 'Reduced coding errors by 10% through meticulous review,' or 'Managed accounts receivable for 500+ patient accounts, improving collection rates by 7%.' Even small numbers make a difference.
Is it okay to have a two-page resume for Medical Billing And Coding?
For entry to mid-level professionals, a one-page resume is generally preferred. Experienced professionals with 10+ years of relevant experience or extensive certifications and accomplishments may use two pages, ensuring every detail on the second page adds significant value.
How do I address a career change into Medical Billing And Coding?
Focus on transferable skills from your previous roles (e.g., data analysis, organizational skills, customer service, attention to detail). Emphasize your new certifications and any relevant coursework or externships. A strong professional summary highlighting your career transition and new qualifications is key.
What specific action verbs are best for medical billing and coding roles?
Use verbs like 'Coded,' 'Processed,' 'Audited,' 'Reconciled,' 'Submitted,' 'Managed,' 'Resolved,' 'Analyzed,' 'Optimized,' 'Reduced,' 'Ensured,' 'Maintained,' and 'Investigated' to convey your proactive contributions.
How important is 'denial management' for a billing resume?
Extremely important. Denial management directly impacts revenue. Highlight your experience in identifying denial trends, appealing denied claims, and implementing strategies to prevent future denials. Quantify successes: 'Reduced denial rate by 12% through targeted appeals and provider education.'
Should I include medical terminology and anatomy knowledge on my resume?
Yes, especially if you are a coder. List it in your 'Skills' section. Understanding medical terminology and basic anatomy is fundamental to accurate coding and demonstrates a deeper grasp of the healthcare context.
How do I describe remote work experience?
Simply list your job title, company, and dates, followed by '(Remote)' or '(Virtual)' next to the location. Ensure your bullet points highlight your ability to maintain productivity, manage time effectively, and collaborate remotely if applicable.
What should I prepare for a Medical Billing And Coding interview?
Be ready to discuss specific coding scenarios, your proficiency with various coding systems (ICD-10-CM, CPT), experience with different EHR/billing software, and your understanding of compliance regulations (HIPAA). Practice explaining how you handle claim denials and resolve complex billing issues. Be prepared for behavioral questions related to accuracy, attention to detail, and problem-solving.
How can I show 'clean claim rate' improvement on my resume?
Directly state the improvement with a percentage or number. For example: 'Achieved a consistent 98.5% clean claim rate through meticulous pre-submission auditing and error correction' or 'Increased clean claim submissions by 10% over six months by refining documentation review processes.'