Medical Coder

Medical Coder — Mercy Health Partners

Chicago, IL | August 2023 – Present

• Analyzed and assigned ICD-10-CM, CPT, and HCPCS codes for 95+ outpatient visits daily, maintaining a 98.8% coding accuracy rate and meeting all departmental productivity benchmarks.
• Audited 120 complex clinical records weekly to identify missing documentation, securing clarification from 14 physicians and recovering $45,000 in potential lost billing revenue.
• Resolved coding-related claim denials by review of Medicare and Medicaid policy guidelines, reducing the clinical coding denial rate from 5.4% to 1.8% over a 12-month period.
• Mentored 3 junior coders on ICD-10-PCS guidelines and 3M 360 Encompass system workflows, improving team-wide query turnaround times by 16% and reducing billing lag by 1.5 days.

Associate Medical Coder — St. Jude Medical Center

Evanston, IL | June 2021 – July 2023

• Reviewed and coded 80+ emergency department and observation charts per shift using Epic EHR, achieving a 97.5% compliance rating against quarterly external auditor metrics.
• Collaborated with the clinical documentation improvement team to reconcile 40+ patient chart discrepancies monthly, reducing the average charge capture lag time by 1.8 days.
• Processed and verified pre-authorization coding codes for 250+ surgical procedures, achieving zero billing delays and reducing initial carrier rejection rates by 14%.
• Participated in 4 coding educational seminars and workshops annually to maintain compliance with ICD-10-CM updates, achieving a 100% score on internal coding competency exams.

ICD-10-CM coding, ICD-10-PCS coding, CPT coding, HCPCS Level II coding, Medical billing & collections, Accounts Receivable (A/R) management, Denial & appeals management, Clinical Documentation Improvement (CDI), HIPAA compliance, Epic EHR, Cerner Millennium, 3M 360 Encompass, Optum CAC, Microsoft Excel

DRG Optimization Initiative

Role: Lead Coding Auditor

Tools: 3M 360 Encompass, Epic, Microsoft Excel

Audited 400+ historical inpatient cases to align Diagnosis Related Groups, identifying coding errors that recovered $120,000 in missed facility reimbursements.

EHR Transition Coding Mapping

Role: Clinical Coding Specialist

Tools: Epic, Cerner, Optum CAC

Mapped over 15,000 medical code combinations during system transition from Cerner to Epic, completing project 2 weeks early and maintaining 99% coding continuity.

• Certified Professional Coder (CPC) (2021)
• Certified Coding Specialist (CCS) (2022)

• Languages: English (Native), Spanish (Conversational)
• Volunteer Work: Provided medical coding support for local volunteer health clinics (2022–present)
• Availability: 2 weeks notice