Medical Coder Customer Service

RACHEL RENTERIA

*** **** **** ****** 786-***-****

Hialeah, Florida 33013 Email: *******@*****.***

Profile Objective

Professional Medical Coder, with 14 years of experience.

Team player works well with others and has exceptional knowledge.

I seek a challenging position utilizing my excellent verbal skills, special attention to Customer Service, computer literacy and the ability to handle many office skills.

Summary: motivated self-starter, problem solver, skilled in decision making and capable of handling several tasks within an allowed time frame. People friendly and reliable team player, as well as an enthusiastic worker. Quick learner and able to adapt to new Responsibilities in other roles aside from the Medical Field.

WORK EXPERIENCE

2024- present Medical City Diagnostic Hialeah, Florida

Scheduler

Answered incoming calls from patients as well from providers to make diagnostic appointments. Also verified insurance and upload into the system on a daily basis. Received faxed information on patients to schedule diagnostic procedures and call the patients and schedule their appointments.

2010--2023 Humana / Conviva Miami, Florida

Professional Medical Coder AAPC

Oversaw a medical center of 50 specialists and seven primary care physicians. Well proficient with MRA regulations, HEDIS regulations, ICD-10, CPT, HCPCS and HPA also DRG regulations. Coordinating patient data into Medical codes for billing, insurance and other related uses, as well as data entry and information security, billing claims, error reports, ACHA Reports.

2005 – 2010 CarePlus Health Plans / Humana Miami, Florida

Referral Coordinator

Process patient referrals for network physicians on a daily basis. Organize referral with doctor’s notes, prior tests, and procedures patient will undergo, in order to obtain authorization from health plan for future surgeries / tests. Prepare patient’s chart for upcoming surgeries and insured that the patient comes to the office for pre-op evaluation. Schedule procedures that will be handled by hospital or private doctor’s office. Coordinate appointments with healthcare providers on patient’s behalf.

1999 – 2004 Pan American / CAC Medical Centers Hialeah, Florida

Processor / Coder Specialist

Responsible for processing and entering over 300 encounters daily using the CPT, ICD-9, and HCPSC manuals for coding and billing purposes. Registered verified insurance, and set up patient appointments for major medical center. Faxed / emailed patient reports for doctors.

1986 – 1999 CAC – Ramsey / United Healthcare Hialeah, Florida

Medical Assistant / Billing Office Clerk

Performed a variety of office tasks for a large Medical Corporation, including Switchboard operator, front desk Receptionist, and other administrative duties, worked with all Primary Care Physicians, filled out proper paperwork to submit claims to patients Insurance and for Billing purposes, also worked with Workers’ Compensation patients, Assisted Physicians and Specialists in the field of Urology and Gynecology by preparing office and trays for medical examinations / procedures. Tasked with ensuring that surgical office was clean and ready for same day and next day procedures.

EDUCATION

Hialeah Miami Lakes Senior High School Graduate / Diploma Class of 1986

LICENSES

2008 American Academy of Professional Coders Miami, Florida

Certified Professional Coders / (CPC) / Certified Professional Medical Auditor (CPMA) – ACTIVE LICENSE,

coded Pediatrics and Medicare and Medicaid Adults

1998 – 1999 National School of Technology Miami, Florida

Coder / Billing Specialist Degree – ACTIVE LICENSE, coded Pediatric and Adult.

1988 – 1989 Bauder National Education College Miami, Florida

Medical Assistant Degree

LANGUAGES

Fluent in English and Spanish, both writing and verbal.

REFERENCES

Excellent references available upon request.

Contact this candidate