Jennifer L. Ellsworth
Jefferson City
Summary
Proven Certified Professional Coder with exceptional record of achievement in enhancing quality improvement initiatives for billing cycle. Continually guaranteeing patients' medical records are coded and abstracted according to standard rules and regulations. Efficiency-driven, highly accurate and well-organized with open and clear communication style and self-motivated approach.
Overview
28
28
years of professional experience
1
1
Certification
Work History
Certified Reimbursement Specialist
University of Missouri Physicians Healthcare
01.2017 - Current
- Professional Coding & Review, Certified CPC-A
- Primary coder/biller for out-patient Endocrinology and Infectious Disease MU Health Care Clinics through Optum CAC Professional
- Process out-patient Cardiology Evaluation and Management (E/M) and edits for MU Health Care Clinics
- Daily run and process Edit Summary Reports through our IDX system.
Provider Communications Representative
Wipro/Infocrossing
05.2011 - 01.2013
- Addressed and resolved Medicaid Provider inquiries into their claims denial status accurately and professionally
- Answered a constant flow of provider calls with up to 30 calls in queue per minute
- Accurately resolved claims and billing issues for providers by asking clear and specific questions in a timely manner
- Referred unresolved provider grievances to designated State of Missouri Departments for further investigation
- Defused volatile provider situations calmly and courteously.
Medical
Jefferson City Medical Group, JCMG
03.1998 - 03.2008
- Billing and Coding
- Completed billing and coding procedures for emergency room, in-patient and outpatient services for appropriate diagnosis and/or medical procedures using my knowledge with CPT and ICD-9 CM coding principles
- Conscientiously reviewed medical record information to identify appropriate coding based on CMS HCC categories
- Interacted with medical providers and other medical professionals in regards to making sure the appropriate documentation policies, procedures and regulations
- Maintained update knowledge of coding requirements, through continuing education unit (CEUs) and certification renewals.
Education
High School Diploma -
JEFFERSON CITY HIGH SCHOOL
Jefferson City, MOSkills
- Skills
- Verbal and Written Communication
- MS Office
- Calm Under Pressure
- Insurance Billing
- Patient Medical Records Maintenance
- Patient Data Coding
- Attention to Detail
- Time Management
- Word Processing Software
- Government Forms
- Data Entry
- Problem-Solving
- Certified Professional Coder
- Medical Billing Processing
- Medical Terminology
- Medical Histories and Vital Statistics
- Records Review
- Patient Rights
- Electronic Filing System Organization
- Medical Information Computerization
- Hospital Inpatient and Outpatient Records
- EMR Systems
- Demographics Information
- Inpatient Coding
- Microsoft Excel
- ICD-10 Coding
- Coding Error Resolution
- Charting and Clinical Documentation
- Doctor Communication
- Protected Health Information
- Patient Information Verification
- Medical Release of Information ROI
- Healthcare Claim Coding
- Medical Record Security
- Knowledgeable in IDX, OPTUM, CERNER, CDI
- Clerical Functions
- Interpersonal Communication
- DRGs Patient Assignments
- Information Analysis
Accomplishments
- Detail orientated
- Patient chart auditing ability
- Billing and collection procedures expert
- Excellent verbal communication
- ICD-10-CM, CPT coding, HCPCS, MS-DRG
- American Academy of Professional Coders
- National Alliance of Medical Auditing Specialists
- IDX (GE) software
- Cerner EMR PowerChart software
- CodeRyte software
- Optum CAC Professional software
- Microsoft Word, Excel, PowerPoint
- Resourceful and reliable worker
Interests
Licensure/ Certification , American Academy of Profession Coders (AAPC) #01517245, National Alliance of Medical Auditing Specialties (NAMAS)
Certification
- Certified Professional Coder (CPC)
- Certified Evaluation and Management Auditor
Timeline
Certified Reimbursement Specialist
University of Missouri Physicians Healthcare
01.2017 - Current
Provider Communications Representative
Wipro/Infocrossing
05.2011 - 01.2013
Medical
Jefferson City Medical Group, JCMG
03.1998 - 03.2008
High School Diploma -
JEFFERSON CITY HIGH SCHOOL