Kerry Gaddy

Experience

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  Prime Care Physicians

  Nov 2003 - Jan 2005

  Verification Representative

  Responsibilities included the following:- tracking down valid patient insurance information which could be handled by accessing different third party payer websites or placing a call to the patient-verify patient insurance-reduce the error log rate-send updated insurance information to the follow up team for claim resubmittal and adjustment

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  Capital District Physicians' Health Plan

  Jan 2005 - May 2009

  Provider Services Correspondence Representative
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  Bryant & Stratton College

  Sept 2010 - Jan 2021

  Instructor

  My responsibilities include empowering students to be conducive in the medical assisting or medical administrative field. Teach them to abstract information from operative reports or medical records in order to bill third party payersApply their knowledge of medical terminology and anatomy and physiology Differentiate the medical necessity of a medical/surgical procedureApply the appropriate diagnosis code with the procedure code to ensure payment by the insurance carrier

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  Ellis Medicine

  May 2015 - May 2017

  Medical Coder II

  Review surgical records and apply the appropriate CPT-4 and ICD-10 codeManage charge entry and charge reconciliation for Bariatric and Neonatology practicesAudit office visits on a weekly basis to optimize accurate documentation and codingCollaborates and assists physician billing office with insurance carrier denials and claim issuesFollow up with providers to ensure clinical documentation supports medical necessity

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  CDPHP

  May 2017 - Jan 2023

  Ambulatory Review Coding Specialist

  Provided appropriate CPT, HCPCS and ICD-10 codes on member submitted claims (includes dental, DME, vision hardware, auditory hardware and COVID testing)Abstraction of medical record to determine diagnosis or procedure code then compared my findings to codes that were submittedFollowed up and resolved high volume of prompt pay cases to ensure timely processingFacilitated Evaluation and Management AuditInitiated and conducted training session on the basics of auditing for Ambulatory Review team Head auditor on Behavioral Health Audit that provided a snapshot on psychotherapy coding compliance Show less

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  Health Research, Inc.

  Feb 2024 - Oct 2024

  Senior Auditor

  Conduct subrecipient monitoring functions to include final voucher reviewRequest additional information to make determination of questionable costsDraft accurate and concise reports of internal audit findingsReview potential variances with senior staff