1. SUSANNE MCGUIRE, CPC, CPMA
8032 Gratiot Avenue 810.543.0235
Columbus, MI 48063 susannemcguire@ymail.com
CERTIFIED MEDICAL CODER & CERTIFIED MEDICAL AUDITOR
E&M SELECTION l MEDICAL BILLING l INSURANCE VERIFICATION
Dedicated Certified Medical Coding and Auditing professional experienced in multispecialty physician billing. Ability to apply diagnostic and procedural
codes to patient health information for claims processing and data retrievalw ith solid medical terminology base. Excellent attention to details, problem
solving skills and communication. Research, analyze, and respond to inquiries regarding compliance, inappropriate coding, denials, and billable
services. Ability to succeed in challenging and deadline-driven environments.
PROFESSIONAL CAPABILITIES
Evaluation & Management Medical Coding CMS Guidelines
Medical Terminology Electronic Medical Records Chart Audits
ICD 10 & CPT Microsoft Word & Excel Compliance
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EDUCATION & CERTIFICATIONS
BAKER COLLEGE, Port Huron, MI
Associate Degree – Medical Insurance Specialist 3/2011
CertifiedProfessional Coder (CPC),AAPC 4/2011
CertifiedProfessional Medical Auditor (CPMA), AAPC 6/2015
ICD-10-CM AAPC ProficientCertification 9/2015
NAMAS E/M Auditing Bootcamp 7/2016
PROFESSIONAL EXPERIENCE
TROY GASTROENTEROLOGY PC 10/2016 - Present
Coder, Biller, Inpatient, Outpatient, ER & Procedural
 Review documentation for appropriate Evaluation and Management levels
 Review for necessarymodifier(s), if applicable
 Apply diagnosis codes and CPT code for claims submission
 Data entry for claims submission to insurance
PHYSICIAN HEALTHCARE NETWORK, Fort Gratiot, MI 8/2011 – 10/2016
Coder, Biller, Auditor
 Perform patient registration, insurance verification, and obtain necessaryauthorizations
 Apply diagnosis codes and CPT codes for claims submission
 Physician queries to clarify medical record documentation issues
 Reduced duplicate billing by developing organizational plan and attaining copies of physician census
 Trained/mentored new coders/billers
 Work claims rejections
 Answer patient calls regarding billing questions
 Designed Home Health Billing Manual for training of Netw orkStaff members
 Review medical records for appropriate documentation relevant for CPT and diagnosis coding
 Review w ith Physicians, audit findings of medicalrecords review
Self Employed Housekeeper 1985 – 2011
Fort Gratiot, Port Huron & St Clair, MI
House cleaning, personalerrands, Holiday and party set-ups, appliance and car repair appointments, personalshopper
AUSTIN, NIESTER, SCHWEIHOFER & FINNEGAN P.C., Port Huron, MI 1996 -2001
Billing Clerk
 Accounts Receivable, Client billing, bank deposits, greet Clients, answ erphones, file, sort mail