# Medical Assistant, CPC, Quality Auditor / Studying for CPMA



## tayloralexis (Sep 24, 2012)

Torie L. Thibodeaux, MA, CPC
2185 Talbot Ridge
Jonesboro, Ga. 30236
Email: torie.thibodeaux@yahoo.com
Cell# 504-450-1812
Phone# 678-834-5571

Dear Sir / Madame:

I am writing to you to apply for employment within your company. Enclosed is a resume of my educational and employment background. I possess excellent verbal and written communications skills demonstrating the ability to communicate effectively, and courteously with physicians, office staff, patients, vendors/and or insurance carriers. I am able to handle high call volumes. I am also very familiar with the guidelines and medical terminology associated with HCPCS, CPT and ICD-9 / 10 Coding, documentation guidelines, medical record auditing (AMA) guidelines, Physician Education Program (PEP) development, Medicare & Medicare Advantage guidelines, HMO and PPO contract terminology, and other insurance billing processes. I am a current Member of the American Academy of Professional Coders (AAPC) since 2008, Attended an Online Coding course through AAPC, and Passed Certified Professional Coder (CPC) Certification Exam on July 10, 2010 (Certification Verification ID#01108516). I possess 13+ years of stable medical background, clinical, and also where outpatient and payer medical coding was an essential job function. I maintain a professional and neat work environment both remotely or in a professional office environment. I am good at managing stress in order to maintain a professional demeanor and perform multiple tasks simultaneously. I also promote a positive image while maintaining strict confidentiality.
I am also scheduling to take my Certified Professional Medical Auditor (CPMA) certification through AAPC this November 2012.

If any additional information or references are required Please contact me at the information listed. 

Sincerely,
Torie Lynn Thibodeaux, MA, CPC


Torie L. Thibodeaux, MA, CPC 
2185 Talbot Ridge 
Jonesboro, Georgia 30236
Email: torie.thibodeaux@yahoo.com 
Cell# (504) 450-1812 
Home# (678) 834-5571

Career Objective: 

To acquire a position in a Remote Capacity, which will allow me to utilize my educational, and employment background, as well as opportunities for continued professional growth. 

Education: 

American Academy of Professional Coders Online (AAPC) 
Course of Study - Certified Professional Coder (CPC) 
Certification Exam Date: July 2010 - Passed - Cert# 01108516

Bryman College – Graduated (December, 1999) GPA 3.0 
New Orleans , Louisiana 
Course of Study – Medical Assistant 

Delgado Community College – August, 1998 and January, 2003 
New Orleans , Louisiana ( City Park Campus) 
Course of Study – Nursing 

John F. Kennedy Senior High School – Graduated (May 22, 1998) GPA 3.5 
New Orleans , Louisiana 
Course of Study – Basic / Nursing Assistant 

Membership: 

AAPC Member – ID# 01108516 Current Thru: Feb 2013 (Member Since: Feb 2008)

Employment: 

03/2011 to 07/12/2012 (Full-Time)
Coventry Health Care of Georgia – Medicare Department
1100 Circle 75 Parkway Suite 1400
Atlanta, Georgia 30339
Coding Quality Auditor – E/M Level Coding & Auditing 

Duties Include:
-Performs audits of Medical Records to ensure all assigned ICD-9 codes are accurate and supported by written clinical documentation.
-Provides education to internal staff and external providers based on audit findings. Provides general education on ICD-9 codes, documentation, and quality measures as appropriate.
-Effectively communicates the audit process and results to the appropriate departments and management.
-Assist senior level staff in providing recommendations for process improvement so that productivity and quality goals can be met or exceeded and operational efficiency and financial accuracy can be achieved.
-Remains current on ICD-9 codes, CMS Documentation requirements, State and Federal regulations, Professional standards, and Accreditation.
-Physician Education Program (PEP) Initiative, HEDIS data collection, and STARS guidelines.
-Performs other duties as required.

10/2010 to 02/2011
USHealthWorks
3440 Preston Ridge Road
Alpharetta, Georgia 30005
Medical Coder (Abstractor) E/M, WC, Urgent Care, Ortho, PT, etc.

Duties Included:
-Log all daily coded batches, which will ensure all censuses have been submitted to regional corporate 
-Create charge batches with the appropriate center, date and division 
-Code all primary care and physical therapy charge tickets for their designated centers 
-Select levels of Evaluation and Management services in accordance with the Official Medical Fee Schedule 
-Code all surgical procedures in accordance with the Official Medical Fee Schedule 
-Capture all x-rays taken and bill the correct number of views taken in accordance with the Official Medical Fee Schedule 
-Capture all supplies and ancillary charges documented 
-Bill all PR2 reports as well as other reports in accordance with the Official Medical Fee Schedule 
-Ensure all billable services have been captured in accordance with the Official Medical Fee Schedule 
-Ensure patient diagnosis is updated in accordance with standard ICD-9 Diagnostic Coding 
-Ensure any outstanding or recurring issues regarding their assigned centers are communicated to their supervisor 
-Ensure all assigned coding is completed in the appropriate time frame to ensure a seven working day month-end close etc. 
-Ability to read and interpret physician handwritten S.O.A.P. notes 
-Working knowledge of ICD-9, CPT/OMFS Coding and medical terminology 
-Other duties as assigned.

