LORENZ E. MENDOZA-REYES, CCS

***** ***** ***, ***** ** 91708 ● 714-***-**** ● adj8ak@r.postjobfree.com

CERTIFIED CODING SPECIALIST

SUMMARY OF QUALIFICATIONS

More than 4 years of coding experience

*-* *harts per hour

Maintains over 95% quality and productivity at all times

Proficient in 3M HDM, 3M HDM-CAC, TruCode, Epic, Meditech, Chartmaxx, Fluency, Cerner Validated Accuracy with HCC profiler

PROFESSIONAL EXPERIENCE

REMOTE MEDICAL CODER May 2018-Present SHaRP Inc.

Maintains current knowledge to ensure that coding and documentation meets regulatory guidelines and audit standards and results in appropriate reimbursements. Maintains professional competency in professional services coding and documentation requirements.

Collaborates w/ the Coding Educators team to develop and implement strategies to make appropriate documentation and coding easier for clinicians.

Audit and Code Inpatient/Outpatient EMR charts using EPIC coding system with the help of Encoder Pro

Verifies the accuracy, completeness, and precision of CPT-4 and HCPCs coding, including modifiers, units and other variables impacting workload accountability and billing. This requires independently re-coding the encounter from source documentation, completing supporting worksheets documenting rationale for coding decisions, recording discrepancies and recording the rationale for changes in coding decisions.

HCC AUDITOR/TRAINER

• Provided seamless onboarding experience training new employees on policies and procedures.

• Conducted quality assurance reviews to ensure compliance with regulations and operations. • Coded in Emergency Room, Hospital Medicine, Anesthesia, Clinic and Pain Management Departments as Certified Coding Specialist..

• Mentoring new coders as they ramp up their production.

HCC CODER October 2017-April 2018 ALLTYPESHIM

• Review provider documentation to abstract and confirm all diagnosis codes mapping to HCC categories, according to Risk Adjustment policies, internal contract terms, and coding guidelines, for proper diagnostic code assignment

• Code medical records for the complete and correct assignment of all ICD-10 codes • Maintain quality accuracy rate while meeting and exceeding production goals, supporting fellow coders in the same goal

HCC CODER March 2017 – June 2017 OPTUM

• Abstract diagnostic data and report ICD-10 codes and other information from electronic and handwritten medical records in accordance with established CMS and client specific guidelines for Medicare Risk Adjustment coding

• Consistently meets productivity and quality standards set forth by client • Monitor coding changes to ensure that most current information is practiced • Perform ongoing analysis of medical record charts for appropriate coding compliance • Experience in using the following programs: Gemstone, Jabber, Outlook, MRM (medical record manager), Emerald.

• Experience in using the HCC Coder website

HCC CODER October 2016- September 2017 ADVANTMED

• Performed HCC risk adjustment ICD-9 coding/auditing per CMS and client specific guidelines

• Reviewed and abstracted records for chronic conditions within given measurement years per client instructions

• Ensure all coded data accurately reflects service provided, based on documentation, guarding against fraud and abuse

• Reconciles NCCI correct edits and discrepancies prior to final coding

• Maintain productivity and quality as per facility requirements

EDUCATION AND TRAINING

CERTIFIED CODING SPECIALIST

Hope of Saint James March 2016 Covina, CA

Doctor of Medicine in Dentistry April 1997, CEU Philippines

Registered Dental Assistant March 2002, Milpitas CA

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