Cemafranco B. Rubia
Certified Professional Coder
AAPC Member ID# 01561488

Address : 1774 Mindanao Ext. Sampaloc, Manila 1008
Contact no. : +63 995-193-0475
E-mail : [email protected]
Skype : cemafranco123

PERSONAL INFORMATION
Age : 38 years old
Date of Birth : February 6, 1980
Civil Status : Married
Gender : Male
Nationality : Filipino
Passport # : P8177850A

EDUCATIONAL BACKGROUND

Professional Coder Training & Certification Course
Healthcare Coding and Billing Institute (HCBI)
Makati City, Philippines
August 2017 – October 2017
Certified – Magna Cum Laude

Bachelor Science in Physical Therapy
Doña Remedios Trinidad Romualdez Medical Foundation
Tacloban City, Philippines
June 1996 – April 2002
Graduate

Care of Elderly, infant & Children
Colegio De San Lorenzo Ruiz De Manila Inc. Tacloban Branch,
Tacloban City, Philippines
November 2002 – June 2003
Certified – Technical Education & Skills Development Authority (TESDA)

Business Application Software
AMA Computer Learning Center, Inc
Tacloban, City, Philippines
April 1998 – May 22 1998
Certified

LICENSURE

American Academy of Professional Coders – AAPC
Title: Certified Professional Coder (CPC-A)
AAPC Member ID# 01561488

PROFESSIONAL EXPERIENCE

Medical Coder / Medical Biller
King Fahad Medical City – SFFD Private Medical Services
Riyadh, Kingdom of Saudi Arabia
May 2015 – May 2017

Medical Coder
Omega Health Care – US Base Project
Ortigas Center, Pasig City, Philippines
January 2018 – Present

Job description:
Pull up actual chart from HIM records and abstract – for Medical coding to data entry.
Review first entry medical chart for CPT, HCPCS and ICD 10 – CM codes.
Obtain approval form/ pre-auth. form for any procedure, consult and work ups.
Confirm mapping and prices.
Review RCM and RMS (Revenue Management System) guidelines.
Confirm and check coverage and eligibility base on contract or benefit.
Adjudicate data entry if it’s an automated claim. For non-automated, input manually.
Recheck CPT and coding guidelines prior to payment posting.
Input or transmit to billing system as required by the payer. Send manual/ billing invoices if required by the payer (e.g. payer is Government agency).
Follow up unpaid and pending claims that is/are beyond TAT (Turnaround time).
Process and discuss all dispute and rejection codes based on abstract to corresponding consultants and surgeons for possible rebuts.

Support Specialist / CSR
Convergys – Quezon City, Philippines
December 2013 – May 2015

Support Specialist / CSR
IBM Philippines – Quezon City, Philippines
December 2012 – November 2013
Medical Claims Adjudicator/Processor
Manulife Business Processing Services
Quezon City, Philippines
December 2008 – June 2012

Medical Claims Adjudicator & Coder
INFINIT-O PHILIPPINES
Makati City, Philippines
August 2006 – December 2008

SPECIALIZED TRAINING AND CERTIFICATION

Medical Coding and Billing
Basic Life Support Training
First Aid Training
Geriatric Care and Care for the Sick and Disabled
Critical Writing and Intensive Grammar Course
Business Application Software
Internet Proficiency

Clinical Centers – Clinical Experiences
Rehab Specialist Pasay General Hospital, Pasay City
Rehab specialist Pascual Gen. Hospital, Quezon City
Sports Rehab Clinic & Pain No More, Pasig city
Rehab PT Clinic, Mandaluyong City
Motion Plus Rehab clinic, Manila
Divine World Hospital, Tacloban City
Health Care Rehab., Ormoc Dist. Hospital, Ormoc city
Bethany Hospital, Tacloban City
Health Care Rehab Corp., Palompon Leyte
Remedios T. Romualdez Hospital, Tacloban City
Ladies of Charity – AIC, Calbayog City

AWARDS AND RECOGNITION

Exceptional Contribution in Billing and Coding – SELAT
King Fahad Medical City Hospital, Riyadh, KSA

I hereby certify that all information and documents stated and attached herein are the factual truth to the best of my knowledge.