DAYANA ALARCON PRADO
Round Rock
Summary
Certified Professional Coder – Apprentice (CPC-A) with experience in Risk Adjustment coding and HCC condition capture for UHC Medicare Advantage and UHC ACA populations. Skilled in reviewing medical records and assigning accurate ICD-10-CM diagnosis codes based on provider documentation and CMS Risk Adjustment guidelines. Detail-oriented professional committed to coding accuracy, compliance, and maintaining high productivity and quality standards in remote coding environments.
Overview
2
2
years of professional experience
Work History
Risk Adjustment Medical Coder
Optum (Contract through The Judge Group)
04.2025 - Current
- Identify and capture HCC conditions to support accurate risk adjustment.
- Assign accurate ICD-10-CM diagnosis codes based on provider documentation.
- Perform retrospective chart reviews to ensure accurate reporting of risk-adjustable diagnoses.
- Review and code medical records for UHC Medicare Advantage and UHC ACA Risk Adjustment projects.
- Reviewed high volumes of medical records, ensuring quality and timely completion in alignment with established deadlines.
Medical Coder
Viva Health Clinic
01.2024 - 03.2025
- Applied ICD-10, CPT, and HCPCS coding for accurate diagnoses and procedures.
- Reviewed medical records for coding accuracy and compliance with payer guidelines, contributing to successful claims processing.
- Managed coding workflows using eClinicalWorks (eCW) and other EHR systems.
- Queried providers for clarification to enhance documentation and coding accuracy, supporting overall compliance.
- Collaborated with billing team to resolve claim issues, facilitating improved reimbursement outcomes.
Education
Certified Professional Coder – Apprentice (CPC-A) -
AAPC
12-2024
Medical Office Specialist Diploma -
NPTI
Miami, FL12-2024
Skills
- Risk Adjustment Coding
- HCC Condition Capture
- UHC Medicare Advantage Risk Adjustment
- UHC ACA Risk Adjustment
- ICD-10-CM Diagnosis Coding
- CPT coding
- Medical Record Review
- Clinical Documentation Review
- HIPAA Compliance
- attention to detail
Languages
- English
- Spanish
Timeline
Risk Adjustment Medical Coder
Optum (Contract through The Judge Group)
04.2025 - Current
Medical Coder
Viva Health Clinic
01.2024 - 03.2025
Certified Professional Coder – Apprentice (CPC-A) -
AAPC
Medical Office Specialist Diploma -
NPTI