Charmaine Angelica Pineda Matela, RN, CPC-A
Room 402, Royal Plaza Hotel Apartment
#34-C Street, Al Rigga
Dubai, United Arab Emirates
050 980 6541
[email protected]

OBJECTIVE:

Seeking for a full-time position as an Insurance Officer in a career oriented and highly motivating company enhancing professional and interpersonal skills.
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KEY ACCOMPLISHMENTS:

• 2018 Certified Professional Coder (CPC) – American Academy of Professional Coders
Active Member ID # 01649256
• 2010 Philippine Registered Nurse (RN) – Professional Regulation Commission
Active License # 0648521
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SUMMARY OF QUALIFICATIONS:

• Strong knowledge in ICD-10-CM, CPT, and HCPCS Coding and Guidelines
• Two years of exposure in handling health insurance–related duties
• UAE work experience in a JCI-accredited and TEMOS-accredited state-of-the-art hospital
• Expertise in medical terminologies for different specialties as required in areas of responsibility
• Excellent written and oral communication skills
• Highly proficient in data processing software (i.e. Microsoft Word, Excel, PowerPoint)
• Possess flexibility to learn and adapt easily to varying office automated programs and
service platforms (i.e. SAP, FFT, d2u)
• Ability to use designated reference materials and sources
• Complies with company procedures and policies in line with protecting patient confidentiality and institutional integrity
• Outstanding prioritization and time management skills
• Maintains critical thinking ability and can work under pressure
• Vast experience working with people from culturally diverse background
• Proven solid work ethic; team player
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HIGHEST EDUCATIONAL ATTAINMENT:

COLLEGE: Bachelor of Science in Nursing
San Juan de Dios Educational Foundation, Inc.
Manila, Philippines
2006 – 2010

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PROFESSIONAL EXPERIENCE:

BURJEEL HOSPITAL FOR ADVANCED SURGERY (A UNIT OF VPS HEALTHCARE)

Samih Tarabichi’s Center for Joint Surgery

Al Quoz 2, Dubai, United Arab Emirates

• Physiotherapy Administrative Assistant
March 2017 – Present

o Manage Physiotherapy Department’s entire insurance activities
o Verify patient eligibility and coverage of approvals in insurance portal upon registration in the system
o Liaise with Front Desk Executives regarding proper registration with accurate entry of patient details
o Liaise with Insurance Department regarding card eligibility, policies and their coverage, approvals, reconciliation of rejections, and other requirements
o Guide Physiotherapy staff for correct usage of claim forms, evaluation forms, reimbursement forms
o Provide the Billing Department itemized modalities of treatment of patients immediately after the visit for issuance of invoice and bill to the Insurer as per insurance company policy
o Assist the Billing Department in verifying proper CPT codes used, validity of approvals, and insurance processing for error-free invoicing
o Maintain and update records related to pre-approvals, approvals, rejections, and resolutions through MS Excel spreadsheets
o Coordinate and cooperate with colleagues of the same department and other related departments for smooth running of insurance-related operations
o Provides quality assurance for CPT codes entered in system as per patient’s approval of treatment
o Leads the whole Physiotherapy Department during external audits and international accreditations of the hospital (i.e. JCI, TEMOS) with regard to electronic medical records and insurance-related requirements
o Perform proper documentation necessary for approvals of physiotherapy
o Transcribe physiotherapy reports and update patient’s electronic medical records in the system platform
o In charge of clerical and office tasks such as data entry and copy typing when need arises.
o Educate and train staff on other work-related matters
DIVERSIFY OFFSHORE STAFFING SOLUTIONS, INC. (SHINE LAWYERS AUSTRALIA)
Manila, Philippines

• Word Processing Officer
August 2015 – December 2016

o Expertly transcribe and proofread medical and legal reports from an Australian based company in a fast paced turnaround time within the limit of law of confidentiality.
o Reports include, but are not limited to, hospital reports, medical negligence reports, motor vehicle accident reports, case plans, insurance claims, personal injury claims, Workers’ Compensation claims, superannuation, public liability, etc.

M*MODAL GLOBAL SERVICES, INC.
Manila, Philippines

• Healthcare Documentation Editor
February 2013 – February 2015

o Handle USA-based hospital accounts with exposure to American, Indian, and MENA accents.
o Edit and proofread speech-recognized medical reports by physicians and other healthcare providers from different medical specialties in a fast paced turnaround time within the limit of law of confidentiality.
o Reports include, but are not limited to, histories and physical examinations; progress reports; consultations; diagnostic procedures; clinic notes; medico-legal reports; emergency room notes; preoperative, operative, and postoperative reports; referral letters; discharge summaries; pathology reports; death summaries; etc.
o Update patient data in medical system database.
o Meet quality and productivity standards and deadlines established by the employer.

AUDIO DICTA TRANSCRIPTION CORPORATION
University of Perpetual Help Dalta Medical Center
Manila, Philippines

• Senior QA Analyst
June 2011 – February 2013

o Handle USA-based and UK-based hospital accounts with exposure to American, Indian, and
British accents.
o Meticulously recognize, interpret, and evaluate inconsistencies and discrepancies in medical documentation and appropriately edit and clarify them without altering the meaning of the dictation or changing the dictator’s style.
o Perform internal audits in medical reports done by transcriptionists and editors.
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ACHIEVEMENTS:

BURJEEL HOSPITAL FOR ADVANCED SURGERY
• Recipient of Professional Excellence Award (3rd Quarter of 2017 and 2018).

M*MODAL GLOBAL SERVICES, INC.
• Consistent Top 1 Incentive Earner with quality score of 99.7% to 99.9% on monthly medical report audits (January 2014 to August 2014).

AUDIO DICTA TRANSCRIPTION CORPORATION
• Recognition for Most Number of On-Calls in a Year (2011).
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PERSONAL INFORMATION:

AGE : 28 years old
DATE OF BIRTH : 11 April 1990
NATIONALITY : Filipino
MARITAL STATUS : Single
LANGUAGES SPOKEN : English and Filipino

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CHARACTER REFERENCE:

Available upon request