Diana Quiceno
NYU Langone Medical Center-Central Billing Office
Port Saint Lucie,FL
6
years of professional experience
1
Certification
2
Languages
Business-focused compliance and revenue cycle professional with a background in coding quality assurance, clinic operations, and billing support. Recognized for strong decision-making, teamwork, and attention to detail. Committed to improving claim accuracy, supporting audit readiness, and strengthening operational performance.
Work History
Coding Integrity and Quality Assurance
3 Years 6 Months- Self-motivated, with a strong sense of personal responsibility.
- Skilled at working independently and collaboratively in a team environment.
- Analyze, review and monitor compliance with established protocols and regulations related to the coding and billing for professional medical services.
- Provide education and guidance to offshore team members to attain preestablish goals related to accurate claim submission, and regulatory guidelines for coding practices.
- Review and audit clinical documentation, CPT, HCPCS, modifiers, and ICD-10 coding to ensure accurate reimbursement and compliance with CMS and third-party payer regulations and laws.
- Pathology, Hospital Inpatient, outpatient, ED, urgent care, Internal Medicine, Multi-specialty workflow coding review and claim submission.
- Independently analyze and weigh the risks vs. benefits in decisions and recommendations related to provider billing and audit issues.
- Collaborates with our multidisciplinary team of AR, compliance and Coder QA analysts.
- Develop complete reports reflecting audit findings including negative and positive trends and presenting accurate findings to our leadership team.
- Presents updated coding and other informative educational material at Revenue Cycle meetings.
Outpatient Clinic Manager
8 Months- Coordinated daily clinic operations, aligning patient flow, scheduling, and staff coverage with behavioral health needs.
- Managed patient intake and insurance verification, improving access to care and administrative accuracy.
- Supervised front-desk and clinical support staff, reinforcing service standards and accountability.
- Monitored EMR documentation for completeness, supporting compliance and timely record updates.
- Communicated with the billing department, regional directors and the chief executive officer to ensure effective outpatient operational processes and HCC coding initiatives.
- Demonstrated proficiency in revenue cycle processes with the implementation of medical documentation guidelines, accurate patient information intake prior to claim submission and effective collection of patient financial responsibility.
- Oversaw the performance of administrative staff members to comply with the reimbursement methodology used by the federal programs and private insurance.
Central Billing Office Escalations Specialist
1 Year 1 Month- Verified eligibility and prior authorization requirements, reducing billing delays and appointment disruptions.
- Verified eligibility, prior authorization requirements, claim denials related to coordination of benefits (COB) and documentation issues.
- Collaborated with clinicians, case managers, and administrative staff to resolve billing and documentation issues.
- Trained new staff on departmental procedures, HIPAA compliance, and electronic medical record processes.
- Followed all company policies and procedures to deliver quality work.
- Improved customer satisfaction rates through proactive problem-solving and efficient complaint resolution.
- Assisted in developing a strategic plan that aligned with long-term company goals.
- Optimized customer experience by delivering superior services and effectively troubleshooting issues.
- Collected, arranged, and input information into a database system.
- Helped meet changing demands by recommending improvements to business systems or procedures.
- · Increased patient satisfaction and quality care benchmark goals by more than 30% within a period of seven months.
Education
Master of Science - Executive Health Administration
Bachelor of Science - Science in Biology
Skills
Compliance auditing
Attention to detail
Problem-solving
Critical thinking
Computer skills
Organizational skills
Decision-making
Effective communication
Teamwork and collaboration
Friendly
positive attitude
Certification
Certified Risk Adjustment Coder (CRC) 12/2024
American Academy of Professional Coders (AAPC)
Certified Professional Compliance Officer (CPCO)
American Academy of Professional Coders (AAPC)
OSHA and HIPAA 02/2023
Medical Group Management Association
Certified Medical Practice Executive (CMPE) 01/2023
American College of Medical Practice Executives
Certified Specialist Payment & Reimbursement 01/2023
Healthcare Financial Management Association (hfma)
Certified Professional Medical Auditor (CPMA) 09/2022
American Academy of Professional Coders (AAPC)
Certified Professional Coder (CPC) & Certified Outpatient Coder (COC) 07/2022
American Academy of Professional Coders (AAPC)
Languages
English
Native or Bilingual
Spanish
Native or Bilingual
Timeline
Coding Integrity and Quality Assurance
NYU Langone Medical Center-Central Billing Office
04.2023 - CurrentRead More
Outpatient Clinic Manager
Fort Lauderdale Behavioral Health Center
08.2021 - 04.2022Read More
Central Billing Office Escalations Specialist
NYU Langone Medical Center - Central Billing Office
07.2020 - 08.2021Read More
Florida Atlantic University
Master of Science from Executive Health Administration
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Florida Atlantic University
Bachelor of Science from Science in Biology
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