Cynthia Gilbert
Crestwood
Summary
Skilled medical coding professional prepared to drive accuracy and efficiency in healthcare documentation. Known for strong analytical skills, attention to detail, and comprehensive knowledge of medical coding systems and regulations. Excel in team collaboration, adapting to evolving requirements, and delivering consistent results. Recognized for reliability and commitment to upholding high standards in all tasks.
Overview
18
18
years of professional experience
1
1
Certification
Work History
Physician Coder/Medical Coder/Billing Specialist
PMRG
09.2019 - Current
- Reviewed and coded medical records for accuracy and compliance with coding standards.
- Collaborated with healthcare professionals to clarify documentation for optimal coding outcomes.
- Implemented process improvements to enhance coding efficiency and reduce errors.
- Reviewed patient charts to better understand health histories, diagnoses, and treatments.
- Reviewed, analyzed, and managed coding of diagnostic and treatment procedures contained in outpatient medical records.
- Maintained a high level of productivity while consistently meeting deadlines for claim submissions.
- Ensured compliance with industry regulations and guidelines by staying up-to-date on the latest coding changes.
- Reduced claim denials by maintaining thorough knowledge of payer-specific requirements and guidelines.
- Generated reports to identify coding trends and discrepancies.
- Prevented costly fines by ensuring adherence to HIPAA regulations when handling sensitive patient information.
- Interacted with physicians and other healthcare staff to ask questions regarding patient services.
- Full Cycle Billing From charge entry to Payment Posting
Physician Coder
Chicago Center For Sports Medicine And Orthopedic Surgery
04.2012 - 09.2019
- Reviewed and analyzed medical documentation to ensure accurate coding for orthopedic procedures.
- Collaborated with healthcare providers to clarify diagnoses and procedures for optimal billing accuracy.
- Implemented coding best practices, enhancing compliance with industry regulations and payer requirements.
- Conducted regular audits of coded claims to identify discrepancies and implement corrective actions.
- Led initiatives to refine coding processes, resulting in reduced claim denials and improved revenue cycle management.
- Supported effective communication between clinical staff and billing departments, addressing questions related to coding and documentation requirements.
- Reduced claim denials for the practice by maintaining up-to-date knowledge of coding guidelines and payer-specific policies.
- Managed appeals for denied claims, providing detailed explanations and supporting documentation to successfully overturn decisions.
- Full Cycle Billing from Charges to Payment Posting
PHYSICIAN CODER/Physician Coder/Medical Coder/Billing Specialist
CHICAGO HEART AND VASCULAR
02.2008 - 04.2012
- Analyzed medical documentation for accurate coding and billing processes.
- Collaborated with healthcare providers to ensure compliance with coding standards.
- Conducted audits of medical records to identify discrepancies and improve accuracy.
- Reviewed and resolved coding-related inquiries from insurance payers promptly.
- Enhanced coding accuracy by conducting thorough medical record reviews and applying appropriate diagnostic codes.
- Provided training to new physician coders, sharing best practices for accurate code selection and documentation review.
- Addressed coding-related inquiries from payers or auditors promptly and professionally, maintaining a strong working relationship with key stakeholders.
- Scanned and uploaded medical records into electronic medical records system.
- Full Cycle Billing from Charge Entry to Payment Posting
Education
High School Diploma -
Curie Highschool
Chicago, IL06-1988
Skills
- Medical coding
- Billing procedures
- Compliance standards
- Claim submissions
- Revenue cycle management
- Payer guidelines
- HIPAA regulations
- Full cycle billing
- Denial management
- Communication skills
- Electronic medical records
- Performance reporting
- ICD-10 proficiency
- Strong attention to detail
- Claims processing experience
- Insurance verification
- Medical reimbursement principles
- Denial management techniques
- HCPCS coding
- Claims processing
- Diagnostic coding
- Data entry
- Knowledgeable in [software]
- Proficiency in [software]
- Insurance claims analysis
- Coding error resolution
- Coding appeals
- Ethical standards
- Medicare insurance regulations
- Problem-solving
- Time management
- Teamwork
- Teamwork and collaboration
Certification
COPC
Timeline
Physician Coder/Medical Coder/Billing Specialist
PMRG
09.2019 - Current
Physician Coder
Chicago Center For Sports Medicine And Orthopedic Surgery
04.2012 - 09.2019
PHYSICIAN CODER/Physician Coder/Medical Coder/Billing Specialist
CHICAGO HEART AND VASCULAR
02.2008 - 04.2012
High School Diploma -
Curie Highschool
COPC
Certified COPC coder since 2024 thru AAPC Number 02096444