Care Physicians Clinical Data

CLAUDIA RIZO MEDICAL CODING AND BILLING SPECIALITST

Miami, FL 305-***-**** *********@*****.***

PROFESSIONAL SUMMARY

Solution-oriented and problem solver with 12 years of experience in the medical field, more specifically in Assisted Living Facilities and Social Work. Highly skilled in communication, expanding and learning skills, and taking initiative when leadership in needed. PROFESSIONAL EXPERIENCE

The Nursing Center at Mercy

Social Services Assistant March 2010- November 2014 Conducting initial psychosocial assessments and entering clinical data in MDS 3.0 Coordination of post discharge services including follow up appointments with Primary Care Physicians, Specialist and/or at Outpatient clinics

Prevent and resolve problems related to or in result of substance abuse, human relationships, rehabilitation and independent care; provide ongoing casework and advocacy services. Oceanside Extended Care Center

Social Services Assistant March 2009- March 2010 Assisted in providing community services at time of discharge and identifying / obtaining community and government benefits for each individual resident.

Adhere to HIPAA privacy rules and Formulate appropriate plans of care side by side floor Registered Nurses to ensure effective recovery time for all inpatient residents as well as completion of PASRR Level II.

Arrange and conduct Utilization Review committee meetings EDUCATION

Technical Diploma in Medical Coding and Billing 2001-2022 Everest Institute

Bilingual- Spanish

SKILLS

Customer Service

ICD-9, ICD-10, and CPT codes

Medical Terminology and Minimal Data Set

(MDS)

Knowledge in Medicare, Medicaid, and

Managed Care guidelines

Time managment and self sufficient work

Data entry, organizing skills, and ability to

work under pressure

Villa Serena Group

Department of Financial Specialist March 2014-present Frequent interaction with Care Managers, Social Workers, Patients, Managed Care Providers, Partnering facility, and Agency Liaisons to ensure appropriate billing strategies. Obtains financial authorization, eligibility status, admission criteria for patient(s) from insurance companies Handle and manage collections of unpaid accounts as well as conducting detailed investigations on denied and unpaid claims

Standard Diploma 1991-1994

Coral Gables Senior High School

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