Registered Nurse Medical
Resume:
Christine Jane I. de Leon RN, CPC, LPT
L** B** Kasiyahan Road, Karangalan Village, Brgy. San Isidro, Cainta, Rizal
******************@*****.***
Objective:
To obtain a position that would best fit my qualifications and enhance my skills for continuous career advancement
Education:
Continuous Profession for Teaching Education, 2012-2013
Bulacan State University
Guinhawa, City of Malolos, Bulacan
Bachelor of Science in Nursing, 2006-2010
Bulacan State University
Guinhawa, City of Malolos, Bulacan
Work Experience:
Employer: Shearwater Health Advisors Inc.
Date Covered: Nov 2015 to July 2019
Position: Medical Coder and Training Specialist for Risk Adjustment, HEDIS and Document Inventory
Plans, assesses, organizes, coordinates, conducts and evaluates all coding training programs and activities. These include New Hire Training, Compliance Trainings, Refresher Courses, Specialty Trainings, Continuing Educations, Cross-Trainings, etc.
Creates interactive and effective training presentations
Creates documents, maintains and organizes Training Library
Maintains the Compliance standards according to the company policies and procedures
Continuously conducts researches, reports, new methodologies, best practices and analyses
HC training program’s efficiency improvement
Works with the Operations and Quality Assurance Teams to analyze performance feedback and resolve issues
Assists in accreditation requirements accomplishment
Additional tasks may include (but not limited to):
Answering questions and reviewing cases from production and QA team, via phone, e-mail, or in person
Escalating issues to supervisor as necessary
Reports Compliance issues accordingly
Conduct and attend team meetings
Coaching
Employer: Altegra Health Philippines, Inc. 17th Floor Picadilly Star Building, 4th Ave corner 27th Ave, Bonifacio Global City, Taguig
Date Covered: March 2013 to Oct 2015
Position: Senior Clinical Abstractor
Assigns ICD-10-CM codes to the principal and secondary diagnoses.
Maintains confidentiality and safeguards the privacy of PHI.
Undertakes special projects and other duties as assigned by the Coding Manager
Clinical Abstraction assignments may include work from all lines of company business
Review assigned medical records and apply appropriate diagnostic codes and modifiers according to Generally Accepted Medical Coding Guidelines, ICD-10-CM Guidelines and CMS Correct Coding Initiatives, coding guidelines approved by CMS, and all rules, regulations and guidelines promulgated by CMS and applicable to contractors and subcontractors of CMS-approved sponsors (collectively “Standards”), all as reasonably interpreted by the Company
Review assigned medical records and document measure specific clinical data according to NCQA technical specifications for hybrid medical records reviews
Review assigned medical records and document relevant clinical data according to stated study objectives
Other specific details of the job will be made known to the employee by their immediate supervisor, which may be in varying scope dependently on prevailing project undertakings
Requires the ability to perform and complete diagnostic coding, abstraction of pharmaceutical studies, HEDIS medical records review and other related duties in a high quality and productive environment
HEDIS Reviews: reviewed designated medical records and documented the measure specific to clinical data
Employer: San Roque Hospital - Liang, City of Malolos, Bulacan
Date Covered: April 2010 to January 2013
Position: Staff Nurse
Assess patient health problems and needs, develop and implement nursing care plans,
and maintain medical records.
Administer nursing care to ill, injured, convalescent, or disabled patients.
Monitor, record and report symptoms and changes in patients' conditions.
Consult and coordinate with health care team members to assess, plan, implement and evaluate patient care plans.
Adhering with the protocols, norms, rules and regulations to maintain complete medical records.
Keeping an eye on each aspect of patient care that includes physical activity plus proper diet.
Achievements:
Certified Professional Coder
Licensed Professional Teacher
Philippine Registered Nurse
Special Skills:
Computer Literate (MS Word, Excel, Power Point, Adobe Photoshop, Canva)
Drawing and sketching
Character References:
Rosevi Mee Ravelas Quality Assurance Specialist
Company Confidential
Brigette Vicente Quality Assurance Specialist
Company Confidential
Dyan Valerie Hipol Training Supervisor
Company Confidential
I hereby certify that all information above is true and correct.
Christine Jane I. de Leon
Applicant’s Signature
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