Medical Coding, Medical Coding Auditor

MA. CECILIA D. MENDOZA

Airport Road • Abu Dhabi City, AZ • +971-**-******* • **********@*****.***

Career Profile

Senior Clinical Coding Officer with 14 years of experience in medical coding and internal coding audit for government hospitals in the Philippines and United Arab Emirates. Supervised and managed a 15-people team of inpatient and daycase medical coders, facilitated internal coding audit, and documentation improvement for Sheikh Khalifa Medical City.

Core Competencies include Clinical Documentation Review, Revenue Enhancement, CPT and ICD 10 coding, Database Management, Physician Documentation Improvement, Medical Records Management, Revenue Cycle Management, and Auditing and Denial Management. Career Highlights

1. Improved the clinical coding quality through monthly audit on coders’ code assignments. 2. Reduced insurance denials through educating physicians on proper documentation. 3. Improved DRG assignment through coders’ education on accurate coding and sequencing of diagnoses and procedures.

Professional Experience

Sheikh Khalifa Medical City Al Karamah, Abu Dhabi, United Arab Emirates Organizing, supervising, and controlling the daily activities and work processes of inpatient coders, this includes regular coding audit, case-mix index statistics, chart analysis, and delinquency reporting. Senior Clinical Coding Officer (Feb 2015 – present)

• Continuously mentors coding staff to develop analytical skills which had resulted in a significant reduction of insurance claims denial.

• Improved the quality of patient care by maintaining the integrity of the coded diagnosis and procedures which reflect the complexity of the patient's condition.

• Assists in enhancing the efficiency of Electronic Medical Record (EMR) through a collaborative relationship with third-party system developers.

• Cooperates with other key management personnel to elevate that quality of service and maximize revenue.

Sheikh Khalifa Medical City Al Karamah, Abu Dhabi, United Arab Emirates Managed a coactive team of 10 inpatient coders that successfully refined the department's coding quality and improved the claims reimbursement.

Clinical Coder -Team Leader (Jan 2012 – Feb 2015)

• Ensured accurate coding and sequencing as specified by established coding principles and guidelines.

• Trained physicians on the proper clinical documentation to help with the coding accuracy, ensured better physician productivity and avoid denials.

• Producing productivity and statistical data and reporting on a daily, monthly and adhoc basis for management and key department/sections as per instruction from Coding Manager. Sheikh Khalifa Medical City Al Karamah, Abu Dhabi, United Arab Emirates Improved the inpatient coding accuracy of the institution thereby decreasing the insurance denials on claim reimbursement. Was recommended to assume the role of Clinical Coding Team Leader by 3M consultants who performed a comprehensive coding and system audit in 2010. HIM Technician (June 2009 – Jan 2012)

• Assisted with the preparation of medical records and provided coding data for quality assurance and medical audit purposes.

• Conducted coding audit on a daily basis.

• Provided solutions to coding issues and other concerns of the coding team. Other Professional Experience

Department of Agrarian Reform Gumaca Quezon, Philippines

Computer Programmer II (Jan 1996 – June 2009)

Department of Agrarian Reform Gumaca Quezon, Philippines

Assistant Statistician (Apr 1991 – Dec 1995)

Philippine Heart Center for Asia Quezon City, Philippines

Medical Records Officer I (Jun 1987 – Apr 1991)

Education

Philippine School of Business Administration Manila, 1986

Bachelor of Science in Business Administration Major in Accounting Certifications

American Health Information Management Association (AHIMA) Certified Coding Specialist (CCS)

Certification # C025596

Certification Date: 11/05/2013

Status: Active

American Health Information Management Association (AHIMA) Certified Coding Associate (CCA)

Certification # A004407

Certification Date: 09/22/2010

Status: Superseded

Awards

Abu Dhabi Health Services Company (SEHA)

Specialised Employee 2019

References

Sama Jasem Al Zaabi

Coding Manager

Sheikh Khalifa Medical City

Cp# (+971) 052-***-****

Shamim Ahmad

Senior Clinical Analyst

Global Medical Solution

Hospital Management

Cp# (+971) 056-***-****

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