KRISTINE JOY MARGAJA, RN, RM,CPC

EMAIL Address

adodol@r.postjobfree.com

Mobile:

+971-**-***-****

Personal Information

Birth date: December 9, 1987

Nationality: Filipino

Address:

Street *, *****very Gardens

Dubai

Career Objective

To find work with a challenging position in a major corporation that will enable me to perform to the best of my capabilities. Work Experiences:

Insurance Coordinator/Medical Coder

Novomed Centers

September 27, 2015-Present

• Collect health information as documented by medical specialist and code them appropriately.

• Translating medical terminology into unique and professional codes (ICD, CPT, and HCPCS) for medical personnel and insurance companies.

• Consult medical specialists for further clarification and understanding of items on patient charts to avoid any misinterpretations.

• Ensure that codes tally with doctor’s diagnosis

• Do the Pre-authorization (verbal/written) thru eclaimlink portal, insurance portal of some procedure if it is covered or not to the patient insurance.

• Evaluate and refile appeals of patient’s claims that were denied.

• Disseminate information of the approved and rejected procedure.

• Collect and distribute coding related information and billing issues.

• Ensuring coverage of claims, guiding staff for correct use of claim forms, approval paper or coordinating with insurance companies for obtaining information on new policies.

• To network with insurance companies to obtain accreditation as a provider.

• To liaise with patients regarding their eligibility and entitlements.

• To train and educate staff in insurance matters and to advise management on insurance matters.

• To design and implement a protocol for insurance practices in the clinic.

• To maintain and update records related to pre-approvals and reconciliation.

• To coordinate and co-operate with colleagues of the same department and other related departments for smooth running of insurance operations.

• Submit the claims thru e-claims or thru manual submission of the documents.

• Close insurance as per remittance advice received and do resubmission if necessary.

• Develop good client relationship in the course duty.

• DO customer service/ front line if necessary.

Medical Coder/Insurance Coordinator/Medical Record Nice Care Medical Center

Al Barsha 1, Dubai

February 3, 2014, to September 24, 2015

• Analyze patient charts carefully to know the diagnosis and represent every item with specific codes.

• Translating medical terminology into unique and professional codes (ICD, CPT, and HCPCS) for medical personnel and insurance companies.

• Consult medical specialists for further clarification and understanding of items on patient charts to avoid any misinterpretations.

• Ensure that codes tally with doctor’s diagnosis

• Evaluate and refile appeals of patient’s claims that were denied.

• Be updated about new coding rules as codes change from time to time.

• Collect and distribute coding related information and billing issues.

• Provide accurate answers to queries on coding.

• Ensuring coverage of claims, guiding staff for correct use of claim forms, approval paper or coordinating with insurance companies for obtaining information on new policies.

• Do the Pre-authorization (verbal/written) of some procedure if it is covered or not to the patient insurance.

• To network with insurance companies to obtain accreditation as a provider.

• To liaise with patients regarding their eligibility and entitlements.

• To liaise with patients regarding their eligibility, payments, approvals, reconciliation and other requirements.

• To maintain and update records related to pre-approvals and reconciliation.

• To coordinate and co-operate with colleagues of the same department and other related departments for smooth running of insurance operations.

• Develop good client relationship in the course duty.

• Checking all the medical record (electronic). Checking its completeness.

• Informing all the concern staff regarding the missing data of our patient. Medical Record Officer/Medical Coder

Ospital ng Lipa

Batangas, Philippines

February 1, 2013 – August 30, 2013

• Maintains attentiveness to customer’s needs: initiates steps that will comply with their requirements to meet and exceed their expectations.

• Maintains alertness on opportunities for service enhancement; endeavors and continually improve quality of work.

• Gets list of admitted and discharged patients from the admitting department daily then encodes list to computer; Prepares daily census report

• Prepares folder for filling of patient’s chart based on terminal digit number; Files records according to its folder; periodically check files for misfiled records.

