risk adjustment coder, biller
Resume:
YAMILE COBAS VALDES
***********@*****.***
Miami, FL 33186
Professional Summary
Hardworking team player, focused on completing work quickly to consistently exceed targets. Reliable team member accustomed to taking on challenging tasks. Dedicated to business success. Work well independently and I'm always ready to go beyond basic assignments. Quick learner with good computer abilities. Skills
• Microsoft Office Excel & Word
• Outlook Medical Programs
• Bilingual
• Time Management
• Communication
Experience
Medical Billing and Coding Specialist, Access Medical Center August 2024-Present
•Provided administrative support to physicians and interpreted medical reports and data to assign ICD-10 codes; entered diagnosis codes and patient information into billing software.
• Updated and managed diagnosis lists, coordinated routine documentation and coding audits, and executed qualitative analyses of discharged charges.
• Followed and maintained currency on coding, sequencing, and procedures’ best practices and updates.
• Reviewed and validated accuracy of charges, including dates of service, services provided, location, patient identification, and provider signature.
• Regularly worked with systems such as MDVita, ECW and Tebra. MRA Specialist, Prime Health Physicians October 2022 - May 2024
• Review outpatients medical record information on both retroactive and prospective bases to identify, assess, monitor and document claims and encounter coding information as it pertains to risk adjustment and quality metrics.
• Account for coding and abstracting of patient encounters, including diagnostics and procedural information, significant reportable elements and complications.
• Ensure that the diagnosis codes for each chronic medical condition have been captured and submitted within the permitted time frame.
• Research and analyze data needs for reimbursement, as well as medical records and identify documentation deficiency.
• Review and verify documentation supports diagnoses, procedures and treatment results. • This position includes ongoing quality improvement activities to assure the organization's MRA programs are implemented and meet all requirements.
Yamile Cobas Resume 2023
• Responsible for assigning the correct code to describe the type of service a patient will receive. They ensure the codes are applied correctly during the medical billing process, which includes removing the information from documentation, assigning the appropriate codes, and creating a claim to be paid by insurance carriers.
• Evaluate Chronic conditions and comorbidities, as well as mastery of ICD-10-CM guidelines and risk adjustment guidelines. As CRCs, they are equipped both to ensure clinical documentation accurately portrays the patient’s health status and to ensure all clinically documented diagnoses are properly reported. Medical Coder (MRA), Cano Health February 2022 - September 2022
• Reviewed and verify documentation supports patients’ procedures and diagnosis by interacting with physicians go ensure their accuracy.
• Utilized systems such as 10CM, CPT, and HPCS coding books to store data of patients visits. •Maintained compliance and HIPAA regulations by keeping patient information confidential.
• This position includes ongoing quality improvement activities to assure the organization's MRA programs are implemented and meet all requirements.
• Evaluate Chronic conditions and comorbidities, as well as mastery of ICD-10-CM guidelines and risk adjustment guidelines. As CRCs, they are equipped both to ensure clinical documentation accurately portrays the patient’s health status and to ensure all clinically documented diagnoses are properly reported. Medical Coder, Centrum Health May 2021 - February 2022
• Maintained patient confidentiality and information security.
• Collected health information as documented by a medical specialist and code them appropriately. • Interacted with physicians and assistants to ensure accuracy of records.
• Utilized systems such as 10CM, CPT, and HPCS coding books to store data of patients visits. • Responsible for assigning the correct code to describe the type of service a patient will receive. They ensure the codes are applied correctly during the medical billing process, which includes removing the information from documentation, assigning the appropriate codes, and creating a claim to be paid by insurance carriers. Perfect Care Home Health Agency August 2021 - July 2022
• Responsible for coding and handling different types of medical claims.
• Abstracted patient information from medical records
• Excelled in PDGM code modeling.
• Assigned ICD10 and CPT diagnostic and procedural codes for billing. Payment posting Specialist, Mount Sinai Medical Center November 2015 - May 2021
• Filed records to keep system efficient and information organized.
• Processed all electronic checks and posted them correctly in individual accounts using Epic Hospital billing and Star program.
• Meet targets consistently by working hard and with strong attention to detail.
• Notified management of any issues related to payment posting, adjustments or denials. • Ensured client records are kept confidential.
• Manage multiple tasks and prioritize the needs of the company. Head Teller, Interamerican Bank February 2012 - November 2015
• Assisted tellers with complex tasks and oversaw the bank's work flow. Audit tellers monthly and quarterly to ensure compliance policies are being followed.
• Keep inventory of cashier's checks, money orders, and gift cards. Responsible for preparing currency transaction reports to the IRS (CTR and others).
• Maintained accurate and balanced cash drawers by carefully counting funds and quickly investigating any discrepancy as well as maintaining a balance of the vault to the bank's compliance standards. Certifications
• CPC- Certified Professional Coder AAPC ID# 01531768 • CRC- Certified Risk Adjustment Coder. AAPC • CPMA- Certified Professional Medical Auditor. AAPC • ID# 01531768 Education
AAPC School
. Medical Coder (February 2018)
University of Havana
• Law (July 1994)
Antonio Guitera
• High School Diploma (July 1989)
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