CURRICULUM VITAE

MARIDEL SALVADOR MAMORNO

ABU DHABI, U.A.E

Mobile Number: +971523001972

E-mail : [email protected]

OBJECTIVES

To seek opportunity with a well-established firm that can offer possibilities of career advancement which I can utilize my expertise and to further develop my skills. A hard working person who likes challenges and is adaptable to any working environment.

STRENGTHS

Meticulous. Systematic. Has sense of responsibility, works with minimal supervision, self-confident and energetic. Capable of prioritizing the work, based on the urgency and importance.

QUALIFICATIONS

ð     Good interpersonal and communication skills.

ð     Always with a positive outlook and possesses good learning attitude.

ð     Proficient in  computer programs related to MS-Word, MS-Excel.

ð     Hardworking, motivated and eager to learn new skills.

ð     Handling a multitude of task at one time.

ð     Maintains confidentiality at all times according to company procedure and  policy.

ð     Ability to provide cover for extended working hours

ð     Significant knowledge of work and ability to work under pressure.

ð     Willingness to participate as a committed member of a busy professional team

EDUCATIONAL QUALIFICATIONS:

SOUTHEAST ASIAN COLLEGES INC. in the PHILIPPINES

Bachelor of Science in Nursing (2005)

Job Profile: February 2009 – up to present

MEDICLINIC AL NOOR HOSPITAL (Abu Dhabi – Khalifa St.)

CLAIMS PROCESSOR/ OFFICER RESUBMMISSION/MEDICAL CODER/

MEDICAL CLAIMS PROCESSOR/MEDICAL BILLING OFFICER/INSURANCE CLERK – (Insurance department/ RCM department)

DUTIES AND RESPONSIBILITIES:

Accurately search and enter codes for medical diagnoses and procedures, using coding from the International Classification Diseases, 9th edition (ICD-9) and (ICD- 10)  and Current Procedural Terminology (CPT) 4th edition.
Enter claims data into ERP system while interpreting coding and understanding medical terminology in relation to diagnosis and medical necessities.
Review insurance policy to determine coverage
Prepare insurance claim forms or related documents, review them for completeness.
Provides customer service such as limited instructions on preceeding with claims or referrals to auto repair facilities or local contractors.
Calculate amount of claim.
Post or attach informmation to claim file.
Transmits claims for payment or further investigation.
Responsible in processing Pharmacy, Laboratory and Radiology, Histopathology(Pathology cases) bills both inside and outside billing and ensures claims were coded properly according to (ICD-9) and (ICD- 10)  and CPT, in ERP as well as checking claim forms, allocation of deductibles, co-pays, co-insurance maximum and provider reimbursements.
Good knowledge in health insurance coverage and it’s concepts.
Audits randomly selected claims to ensure quality processing.
Assigning all correct and complete codes on medical reports, entering data on computer and doing work on time and accurate manner.
Coordinates with respective departments regarding the approvals, covered and non-covered services and any other queries.
Verify patients coverage and to obtain information from external insurance companies concerning extent of benefits.
Coordinate with doctors in ensuring complete and accurate coding of data in patient’s electronic filing system.
Issuance of official reports by logging all medical results in the computer to which the all the physician have access to their respective results in the clinic.
Maintain strict code of confidentiality regarding information received.
Perform other task and duties as requested by HOD.
Responsible for data coding and abstracting selected information for quality improvement, mandatory statistical reporting & billing which to be submitted as outpatient claim.
Dealing with different types of Resubmission for justification on the claim (member ID, prior authorization number, price discrepancies, CPT, HCPCS or ICD, checking valid drug codes), medical necessity justifications, and duplicate codes to resolve rejected claims.
Maintain proper records of billing, approvals, and rectifications statements.
Checking list of Pharmacy, Lab, and Rad rejected bills, preparing bills which are requested to submit as a hardcopy to Insurance companies. Researches claims overpayments and request funds.
Participates in the quality improvement and safety activities of the hospital.

Medical Secretary/Transcriptionist – (August 2007 – February 2009)

Transcribes and edits a variety of medical reports, recorded or written materials like discharge summaries, history & physical examination reports, emergency room visits, operative reports, chart reviews, consultation reports, diagnostic imaging studies, and Progress notes .
Produce medical reports, correspondence, records, patient-care information, medical research and administrative material.
Perform data entry and data retrieval services, providing data for inclusion in medical records and for transmission to physicians.
Handling medical reports and/or referral letters for filing approval of patients.
Verifies accuracy of patient information such as name and identification number; verifies accuracy of transcription for correct punctuation, grammar and spelling.
Identify mistakes in reports and check with doctors to obtain the correct information.
Set-up and maintain medical files and databases, including records, such as x-ray, lab, and pprocedure reports, histories, diagnostic work-ups, admission, discharge summaries and clinical resumes.
Return transcribed documents to the physicians or other health care professionals for review and signature / corrections; for inclusion in patient medical records.
Sorts, copies, prepare, assemble and files records and charts.
Document phone calls in system, and follow u on issues if needed.
Updating records of the patient in the system.
Responsible for proper handling of files/ records of the patient.
Update file copies, filing minutes of the meeting, typing agenda of the Meeting and other document stated by the doctor.
Typing letters; Scanning of all documents, fax documents.
Performed other duties assigned by the doctor from time to time.
Keep track of documents in the department for easy traceability.
Complete administrative task procedures correctly and on time.