05/2008 to 07/2010 
Humana 
1 Galleria Boulevard 
Metairie, Louisiana 70001 
Clinical Intake Specialist 

Duties Included: 
Assisting Nurses with Preauthorizations, Data Entry, Waiver Request, Disease Management Referrals, Office Referrals, taking incoming calls from providers, DME providers, members, etc. inquiring about preauthorizations. Building and approving authorization cases, assisting providers in selecting correct ICD-9 and CPT codes for Home Health, Durable Medical Equipment, Emergency Room (ER), Ambulatory Surgical Centers , Inpatient and Outpatient preauthorization request. Researching Humana systems for any information that is needed to resolve claim/auth issues. Act as primary point of contact, communicate with vendors/members, and other Humana staff to resolve escalated case management, claims, customer service and/or reporting issues. Answer questions about Benefits, eligibility, and claims, actively listen to others to understand their perspective and ensure continuous understanding regardless of communication channel or audience. Excellent at organizing and managing multiple priorities and projects by using appropriate tools. Strong telephone, Customer service skills, excellent written and verbal communication skills, other duties as assigned etc. 

Computer Skills: 
Lotus Notes, IM, Microsoft Word and Excel Spreadsheets, MetaVance, CCA, CCP2, Physician Finder, PAL, Access, HSS, Mentor, Milliman etc. 

10/2005 to 08/2006 
HCA Patient Account Services 
10030 North MacArthur Boulevard Suite# 100 
Irving, Texas 75063 
Collections Analyst / Refunds Analyst 

Duties Included: 
Processing Patient and Insurance Overpayments, Accounts Receivable, Researching and Resolving Denied Insurance Claims, Following Policies and Procedures on Medicare and Medicaid accounts, Reviewing EOB's and UB92 to process claims, Insuring proper documentation on all accounts, Resolving accounts in a timely manner, Processing Returned Checks in a 48 hour time period, calling insurance companies for verification, calling patients and Insurance companies to collect payments on past due accounts, Analyzing Patient accounts to refund patients for overpayments etc. 

Computer Skills: 
LSAMS, Meditech, IDX, Collections Systems, Host / Patient Accounting Systems, eTran, Microsoft Word, Excel, Powerpoint, and Outlook etc. 

04/2002 to 08/29/2005 
Tulane University Hospital & Clinic (HCA Facility)
1415 Tulane Avenue 
New Orleans, Louisiana 70118 
Endoscopy Department Secretary (PSC) / Urological Technical Specialist / Medical Assistant 

Duties Included: 
Hospital & Clinic, Schedule and confirm appointments, Schedule and Coded various special testing appointments and Surgical Procedures for patients, Maintain filing system, Open, Sort, and route incoming mail, Answer inquiries and provide information to patients, Ensure compliance with HIPPA regulations, Insurance Verification, Routing phone calls, taking messages, greeting visitors, Ensuring that the Medical Record is in the appropriate and approved sequence, Responsible for coordinating all documents for surgical and anesthesia patient procedures, Performed all Clerical Duties and Responsibilities….Medical Assistant / Urological Technical Specialist: Vital Signs, Procedure Room duties, Sterile Technique, Assisting and preparing Cystoscopies, Prostate Biopsies, and other invasive procedures, etc. 

Computer Skills: 
Meditech, IDX, Microsoft Word, Excel, and Outlook etc. 

12/1999 to 03/2001 
Clinical Research Center (CRC) 
143 South Liberty Street 
New Orleans, Louisiana 70118 
Clinical Research Coordinator / Medical Assistant 

Duties Included: 
Inpatient Research Center, Administrative Office Procedures, Medical Terminology, Vital Signs, Injections, Venipuncture, EKG's, Urinalysis, Bookkeeping, Filing, Screening patients for Research studies, Answering multiple phone lines, Scheduling meetings, Scheduling follow-up appointments, Type 35wpm, other duties as assigned.

Summary of Qualifications: 
Responsible, dedicated, reliable individual. Highly inquisitive, creative and resourceful. Exceptional organizational skills. 
Excellent interpersonal skills, team player and ability to work with all levels of an organization. Effective verbal and written communication skills. 
Able to handle several priorities at once. Skilled in handling the public with professionalism, courtesy, and respect. 
Skilled in listening to customer needs and developing effective solutions. Professional in appearance and presentation. Willingness to go the "extra mile". 


References are available upon request


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