Diosmeli Gutierrez
Certified Risk Adjustment Coder
Miami,FL
Summary
Medical Billing and Coding Specialist with 7 years providing administrative and patient support in hospital and medical office settings. Advanced knowledge of private insurance processes and codes. Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy.
Overview
7
7
years of professional experience
Work History
Risk Adjustment Coder
MedFlorida Medical Center
Miami Lakes , FL
01.2023 - Current
- Reviewed medical records for completeness and filed records in alphabetic and numeric order.
- Utilized electronic medical record systems to store, retrieve, and process patient data.
- Pre and Post-Medical Records Review
- Capture and Validate New HCC
- Review Medical Records from other types of sources and Recommend New findings or diagnoses to Providers.
- Managed over 50 customer calls per day.' or, "Increased sales by 10%".
Medical Coding Specialist
Doctors Medical Centers
01.2019 - 01.2023
- Worked with individual patients to code medical observations and professional services.
- Resourcefully used various coding books, procedure manuals, and on-line encoders.
- Correctly coded and billed medical claims for various hospital and nursing facilities.
- Reviewed outpatient records and interpreted documentation to identify diagnoses and procedures.
- Interacted with physicians and other healthcare staff to ask questions regarding patient services.
- Reviewed, analyzed, and managed coding of diagnostic and treatment procedures contained in outpatient medical records.
- Verified signatures and checked medical charts for accuracy and completion.
- Reviewed patient charts to better understand health histories, diagnoses, and treatments.
- Generated reports to identify coding trends and discrepancies.
- Monitored changes in coding regulations to provide recommendations for compliance.
- Input data into computer programs and filing systems.
- Communicated effectively with staff, patients, and insurance companies by email and telephone.
Billing Clerk
Doctors Medical Center
01.2017 - 12.2018
- Monitored outstanding invoices and performed collections duties.
- Executed billing tasks and recorded information in company databases.
- Handled account payments and provided information regarding outstanding balances.
- Managed invoicing and payment processing operations.
- Handle Account Payments, Invoices, Reconciliations, Write Offs.
- Capitated Payments Posting
- Pediatric Billing, Vaccines and EPSDT
- Data Entry, Bank Reconciliation
Education
Certifications CPC, CRC, CPMA - Medical Billing And Coding
CCM Coding Academy
Miami02.2018
High School Diploma -
Cerafin Sanchez Vladivia Pre _universitario
Cuba06.2010
Skills
- Patient Data Compilation
- Insurance Claims Analysis
- Proficiency in ECW, Greenway
- ICD10 Coding, HCC, V24, V28
- Patient Data Coding
- CPT Code Modifiers
- Information Sourcing
- Medical Billing Processing
- Treatment Documentation
- Medical History Recording
- Procedural Codes
- Insurance Billing
- File transmissions
- EDI, Clearing house User
Languages
English
Professional Working
Spanish
Native or Bilingual
Timeline
Risk Adjustment Coder
MedFlorida Medical Center
01.2023 - Current
Medical Coding Specialist
Doctors Medical Centers
01.2019 - 01.2023
Billing Clerk
Doctors Medical Center
01.2017 - 12.2018
Certifications CPC, CRC, CPMA - Medical Billing And Coding
CCM Coding Academy
High School Diploma -
Cerafin Sanchez Vladivia Pre _universitario
Similar Profiles
Yunei GonzalezYunei Gonzalez
Cleaner at medflorida medical centerCleaner at medflorida medical center
MAREUG GONZALEZMAREUG GONZALEZ
Patient Service Representative at MEDFLORIDA MEDICAL CENTERPatient Service Representative at MEDFLORIDA MEDICAL CENTER
Nadine SamuelNadine Samuel
Medical Assistant/Check In/Check Out / Phlebotomist at MEDFLORIDA MEDICAL CENTERSMedical Assistant/Check In/Check Out / Phlebotomist at MEDFLORIDA MEDICAL CENTERS