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Coding Specialist

Burbank, CA
February 20, 2020

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*** *. ********* ** *******, CA 91501 E-MAIL:


To secure a responsible position as a Certified Medical Coder where positive personality, relevant training and valuable over 15 years medical experience will allow me to develop my professional skills and opportunities for advancement.


Achievement oriented, effective negotiator and problem-solver.

Poised under stressful working and deadline driven environments.

Detailed oriented with the ability accomplish multiple tasks accurately.

Trained and qualified to understand medical terminology, abbreviations and CPT and ICD-10 coding.

Articulate and expressive innately friendly and accommodating.

Qualified in data input/retrieval, word processing and spreadsheet analysis.

Skilled in utilizing the Internet for research purposes.

Demonstrating leadership ability and delegating.

Work independently to carry out work efforts.

Proficient in Word, Excel, PowerPoint, Multimedia projector, IDX BAR, 3M Encoder, Encoder Pro.

Computer literate with electronic medical records such as Epic, Nextgen, Allscripts,Centriciy and multiple medical billing soft wares.


Medical Coding Knowledge

Extensive knowledge of medical terminology, Federal and State guidelines on E/M, CPT-4 and ICD-10, applying modifiers and sponsored programs such as Medicare, Medi-Cal, HMO, PPO and Managed Care.

Independently perform high complex and detailed coding and auditing for all inpatient and outpatient services from dictated reports, written ER reports, chart notes, procedure and clinic notes.

Coding diagnosis and procedures utilizing the ICD-10 and CPT-4 coding system and auto encoder/grouper program and abstracting key data elements from patients’ records for data reporting purpose with high degree accuracy.

Perform medical chart audits, maintain excel database with the result of all audited medical charts. Ability to interface and disseminate audit results to clinicians and management.

Stay abreast of industry coding and compliance issues.

Certified ICD-10 Trainer

Worked on Epic, Nextgen, Cerner, Enterprise and 3M and encoder pro.

Medical Billing Knowledge

Knowledge of Medicare, Medi-Cal and third party, patient and Worker’s Compensation billing.

Responsible for producing billing statement including HCFA-1500 and patient statements.

Maintained and updated all patient computer data information such as insurance information, referral sources, new codes and changes.

Perform all daily, monthly and annual reporting and closing procedures.

Follow up with insurance companies on all unpaid claims and denials, appealing underpaid claims and erroneous denials.

Balanced daily deposits with posted payments.

Monitored and worked all aging accounts to ensure prompt payment.


August 2004-Present

HCP Part of Optumcare, Commerce Ca

Position: Manager Coding Department

Duties and Responsibilities:

Responsible for coordinating coding data audit function and assisting administrative and quality assurance efforts for the department. Monitor productivity, prioritizes duties and trains and evaluates staff. Serve as subject matter expert by conducting seminars for clinicians and staff, performing medical chart audits and other efforts necessary to support organizational coding expertise.

Serve as subject matter expert for the organization on the coding function. Handle clinician and staff coding education with an emphasis on HCC coding. Conduct coding seminars. Perform medical chart audits. Develop new encounter forms and rounding logs and revises existing EF’s and rounding logs using the most current codes. Perform quality assurance audits of staff, reports results in the department report cards and meets with staff regarding any coding deficiencies. Participate in projects for various committees requiring coding related expertise. Manage training for new staff. Expert in E/M coding ( 1995 and 1997 guidelines).

July 2015- September 2019

Navigant Cymetrix, CA

Position: Remote Quality Assurance Reviewer

Performs quality reviews ( Prospective and Retrospective) of coding vendor and/or coding team work activities to ensure all collected data is accurate, complete, and compliant with state and federal regulations as well as Official Guidelines for Coding and Reporting. Abstracts all necessary information from health records to identify secondary complications and co-morbid conditions. Identifies and reports issues or errors, such as incomplete or missing records and documentation, ambiguous or nonspecific documentation, or codes that do not conform to approved coding guidelines. OP Coding: Reviews medical records for the determination of accurate assignment of all documented ICD-10-CM codes for diagnoses and procedures.

Abstracts accurate required data elements (facility/client specific elements) including appropriate discharge disposition. Uses discretion and specialized coding training and experience to accurately assign E/M, ICD-10, CPT-4, HCPCS and modifier codes to patient medical records.

December 2011- January 2015

TrustHCS, Springfield, MO

Position: Remote Out Patient/ physician coder

Duties and Responsibilities:

Responsible for coding Professional outpatient services and Diagnostic Radiology and Interventional radiology services from dictated reports . Coding E/M, procedures and diagnoses for General Surgery, Internal Medicine practices, Ob/Gyn and Pediatrics. Coding for Hospitalist visits. Correcting the coding errors on claim edits.

February 2007-September 2012

Family Practice of Glendale, Glendale Ca

Position: Remote Physician Outpatient Coder

Duties and Responsibilies:

Responsible for E/M and procedural coding based on the medical records on a daily basis for Internal Medicine specialty group of physicians. Assist other coders for complex coding cases. Conducting a series of physician focused documentation in -service and also one on one debriefing. Training office managers and billers appropriate coding guidelines based on the documentation.

March 2000-August 2004

Medical Business Concepts, Pasadena Ca

Position: Coding and Compliance Manager

Duties and Responsibilities:

Responsible for coding all inpatient, outpatient and ER Diagnostic Radiology and Interventional radiology services from dictated reports for Outpatient and inpatient facility radiologists such as California, City of Angels and La Metropolitan Hospitals. Coding E/M, procedures and diagnoses for General Surgery and Dermatology and Internal Medicine practices. Train new employees on coding and billing areas. Managing and support charge process, account receivable and posting payments. Processing Medicare, Medi-Cal and third party denial received, submitting appeals.


Certified Professional Coder, American Academy of Professional Coders. Member of AAPC since 2003

Graduated Medical/Dental Office Management, Glendale College, CA.

Diploma, St Mary High School.

RHIT in Process at Santa Barbara City College.

ICD-10 Certified Trainer with AAPC.

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