Receptionist – (August 2007 – February 2009)

Meets and greets patients in a courteous and efficient manner as they arrive in the department.
Provides customers, visitors and staff with accurate and updated information regarding the services.
Explains the status of the on-going processes. Provides customers with the necessary details i.e. waiting time, requirements.
Schedule and confirm patient diagnostic appointments, surgeries, or medical consultations.
Complete insurance or other claim forms.
Interview patients ton complete documents, case histories, insurance forms.
Compile and record medical charts and reports.
Arrange hospital admission for patients.
Hear and resolve complaints from customer.
Answers the telephone: provides information; takes and relays messages and/or directs calls to appropriate personnel; returns calls as necessary, answer all patient queries in a pleasant and efficient manner.
Takes and conveys messages and answers general queries in a pleasant and efficient manner.
Performing general clerical functions, keeping files and maintaining a neat and orderly work environment.
Provides prompt customer service to members providers, finance and accounts department and other insurance companies claims.
Resolves problems resulting from claims adjudication and customer service phone calls.
Perform a variety of clerical report and office task, such as handling incoming and outgoing mail, completing and submitting insurance claims, typing, filing, nad operating office machines.

CERTIFICATE OF COMPLETION

Medical Coding Workshops: HAAD 2009

Has completed and has passed with certificate of assessment tests -7 categories of Coding attended.

MEMBER OF AMERICAN ASSOCIATION OF PROFESSIONAL CODERS (AAPC)

MEMBERSHIP NUMBER: 01221296

SEMINAR and TRAININGS:

1.    CLINICAL CODING STEERING COMMITTEE

Educational Program for Clinical Coder

“FUTURE OF CODING IN ABU DHABI” – February 24, 2009

Health Authority Abu Dhabi

2.     New 2011 CPT and IC9-CM codes (March 22, 2012)-Attendance Certificate

By: MEHIM – Middle East Health Information Management and Health Authority of Abu Dhabi (HAAD) Instructor, Educator and Proctor: Ms. Ann Webster (RHIA, CCS)

3.    Certificate of the Clinical Coding Seminar: Evaluation and Management Coding for Outpatient and Emergency Department (November 22, 2010)

By Clinical Coding Steering Committee

14 September, 2011 at the Health Authority of Abu Dhabi, UAE

Instructor, Educator and Proctor: Michelea Peech, CCS, CCS-P

4.    Certificate of the Clinical Coding Workshop: Inpatient Evaluation and Management (E & M) codes” (November 22, 2010)

By Clinical Coding Steering Committee

19 September, 2011 at the Health Authority of Abu Dhabi, UAE

Instructor, Educator and Proctor: Michelea Peech, CCS, CCS-P

Tarlac General Hospital

Assistant Nurse – November 2006-March 2007

DUTIES AND RESPONSIBILITIES:

Do Charting; Observe and Monitor patient for undue development and refer as
Necessary.

Check and Record vital signs such as temperature, blood pressure, pulse, and respiration rate.
Measure and record food and liquid intake or urinary and fecal output, reporting changes to medical and nursing staff.
Performed other duties assigned by the Doctor from time to time.
Maintain the work place clean and tidy.
Administer Oral and IV drugs as ordered by the doctor.
Assisted the doctor for the procedure to be done in the patients.
Assisted with the admittance and discharge of the patients.
Observe and Monitor patient’s Vital Sign and report undue development.
Assisted the doctor for examinations to be done to the patients.

St. Lukes Medical Center

Private Nurse/ Caregiver– June –October-2006

Administer Oral and IV drugs as ordered by the doctor.
Monitor, Record Vital Sign’s, intake and output and reports changes.
Attend to the needs of the patients.
Provide physical suppport to assist patients to perform daily living activities, such as getting out of bed, bathing, dressing, using the toilet, standing, walking, or exercising.
Review patients dietary restrictions, food allergies, and preferences to ensure patient receives appropriate diet.
Exercise patients who are comatose, paralyzed, or have restricted mobility.
Observe or examine patients to detect symptoms that may require medical attention, such as bruises, open wounds or blood in urine.
Remind patients to take medications or nutritional supplements.
Feed patients or assist patients to eat or drink.
Communicate with patients to ascertain feelings or need for assistance or social and emotional support.
Lift or assist others to lift patients to move them on or off  beds, examination tables, surgical tables, or stretchers.
Appply clean dressings.
Initiating preventive and rehabilitative nursing procedures as apppropriate for the patients care and safety.
Work interdependently with other health professionals.

Baesa General Hospital and PolyClinic

Medical/ICU-Assistant Nurse- April 2005 – May 2006

Consults and coordinates with healthcare team members to assess, plan, implement, and evaluate patients care plan.
Prepares and administers (orally, subcutaneously, through an IV) and records prescribed medications.
Educates Patient on surgical procedure
Records patients’ medical information and Vital signs.
Provide bedside care for a wide variety of medical patients, including pre and post – surgery patients
Changes dressings, insert catheters, start IV’s
Prepare equipment and aid physicians during examination and treatment of patient.
Participates in discharge planning
Help patient accomplish treatment plan
Instructing, encouraging, and assisting patients in performing physical activities, ambulatory functional activities and daily-living activities and in using assistive and supportive devices, such as crutches, canes and prosteses.
Assures continuation of therapeutic plan following discharge.

Personal details will be given upon request.