Documentation Specialist/ coding specialist/ risk adjustment

Zubia Shoaib

*****.******@*****.***/ 630-***-****

Professional Summary I am a certified professional coder and experienced documentation specialist with a demonstrated history of working in the healthcare industry. Skilled in ICD-9, ICD-10, charts reviewing, translation of clinical information into coding with the guidance of CMS, and experienced in healthcare management.Data collection, formulation of clinically credible queries for the physician to ensure accurate documentation and communication are my strong skills. CPC/CCS

Skills

● Management

● Medical terminology and disease pathophysiology

● Computer skills( Word, Excel, Power point)

● Review medical records for completeness and accuracy of severity of illness(SOI) using CDMP(Compliant documentation management program) strategies

● IPPS and OPPS payment systems

● MS-DRG system

● APR-DRG

● SOI and ROM

● Revenue cycle

● High weight GRG

● CCs and MCCs documentation

● Familiar with Epic/ HCC Coder/ Eclinicalworks/ Practice fusion

● 3M 360 coding software

● Revenue reimbursement Optimization

● Both Concurrent and Retro account review

● Queries generation and communication with the physician

● Critical thinking and advanced medical knowledge Professional Experience Coding Specialist at Optum/ United Health Group: 01/01/2022- Present

● Medical coding, both inpatient and outpatient-Medicare and commercial.

● Handle multiple projects and different encounters

● Blind charts, OS, RADV to increase auditing activity and to increase payment errors

● Submit provider queries for missing or wrong patient chart information for clarification purpose

● Maintained strong medical knowledge, identify disease process and coding of correct procedures

● Communication with other team members and participate in team meetings

● Risk adjustment coding

● Abstract the codes according to AHA ICD 10 CM/PCS, UHDDS and CMS regulations and guidelines. Utilize encoder to assign codes and MS-DRG/APR-DRG assignment.

● Maintains coding accuracy 90% and above.

● Biweekly assessment to maintain competency

Clinical Coordinator: Exult Healthcare: 10/2018- 10/2021

● Patient interviews and answer their questions by communicating with the physician. Charts reviewing and coding, data extraction, analyzing documents and disease processes. Coding of the charts, query providers for any misinformation or documentation error. Check for the correct codes using ICD-10 CM guidelines. Use of encoder.

● Prior authorizations, insurance verifications, data entry, and presentation of the case and queries to the physician. Communication with staff members for data collection and explanation of treatment plan.I am a certified TMS coordinator. I am a certified coordinator for NeuroStar and Brainsway TMS. 2016-2018-Sunbeam Clinical research-Clinical Research Coordinator

● Patient interview and complete the recruitment process based on the inclusion and exclusion criteria. Collection of the data and maintain the paper work as per GCP guidelines. Communication with the physicians and maintaining patients charts, handling queries, and submission of paperwork to primary sponsors Education Education

I am a foreign Medical doctor-M.B.B.S from Sindh Medical University, Karachi, Pakistan. I am BSN/RN at University of Texas at Arlington. Credentials:

CPC- AAPC CCS-AHIMA

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