• Assign ICD-10 Code to the main condition from the final diagnosis of the Doctor on the patient’s chart and operations based on the accepted classification system.

• Check in charts to MRD’s record according to list of discharges from previous day.

• Check basic forms required and all information required by the case.

• Checks necessary authentications and all necessary authorizations are attached to the chart.

• Checks for errors or unexplained inconsistencies and analyzes records to release to the patient requesting them.

• Authenticates records before discharging them to the authorized requestee.

• Process birth and death certificated

• Collects and compiles data from medical records for statistical and other related reports.

• Reviews medical records or ensure that required reports and signatures have been included (quantitative and qualitative analysis); Nurse II, ( Secretary/Nurse)

City Health Office

Lipa City Batangas

August 24, 2009- January 31, 2013

SECRETARIAL

• Provide secretarial support to the City Health Officer by encoding correspondences, reports and documents thru the use of Microsoft Office

• Handling or screening of incoming calls and random visitors, setting meeting with various offices/district centers, clients etc.

• Manage all inward and outward communication of the City Health Office in order to ensure timely and accurate receipt and dispatch of the same.

• Set-up and maintain City Health Office correspondence files and ensure safe custody and confidentiality.

• Make follow up to the different health districts, department, and person any pending documents as requested by the City Health Officer including the status thereof.

• Make all the presentation of the office by the use of Microsoft Power point.

• Remind the City Health Officer regarding her daily activity.

• Make some Purchased Order, Voucher, Annual Budget Report, Work program of the certain activity of the office.

• Received all the CV and screened all applicants in Ospital ng Lipa. PUBLIC HEALTH NURSE

• Conduct primary health care to the clients with simple disease.

• Taking Vital signs; Blood Pressure, Temperature, Body Weight, Pulse rate, Respiratory Rate.

• Get the history of a pregnant women (LMP, AOG,EDD); Vital Signs (BP,Weigth,Fetal Heart tone thru the use of Doppler)

• Perform newborn screening.

• Give BCG, DPT, MMR, Hepatitis B, Tetanus Toxoid vaccination and other vaccines.

• Assist the doctor in rendering patients care.

• Assist the dentist in performing dental extraction.

• Administer medication orally and parenteral.

• Instruct the client in their home medication.

• Perform health teaching.

Educational Background:

Lyceum of the Philippines-Batangas

Bachelor of Science, Nursing

2008

The Mabini Academy

Secondary

2000-2004

Licenses & Certifications

CERTIFIED PROFESSIONAL CODER (CPC)

License No. 01397390

Certified ICD-10 CM Proficiency

License No. 01397390

REGISTERED NURSE

License No. 0528392

REGISTERED MIDWIFE

License No. 0151035

Trainings/Seminars:

“Training for Certified Professional Coder-CPC (CPT4,ICD-9,HCPCS) Health Care Billing Institute,Phillipines

“International Classification of Disease version 10 (ICD 10) Training for Coders”

University of the Philippines Manila, College of Public Health May 6 to 10 2013.

“Basic Orientation on Newborn Screening and Practicum on Actual Heel Prick Method”

By Center for Health Development CALABARZON; AV, City hall Compound Lipa City Batangas

March 24, 2013

‘Basic Life Support System and Cardio-Pulmonary Resuscitation” By Philippine National Red Cross; Barangay Hall Lodlod, Lipa City Batangas May 22-24, 2009

“Therapeutic Communication Techniques in Psychiatric Nursing Practicing Responsible, Assertive and Caring Client Interactions” By Dr. Sheila L. Videbeck, SM Batangas Event Center, Batangas City July 27, 2008

“Lyceum of the Philippines-Batangas: Leading the Way for Competitive Future Professionals”

Freedom Hall Building, Lyceum of the Philippines-Batangas February 20, 2008

“Fundamentals of Nursing Relating Old Concepts to New Ideas in an Evidence- Based Hospital Practice”

By Audrey Berman RN, AOCN, World Trade Center Metro Manila, Pasay City January 26, 2008

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