Narda J. Moreno, CCS, CPC, CPC-I, CPMA

Certified Coding Specialist

Certified Professional Coder

Certified Professional Coding Instructor

Certified Professional Medical Auditor ad3eed@r.postjobfree.com

Certified Risk Adjustment Coder (pending) 620 Canyon Oaks Dr. Apt C

Medical Billing Specialist Oakland, CA 94605

Home: 209-***-****

Professional Profile

Certified Coding Specialist with 20+ years in the industry, specializing in compliance, coding/auditing and revenue cycle for Medicare, Medicaid, Commercial, etc. Also experienced in CPT, ICD-9, ICD-10, HCC, FQHC/RHC (Federally Qualified Healthcare Clinic/Rural Health Clinic) setting. Skilled in HEDIS Measures, HCPCS, code-set training and official guidelines. Proficient in Coding Clinic, 3M software, Epic, Cerner, Excel, Word, Power Point as well as the ability to research the internet for multiple resources to perform my duties.

Experience October 2023-January 2024 Optum (Contract)

HCC Coder

Apply in-depth knowledge of coding principles to validate missing, incomplete, or incorrect CPT and diagnosis codes, abstracts, or sequences.

Code chronic disease that meets HCC and Risk Adjustment criteria.

Assign diagnosis and procedure codes according to CMS HCC and all CPT and ICD 9 and 10 guidelines.

Validate missed coding opportunities.

Demonstrate advanced knowledge of medical terminology, anatomy, and physiology.

Communicate with physicians about documentation and coding.

Reliability and a commitment to meeting tight deadlines on all assigned charts.

Knowledge of HIPAA recognizing a commitment to privacy, security, and confidentiality of all medical charts.

Aug 2022-March 2023 Cook County Hospital System, Chicago, IL

Medical Chart Auditor (contract)

Responsibilities included auditing diagnoses to validate HCC’s and identify problem areas for better physician training and feedback.

Responsible for auditing E&M, CPT, ICD-10CM and HCC codes for outpatient, ambulatory and ED.

Identify and report missed opportunities.

Research all coding and reimbursement sources to accurately identify correct coding.

Mar 2022-Sept 2022 Alameda Health System

Compliance Specialist

Account for coding and abstracting of patient encounters.

Research and analyze data needs for reimbursement.

Make sure that codes are sequenced according to government and insurance regulations.

Ensure all medical records are filed and processed correctly.

Analyze medical records and identify documentation deficiencies.

Serve as resource and subject matter expert to other coding staff.

Review and verify documentation for diagnoses, procedures, and treatment results.

Identify diagnostic and procedural information.

Develop training materials and present them to physicians for compliance.

Nov 2018-Present Pro-Med Coding & Education

Physician Trainer/Revenue Cycle Specialist

Develop a schedule to assess training needs.

Conduct employee surveys and interviews.

Track and compile collected data.

Conceptualize training materials based on data and research.

Communicate training needs and online resources.

Create training strategies, initiatives, and materials.

Contact and utilize outside vendors and resources for instructional technology.

Test and review created materials.

Maintain a database of all training materials.

Instruct employee training and onboarding.

Conduct training through new materials.

Review employee performance and learning.

Coordinate and monitor enrollment, schedules, costs, and equipment.

Dec 2015 – June 2018 Kaiser Permanente

Manager, Finance Department

Manage 15-28 Remote Auditors to ensure quality documentation by clinicians..

Review disagreements by QA department and discuss with staff/auditors.

Manage/discuss appeals with remote auditors.

Provide daily/weekly/monthly feedback with auditors regarding disagreements/appeals.

Create and conduct monthly webinars for auditors and QA staff to ensure consistent distribution of information throughout the department.

Promote the highest quality output of information to leadership.

Complete and conduct yearly evaluations for staff.

Sept 2010 – 2015 Kaiser Permanente-DSA Walnut Creek, CA

Data Quality Trainer

Responsible for auditing Clinical Documentation Integrity, both in the outpatient and acute inpatient areas.

Audit ICD-10 CM and PCS for readiness. Develop and deliver training material to ensure that physicians and staff would be prepared for rollout.

Responsible for training and providing feedback to clinicians to properly capture, document and address conditions which are reported to CMS and other payers.

Assist auditors in providing quality feedback for CMS reporting purposes.

Develop and deliver detailed training materials for clinicians to ensure proper coding and documentation of chronic conditions.

Have been an instrumental part in increasing physician coding accuracy by 20% in the past 12 months.

2008-2010 Kaiser Permanente-Regional Livermore, CA

Medical Documentation Auditor

Responsibilities included auditing diagnoses to validate HCC’s and identify problem areas for better physician training and feedback.

Responsible for auditing E&M, CPT, ICD-10CM and HCC codes for outpatient, ambulatory and ED.

Identify and report missed opportunities.

Research all coding and reimbursement sources to accurately identify correct coding.

2001-2008 MedTech Medical Billing Tracy, CA

Revenue Cycle Director

Responsibilities included managing and directing all activity for the billing and coding departments with a staff of 10+. This included verifying all patient and insurance information.

Posting all services; including office, inpatient and outpatient surgery, Medical Legal Reports, deposition, and expert testimony.

Weekly reporting of all activity to client. Involved with decision making to improve the quality assurance and accounts receivable in the billing department. Responsible for reviewing CPT, ICD-9, HCPCS and their accuracy for reimbursement purposes.

Education 1999 San Joaquin Delta College

2008 LS Coding/CPC preparation

Certificates Certified Coding Specialist, AHIMA. Certified Professional Coder, AAPC, Certified Professional Medical Auditor, AAPC, Certified Professional Coding Instructor, AAPC. Also current with Medicare/Medi-Cal Compliance Rules and Regulations.

Specialties Include

But Not Limited To Othopedics, OB/GYN, Pediatrics, Neurology, Nephrology, Oncology, Endocrinology, Cardiology, Anesthesia.

Computers EPIC, NextGen, Lytec, Medical Manager, Infinity. Coding Clinic, 3M, Windows, Microsoft Office, Word, and Excel, Fully literate with Internet Services. Well versed in remote work.

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