Medical Manager
Resume:
Miriam F Hernandez
North Miami FL 33161
E-mail: ********@*****.***
Q UALI FI CAT I O N S
** ***** ********** ** * professional Auditor and Coding instructor
Strong knowledge of ICD-9, HCPCS, CPT, COMPLIANCE, DRG, AAPC certified
Effective educator in the field of Science,Insurance coding system and EMR
Healthcare provider-AHA-CPR certified
Proficient in the use of Medical Billing,Coding software,EMR Cerner Millennium; Cerner Powerwork,AS400
Effective communicator in English and Spanish.
Extensive experience with CMS guidelines. Exceptional knowledge of PC applications such as Microsoft Office
Suite,
Exceptional interpersonal skills
WORK HISTORY
Physician Coding and Compliance Manager (MCH)- 2005-2012
Prepare, implement a compliance plan for each of the practices in coding procedures/office regulations and maintain
the plans up to date. Perform periodic and concurrent audits on office procedures and surgical procedures. Assist and
re-train the physicians, non-physician practitioners and office staff on coding protocols. Perform audits of the billing
vendor to ensure proper billing and collections in accordance to MCH policies and procedures. Stay abreast of all
coding and regulatory changes that would impact each of the physician practices. Participate in Revenue Cycle
Committee, Operations Committee and other Committees. Subject matter expert on Cerner Millennium application
Corporate Compliance Manager - Holy Cross Hospital (HCMG)- 2002-2005
Responsible for managing, directing and supervising coding activities for all medical group services including
securing, maintaining and distributing the most current coding information and implementing changes. Ensure
medical group services are in compliance with correct coding practices as specified by CMS others. Liaisons with
physicians, office managers and coding staff to ensure timely, accurate and complete processing of clinic services
Monitor reimbursement of selected procedures on a continuous basis and identifies changes in reimbursement patterns.
Physician Coding Compliance, Aztec Medical Systems 2000-2002
Responsible for conducting external audits, training all new employees,keeping abreast of all federal documentation
guidelines. Supervised a group of 5-10 coders and auditors at a time. Audit procedures, management, and all coding
activities of clients including DRG coding.
Coding and Billing Instructor, National School of Technology 1998-2000
Experience on training students on the field of managed healthcare and various type of insurance programs such as
Medicare, Medicaid and worker compensation as well as computerized billing and coding.
Medical Instructor, Alpha Train Computer Solution. 1997-1998
Effective teacher of various medical classes to prepare students in the field of medical transcription, terminology and
insurance billing and coding
Medical Instructor, Medical Training Institute. 1995-1997
Instructor of various medical classes to prepare students to work in healthcare field. Classes included; Anatomy and
Physiology of the cardiovascular System, phlebotomy, Electrocardiography, Medical laboratory techniques, Medical
Assistant training, General Human Anatomy, clinical care, Cardiopulmonary resuscitation and
First Aids.
E D U CAT I O N
Bachelor Of Science, Biology Major Saint Peter's College
Medical Degree, University of Guadalajara
CPC, CPMA, American Academy of Professional Coder
References are available upon request.
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