Medical Customer Service

CLINT B. ROJAS, CCS ***** Blythe. Street Reseda, CA 91335 Cell No. 818-***-**** **********@*****.*** HCC CODERProfessional Qualification * A total of 5 years of intensive auditing of Medicare Risk Adjustment Coding (HCC). Providing positive feedbacks through comprehensive reporting, physician education and documentation training as required by Medicare. Highly skilled Certified Coding Specialist with over outstanding experience seeking a position as a Medical Coder. Proficiency in ICD9-CM and CPT-4 coding with excellent working knowledge. * Excellent record of fast-track growth base upon solid contribution to bottom-line results. Demonstrated ability to work with all internal and external customers in a professional manner. Knowledge of Coding Clinic guidelines, medical terminology anatomy and physiology, and pathological basis of disease.* Highly dedicated and hardworking with well developed customer service skills, goal-oriented & result-oriented, a key participants in business and strategic decision making, and have the ability to make effective use of all available resources.Education :Saints James of Hope Medical SchoolGlendale, CaliforniaMedical Coding CertificateCommunity Training ConnectionAdult Residential AdministratorChatsworth, Ca. 91311Far Eastern UniversityManila, PhilippinesMajor in ManagementGraduated 1985WORK EXPERIENCE :California Coding Specialist390 Rabro DriveChino Hills, Ca. 91023 June 2012 - PresentDuties:Identifies coding and medical record / chart documentation problems impacting the accuracy and consistency of coded data in the medical record and HCC database. Accurate assign HCC ( Hierarchical Condition Coding ) codes per company’s regulation and policy. HCC/Medicare Risk Adjustment Coder. Responsible for coding and validation of HCC assigned codes.HCC/Medicare Risk Adjustment Coder. Responsible for coding and validation of HCC assigned codes.In addition, part of my task was to provide comprehensive analysis report per month as part of HCCspecial projects. Currently working remotely with Molina project.Review / audit medical records to determine if specific disease conditions were overlooked in billing. And ensure the records have been appropriately ICD-9 coded to the highest level of specificity in accordance with Medicare regulations. Query physicians if documentations is inadequate. Peak Health Solutions 1 Centerpointe Drive, Suite 415La Palma, CA 90623 USASept. 2011 - June 2012Duties:Review / audit medical records to determine if specific disease conditions were overlooked in billing. And ensure the records have been appropriately ICD-9 coded to the highest level of specificity in accordance with Medicare regulations. Query physicians if documentations is inadequate.HCC/Medicare Risk Adjustment Coder. Responsible for coding and validation of HCC assigned codes.In addition, part of my task was to provide comprehensive analysis report per month as part of HCCspecial projects.Identifies coding and medical record / chart documentation problems impacting the accuracy and consistency of coded data in the medical record and HCC database. Accurate assign HCC ( Hierarchical Condition Coding ) codes per company’s regulation and policy. The Coding Source3415 Sepulveda BlvdLos Angeles, Ca. 90045April 2008 - Sept. 2011Duties:HCC/Medicare Risk Adjustment Coder. Responsible for coding and validation of HCC assigned codes.In addition, part of my task was to provide comprehensive analysis report per month as part of HCCspecial projects. At times, I am assigned to fill-in to work as an onsite coder for other physician officesaround Los Angeles. Review / audit medical records to determine if specific disease conditions were overlooked in billing. And ensure the records have been appropriately ICD-9 coded to the highest level of specificity in accordance with Medicare regulations. Query physicians if documentations is inadequate.Identifies coding and medical record / chart documentation problems impacting the accuracy and consistency of coded data in the medical record and HCC database. Accurate assign HCC ( Hierarchical Condition Coding ) codes per company’s regulation and policy.Certificates and Licenses :Type: Certified Coding SpecialistIssued By: American Health Information Management AssociationType: Adult Residential Facility # 100****-*** / AdministratorIssued By: Community Training ConnectionType: Senior PastorIssued By: Lord of the Harvest Church InternationalSpecial Skills:ED CodingHCC CodingOut-patient Clinical CodingAmbulatory Surgery CodingDiagnostic and Ancillary Coding Computer System:ArcFilebound EncoderPro. IDXSage Intergy Medinformatix Office 3M Ascender Reference:Available upon request.Sent from my iPad