Summary
Overview
Work History
Education
Skills
Certification
Timeline
Generic

Tiffany Burton

Memphis,TN

Summary

Certified Professional Coder thru AAPC with excellent interpersonal skills. Highly effective in many Software for example Athena, Encoder360,Cerner, and Epic. Handled many medical records from various sources such as insurance, lab works, and consults with other providers. Expertise in Medical billing and coding physician, Surgeries, Hospital rounding, Charge-Entry Billing slips. Knowledgeable medical office professional talented at correcting and resubmitting claims, preparing patient charts and reviewing health records to identify proper diagnosis codes for billing. Offers background in reviewing, analyzing and managing medical record information to obtain prior authorizations from insurance companies and ensure payment. Available 40 hours per week. Detail-oriented professional with focus on deadlines.

Overview

12
12
years of professional experience
1
1
Certification

Work History

Unit Coordinator

Methodist Lebonheur Healthcare
08.2012 - Current
  • Welcome patients, check-in new patients, and answering approximately 30 phone calls
  • Maintain the appointment calendar, schedules, and medical charts
  • Communicate with patients, families, medical staff, and caregivers to guarantee smooth operations
  • Plan patient procedures and activities
  • Order medical equipment, supplies, and infrastructure for the hospital
  • Assist patients with important hospital forms and inform them about the procedures of the hospital
  • Resolve all patient complaints and collect reviews to help improve functionality
  • Maintain and update patient medical records
  • Work with medical and non-medical employees
  • Train new employees on hospital processes.
  • Achieved appropriate patient flow by admitting, transferring and discharging patients in computer system and notifying appropriate personnel of patient status verbally and through signage.
  • Managed medical emergencies calmly and effectively while activating appropriate codes according to hospital policy; ensuring prompt response from specialized personnel.
  • Streamlined patient admissions by efficiently managing and organizing medical records.
  • Assisted in ordering and serving patient meals, transporting patients and performing indirect patient care duties at competent level and according to needs of patient population served.
  • Monitored office supply inventory, analyzing usage patterns and requisitioning supplies and equipment as well as maintenance repair services.
  • Responded to patient call lights to expedite appropriate follow-through.

Certified Medical Coder

Proman Staffing- The Urology Group
03.2024 - 05.2024
  • Improved accuracy of medical coding by thoroughly reviewing patient records and assigning correct codes for diagnoses and procedures.
  • Reviewed outpatient records and interpreted documentation to identify diagnoses and procedures.
  • Maintained compliance with industry regulations by staying up-to-date on the latest changes in medical coding guidelines and conventions.
  • Verified, coded and added modifiers to diagnoses.
  • Supported continuous improvement initiatives within the coding department by actively participating in team meetings, trainings, and sharing best practices with colleagues.
  • Protected patient confidentiality by adhering strictly to HIPAA regulations when handling sensitive information related to medical records, treatments, and diagnoses.
  • Utilized advanced knowledge of anatomy, physiology, and medical terminology to accurately assign codes for complex or rare diagnoses and procedures.
  • Reduced claim denials by consistently applying knowledge of payer-specific coding requirements while preparing claims for submission.
  • Coded APV charts at rate 30 per hour.
  • Correctly coded and billed medical claims for various hospital and nursing facilities.
  • Resourcefully used various coding books, procedure manuals, and on-line encoders.

HCC Coder

The Judge Group
11.2023 - 01.2024
  • Accurately reviewing, interpreting, auditing, coding and analyzing medical record documentation for diagnosis accuracy, correct documentation for approximately 4 charts an hour and Hierarchical Coding Condition (HCC) abstraction.
  • Review may include inpatient, outpatient treatment and/or professional medical services, according to ICD-9/ICD-10 CM coding guidelines and risk adjustment model regulations
  • Supports Annual Commercial (ACA) and Medicare Advantage Risk Adjustment Data Validation Audits (RADV) along with the annual Risk Adjustment life cycle for the Medicare, Medicaid, and Commercial lines of business.

Financial Counselor

Baptist Healthcare Corp.
05.2023 - 11.2023
  • Attending and participating in meetings, training, and presentations
  • Completing financial applications
  • Draw up at least 20 per day estimates of treatment using CPT codes in EPIC
  • Assisting patients with financial applications and arrangements
  • Collecting estimated liabilities from patients
  • Establishing health insurance benefits, conditions, and requirements by making phone inquiries, and by using eligibility systems and contact insurance companies
  • Verifying patients’ employment details and other particulars
  • Reporting problems and concerns to supervisor
  • Complying with relevant rules, regulations, policies, and procedures
  • Performing other duties as assigned
  • Explain EOBs to patients
  • Consult with Revenue Cycle Team.

Senior Medical Billing Specialist

Cigna/Accredo Virtual
08.2021 - 11.2022
  • Communicated with insurance providers to resolve denied claims and resubmitted
  • Collected payments and applied to patient accounts
  • Filed and updated patient information and medical records
  • Posted payments and collections on regular basis
  • Reviewed patient records, identified CPT codes and ICD-10 codes
  • Created Billing Invoices
  • Delivered timely and accurate charge submissions
  • Adhered to established standards to safeguard patients' health Information
  • Processed billing calls and answered questions from patients and Third-party carriers
  • Obtain pre-authorization and /or pre-certification from insurance company or medical necessities from Medicare or Medicaid.

Education

Medical Billing and Coding Specialist Diploma -

Delta Technical College
Horn Lake, MS
05.2023

High School Diploma -

Ridgeway High School
Memphis, TN
05.2010

Skills

  • Customer service
  • Medical Terminology
  • Data Entry
  • Advanced in Microsoft Word
  • Advanced in Microsoft Excel
  • Advanced in Microsoft Access
  • Advanced in Microsoft PowerPoint
  • Type 50 wpm
  • 2024 ICD-10 Guidelines
  • 2024 CPT Guidelines
  • 2024 E&M Coding Guidelines
  • 2024 CMS Guidelines
  • Proficient in Medicare
  • Proficient in Medicaid
  • EHR
  • A/R
  • Epic trained
  • Cerner trained
  • Medical Billing
  • Medical Coding
  • Charge-Entry Specialist
  • Risk Adjustment
  • Proficient in NCCI edits
  • EMR systems
  • Insurance Verifications
  • Advanced in EOBs
  • Software Knowledge
  • Charting
  • Document Control
  • Patient Registration
  • EMR Updating
  • Certified in CPR/AED
  • Basic Life Support for Health Care Providers (BLS)
  • HIPAA Guidelines
  • Medicare Compliance

Certification

  • 09/16/23, AAPC- Certified Professional Coder (02103321)
  • 02/28/2024 BLS
  • 04/31/11, Nurse Aide

Timeline

Certified Medical Coder

Proman Staffing- The Urology Group
03.2024 - 05.2024

HCC Coder

The Judge Group
11.2023 - 01.2024

Financial Counselor

Baptist Healthcare Corp.
05.2023 - 11.2023

Senior Medical Billing Specialist

Cigna/Accredo Virtual
08.2021 - 11.2022

Unit Coordinator

Methodist Lebonheur Healthcare
08.2012 - Current

Medical Billing and Coding Specialist Diploma -

Delta Technical College

High School Diploma -

Ridgeway High School

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Tiffany Burton