OBJECTIVE: Seeking a Medical Coder job.

QUALIFICATIONS SUMMARY

· Over 8 years experienced as a Medical Coder, Auditor and Team Leader handling simple to complex coding and billing responsibilities and 2 years Clinical Experience as a Staff Nurse ER department.

· Registered Nurse, Certified Professional Coder (CPC) and Certified Coding Specialist (CCS).

· Broad and Extensive experienced with regards to Medical Coding and Billing guidelines and coding techniques (ICD-10-CM, ICD-9, CPT-4, HCPCS, and DRG’s) and medical terminology, anatomy and physiology, reimbursement, HIPAA policies, insurance verification, and report creation.

· Expert and exposed on different coding and billing software (3M, CAC, Varian, G4, Citrix, Centricity and OncoEMR.

SPECIAL SKILLS:

· Proficient skills with 98% and above accuracy and maintains above expectation production in the execution of Outpatient and Inpatient Hospital Coding including Surgical Procedure and Facility.

· Handled complex coding specialties (Cardiac Catheterization, GI Endoscopy, Inpatient Acute Care, Interventional Cardiology, Same Day Surgery, Surgical Pathology, and Neurosurgery.

· Profound ability to work with computers and popular medical coding software (3M Coding Software, Computer Assisted Coding, EncoderPro, Optum, and  Selectcoder).

· Handled Team efficiently and maintains professionalism.

· Excellent Entry Data Skills.

EDUCATION/QUALIFICATIONS:

· Certified – Certified Coding Specialist (CCS) from AHIMA – Licensed no. 220338

· Certified – Certified Professional Coder (CPC) from American Academy of Professional Coders  (AAPC) –licensed no.01362181

· Registered Nurse -Nursing Licensure Exam Passer from Professional Regulation Commission –  Licensed No. – 0475539

PROFESSIONAL EXPERIENCE

RN Certified Coder

Microsourcing/California Cancer Associates for Research and Excellence

August 09, 2016 – August 21, 2018.

· Doing Neurosurgery Coding and directly communicates with the neurosurgeon.

· Provide the most accurate coding for laboratories maintains 100% quality audit.

· Provide answers to queries from coding and billing department regarding clinical, medical and billing concerns.

· Directly reporting statistical data to manager and COO for overall status daily.

Inpatient Medical Coder

Back Up OP Coder

e4e Global Services Philippines/Auxilio Mutuo

September 21, 2015– June 01, 2016.

· Worked in a fast-paced medical coding company dealing with 1000 bed capacity hospital that handles acute complex cases.

· Review medical records and accurately assigns and sequences diagnosis and procedure codes in accordance with coding books using ICD-10-CM, PCS, CPT-4, Medicare policy, CCI Edits, and Client coding guidelines; ICD 10 CM ProficientProvide answers to queries from coding and billing department regarding clinical, medical and billing concerns.

· Maintains 24 IP charts/40 OP charts per day adhering to AHIMA/CPC guidelines production with 97% up accuracy

Inpatient Medical Coder

UnitedHealth Group, Philippines

April 13, 2015 – September 19, 2015

· Reads through the hospital/medical records and accurately assigns and sequences diagnosis and procedure codes in accordance with coding books using ICD-10-CM, CPT-4, Medicare policy, CCI Edits, and Client coding guidelines;

· Maintains no less than 97% coding accuracy for all specialties and no less than the CPH (Chart Per Hour) target on designated specialty.

Risk Adjustment coder/Claims Triager/Fraud, Waste and Abuse Clinical Investigator

UST Global Inc., Philippines
January 06, 2014 –April 10, 2015

· Review medical records for same DOS and provide codes according to Risk Adjustment coding guidelines; Applying F codes and add secondary diagnosis related to encounter.

· Assure the assignment of complete, accurate, timely and consistent codes by the medical coding unit.

· Reconcile clinical notes, patient encounter form, health information for compliance with HIPAA rules.

· Analyze billing to improve coding data accuracy for Medicare compliance reimbursement

· Ensure coded data accurately reflects service provided, based on documentation, guarding against fraud and abuse.

Outpatient Medical Coder/Quality Assurance Validator/Team Leader

Equicom Information Technology Inc.,

Philippines

June 07, 2010 – January 2, 2014

· Responsible for complete and accurate assignment of ICD-10-CMand CPT codes in accordance with current internal and external coding guidelines in Outpatient setting.

· Abstract clinical, demographic, and quality information from medical records for statistical, indexing and third party payer reimbursement purposes.

· Support Coding Supervisors auditing, reporting and educational functions as appropriate.

· Excellent working knowledge of Diagnostic Related Groups, sequencing of procedure and diagnosis codes and selection of Principal diagnosis and procedure codes in addition to an understanding of Peer Review Organization quality initiatives and Medicare reimbursement guidelines.

Emergency Nurse/Staff Nurse

Aleosan District Hospital, Philippines

February 2008- April 2010

· Utilized the nursing processes; assessed, planned, provided and evaluated nursing care based on staff and patient interviews.

· Provided and managed goal-oriented patient care by utilizing established nursing processes and principles.

· Established nursing diagnoses and wrote out plan for treatment. Implemented cure and evaluated care.

· Collaborated with other ER professionals to ensure effective patient care delivery – Identified patients’ conditions and addressed nursing care.