Diaren Yunez
MIAMI,FL
Summary
Oriented medical professional with 19 years of experience in healthcare administration, medical coding, and billing. Expertise in documentation and reimbursement processes drives efficiency and accuracy. Proven track record of delivering high-quality work while pursuing continuous professional development. Committed to contributing to organizational growth and success.
Overview
19
19
years of professional experience
Work History
Professional Coder
University of Miami
04.2017 - Current
- Conduct thorough reviews of OP Report documentation and Encounter Notes, meticulously identifying and rectifying inconsistencies, deficiencies, and discrepancies in medical documentation.
- Ensure accuracy of ICD-10, ICD-9, CPT, and HCPCS codes and modifiers based on data retrieved from documentation, adhering to insurance guidelines, LCD, and CCI edits.
- Communicate with physicians regarding coding documentation deficiencies or edits via email to facilitate accurate coding practices.
- Evaluate, verify, and efficiently complete unbilled claim cases, enhancing revenue cycle management.
- Perform denial coding reviews and corrections within established time frames to improve claim approval rates.
- Code neurosurgery cases, including spine surgeries, open skull base procedures, craniotomies, stereotactic radiosurgery, and neuro-endovascular procedures, ensuring compliance with coding standards.
Manager of Coding & Billing Department
LG Diagnostic, Inc
01.2010 - 04.2017
- Collaborated with various provider specialties, including Family Practice, Internal Medicine, Otolaryngology, Orthopedic Surgery, Physical/Occupational Therapy, Pain Management, Ambulatory Surgery, Chiropractic, Dermatology, and Diagnostic Services (Laboratory, X-Ray, Sonograms, PFT, NCV, etc.).
- Meticulously identified and rectified inconsistencies, deficiencies, and discrepancies in medical documentation to ensure compliance and accuracy.
- Ensured the accuracy of ICD-10, ICD-9, CPT, and HCPCS codes and modifiers based on documentation and coding audits, adhering to insurance guidelines for proper reimbursement.
- Conducted thorough research on newly identified diagnoses and medical procedures to enhance team skills and knowledge.
- Led clinical documentation improvement initiatives, developed internal education programs, and facilitated physician education sessions to promote best practices.
- Evaluated and coordinated unbilled, denial, and rejected reports to ensure all corrections were completed within specified time frames.
- Committed to maintaining the security of patient health information and compliance with HIPAA regulations.
- Performed additional duties and special projects as assigned to support departmental goals.
Medical Coder & Biller
Dnatural Rehabilitation Center
01.2006 - 01.2009
- Company Overview: General Medicine & Chiropractic Facility
- Assigned ICD-9-CM and CPT codes accurately and in compliance with current internal and external coding guidelines.
- Monitored and analyzed regulatory coding changes to ensure ongoing adherence to updated rules and regulations.
- Collaborated with physicians and clinical staff to clarify coding issues and ensure precise and complete medical record coding.
- Supported seamless billing operations by verifying code accuracy for various medical and chiropractic services.
- General Medicine & Chiropractic Facility
Education
• Certified Professional Medical Auditor
American Academy of Professional Coders
01-2016
• Certified Risk Adjustment
American Academy of Professional Coders
01-2016
Certified Professional Coder
American Academy of Professional Coders
01-2013
Bachelor of Science - Information Technology
American Intercontinental University
01-2004
Associate of Science - Natural Health
Florida College Or Natural Health
Florida01-2001
Skills
- Comprehensive knowledge of Medicare rules for Teaching Physicians, including billing and documentation guidelines
- Proficient in ICD-9/ICD-10, CPT, HCPCS coding, and HIPAA compliance
- Strong understanding of medical coding guidelines, compliance regulations, and reimbursement processes
- Skilled in medical record auditing
- Experienced with EHR and billing systems including Epic, Cerner, Availity, Practice Fusion, Kareo, NDC Lytec, AdvancedMD, EzClaim, and Medisoft
- Proficient in Microsoft Office Suite (Outlook, Word, Excel, etc)
- Knowledgeable in documentation requirements for PIP, Bodily Injury, and Commercial Liability cases
- Fluent in Spanish (bilingual)
Timeline
Professional Coder
University of Miami
04.2017 - Current
Manager of Coding & Billing Department
LG Diagnostic, Inc
01.2010 - 04.2017
Medical Coder & Biller
Dnatural Rehabilitation Center
01.2006 - 01.2009
• Certified Professional Medical Auditor
American Academy of Professional Coders
• Certified Risk Adjustment
American Academy of Professional Coders
Certified Professional Coder
American Academy of Professional Coders
Bachelor of Science - Information Technology
American Intercontinental University
Associate of Science - Natural Health
Florida College Or Natural Health
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