Outpatient Coder/SDS/Ancillary Coder

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**** ******* ****** * EASTVALE, CA *****

HOME PHONE 909-***-**** • CELL PHONE 909-***-****

E-MAIL: ***********@*****.*** ***********@***.***

SUSAN L.YAO, CPC, CCS

OBJECTIVE

To work in a full-service medical field as a coder utilizing my extensive training and experience in all aspects

SKILLS

Experience in various company database

Fluency in English, Mandarin, Taiwanese, and Tagalog languages Knowledge of medical terminology, medical billing and coding, and alpha numeric filing system

Proficiency in quality customer service

SUMMARY OF QUALIFICATIONS

Goal driven individual with coding and medical billing skills. Exceptional personality with strong abilities to interact with physicians/patients from all walks of life. Capable of performing with frequent interruptions /distractions with the ability to set priorities and meet deadlines.

Excellent communication and writing skills, with fluency in English, Mandarin, Taiwanese, and Tagalog languages.

Special ability to learn various job duties within an organization in a short period of time.

Knowledge and experience of terminal digit filing

Licensed Certified Professional Coder

Certified Coder Specialist

2

EDUCATION

Jan 2007 – Dec 2007 Hope of St. James Covina,

CA

Certified Coding Specialist Review Class

Nov 2003-Feb 2004 Hacienda La Puente Adult School La Puente, CA

Medical Billing and Coding Specialist

Jan 2003-Nov 2003 Hacienda La Puente Adult School La Puente, CA

Medical Terminology Certificate

Sep 2002-June 2004 Mt. San Antonio College

Walnut, CA

Medical Insurance Billing Specialist Certificate

June 1974-June 1978 Centro Escolar University Manila, Philippines

Doctor of Optometry

WORK EXPERIENCE

January, 2024-Present

Amergis

Outpatient coder

Review outpatient Health records and assigns ICD 10 diagnosis and CPT procedure codes. This involves a wide variety of medical specialties and clinical services and requires translation of the documentation into a corresponding code that captures and describes the patient’s condition and services provided. Review and verify chart information (i.e. POS, attending provider). Assess and inputs data.

Review and verify component parts of medical records to ensure for accuracy and completeness of diagnostic and therapeutic procedures that must conform to CMS coding rules and guidelines. 3

Ability to manage significant workload, and to work efficiently under pressure meeting established deadlines with minimal supervision. September 2023 – January 2024

University of California Health Irvine, California Coder 3

Coding and abstracting: Reviews medical record documentation to identify diagnoses to be coded.

Codes all appropriate diagnosis and procedures from the medical record using ICD-CM, ICD-PCS, CPT and HCSPCS coding classification systems.

Responsible for the sequencing of diagnoses and procedures in accordance with guidelines outlined in ICD-CM, ICD-PCS, CPT, Uniform Hospital Discharge Data Set, Medicare regulations and other appropriate classification systems.

Verifies and abstracts the appropriate data from the medical records to meet requirements for data submission and reporting. Ensures the accuracy and integrity of data abstracted and coded based upon medical record documentation prior to data submission or coding completion.

Interacts with physicians to clarify and accurately document patient diagnostic and procedural information.

May 2023 – May, 2024

Optum St Louis, MO

SDS Coder

Identify appropriate assignment of CPT and ICD-10 Codes for outpatient Ambulatory Observation services while adhering to the official coding guidelines and established client coding guidelines of the signed facility.

Apply coding knowledge to analyze/correct CCI Edits and Medical Necessity Edits

Understand the Medicare Ambulatory Payment Classification (APC) codes.

4

Abstract additional data elements during the chart review process when coding, as needed.

Provide documentation feedback to providers, as needed, and query physicians when appropriate.

November 2021 – July 2022

Canyon Ridge Hospital Chino, California

Coder

Accurately codes diagnoses from inpatient medical records using ICD 10 CM coding system.

Abstracts prescribed data elements from the medical records. Ensures compliance of coding rules and regulations according to Regulatory Agencies (CMS,OIG)

February 2008- June 2021

Kaiser Permanente Riverside, and Fontana CA

Coder II

Responsible for the timely coding and abstracting of medical records.

Code in accordance with current principles of ICD-10-CM and CPT guidelines using 3M coding system.

Responsible for accurate abstract of patient data into computerized database in accordance with department policies and guidelines and OSHPD discharge data reporting requirements. Ensure the accuracy of ICD-9-CM/ICD-10-CM coding of diagnoses which fall into HCC model as required by CMS for Medicare Advantage plans. See to it that the provider documentation of ICD-9-CM/ICD-10-CM codes meets both established coding standards as well as CMS Risk Adjustment guidelines.

Responsible for coding all Code inpatient charts of high dollar account.

Responsible for coding all diseases, on ED according to ICD-10-CM, UHDDS, American Medical Association’s CPT-4, according to client according to client specifications for more than 5 years. Responsible to discuss any unclear information needing clarification with supervisor and/or data quality specialist.

Works with 3M Encoder and EPIC EMR System.

Maintain productivity of 16 CPH.

Code inpatient charts of high dollar account.

5

Meet the productivity and accuracy guidelines of Kaiser Permanente

August 2013- February 2019

AE and Associates, LLC Corona, CA

Inpatient Coder

Responsible for the timely coding and abstracting of medical records.

Code in accordance with current principles of ICD-10-CM and CPT guidelines using 3M coding system.

Responsible for accurate abstract of patient data into computerized database in accordance with department policies and guidelines and OSHPD discharge date reporting requirements

Ensure the accuracy of ICD-10-CM coding of diagnoses which fall into HCC model as required by CMS for Medicare Advantage plans.

See to it that the provider documentation of ICD-10-CM codes meets both established coding standards as well as CMS Risk Adjustment guidelines.

Code inpatient charts of high dollar account

Meet the productivity guidelines of the hospital.

December 2013 – June 2014

Mawi Consulting, LLC Las Vegas, Nevada Coder

Reviewing medical records to validate ICD-9 codes for HCC reports are supported with correct documentation.

Perform chart audits & gathers unreported diagnosis codes. 6

6-23-2024, includes only work experience from 2014-present)

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