Estela Cervantes
Los Angeles,CA
Overview
6
6
years of professional experience
Work History
Coder I Certified
PIH Health Hospital
Whittier, CA
08.2022 - Current
- Accurately assign ICD-10-CM, CPT and HCPCS codes- ensuring compliance with organizational guidelines and industry standards
- Reviewed and resolved coding-related claims with billing to prevent further rejections, denials, and adjustments
- Manage a variety of specialties and projects for coding which include Orthopedic, Podiatry, Family Practice, Pulmonary, Vascular Studies, Mammograms, Cardiology Pacemakers, Neurology
- Knowledge and experience of computer software and coding applications for daily use that include e.H.R., RCx, SRIS, Epic, 3M Coding, Optum Encoder Pro, Outlook.
Certified Medical Coder
Molina Healthcare
Long Beach, CA
03.2020 - 07.2022
- Perform ongoing chart reviews and abstracts diagnosis codes
- Understanding of current billing practices in provider offices to ensure that ICD-10-CM diagnosis and CPT codes are submitted accordingly
- Document results from chart reviews and provide feedback to management, providers, and office staff
- Build positive relationships between providers and Molina by providing coding assistance when necessary
- Maintain knowledge in the latest coding guidelines (official through CMS) as well as AHA Coding Clinic guidance.
Medical Coder - Contractor
OPTUM/UHG
Los Angeles, CA
07.2019 - 01.2020
- Identify appropriate assignment of ICD-10 Codes for professional services and facility services
- EHR, MRM, NextGen experience
- Risk adjustment, HCC experience
- Abstract and code diagnosis and documentation information
- Ability to manage significant workload, and to work efficiently under pressure meeting established deadlines with minimal supervision
- Perform ongoing analysis of medical record charts for the appropriate coding compliance.
HCC Medical Coder, Specialist II
Davita Medical Group, HealthCare Partners
Commerce, CA
06.2018 - 07.2019
- Perform medical chart audits meeting productivity standards
- Educate clinicians on specific coding issues found in senior HMO pre-audits
- Train providers on Fee for Service (FFS) office visits Evaluation and Management
- Audit Evaluation and Management (E/M) notes and select the right office level visit
- Submit and follow up on query forms to clinicians based on inferred chart audit data
- Audit clinician charges to ensure acute code assignment to patient encounters
- Perform claims analysis for appropriate CPT and ICD-10 coding
- Identify CPT unbundling in claim submissions
- Use coding knowledge to work claim system edits.
HCC Medical Coder, Specialist I
Davita Medical Group, HealthCare Partners
Commerce, CA
06.2018 - 07.2019
- Review medical record information to identify all appropriate coding based on CMS HCC categories
- Serve as a key contact and liaison with clinicians to answer coding questions
- Provide status reports and productivity to management on a weekly basis
- Pass monthly quarterly audits with a successful score of 95-100%
- Audit internal medicine, UCC, family practice, and specialties - cardiology, pulmonology, endocrinology, neurology, infectious diseases, rheumatology, nephrology.
Education
CCS - IN PROCESS -
Prima Coding Masters
05.2024
CPC -
Ohana Medical Coding
05.2018
BA in Global Studies -
UC Santa Barbara
06.2013
Skills
- Touch works EMR (2 yeas)
- IDX (2 years)
- Encoder Pro (5 years)
- Epic (2 years)
- EMD (2 years)
- RCx (2 years)
- 3M (2 years)
- Outlook (7 years)
- Medical Coding
- ICD-10-CM
- CPT
- HCPCS
- AAPC Membership
License
CPC #01604800
Timeline
Coder I Certified
PIH Health Hospital
08.2022 - Current
Certified Medical Coder
Molina Healthcare
03.2020 - 07.2022
Medical Coder - Contractor
OPTUM/UHG
07.2019 - 01.2020
HCC Medical Coder, Specialist II
Davita Medical Group, HealthCare Partners
06.2018 - 07.2019
HCC Medical Coder, Specialist I
Davita Medical Group, HealthCare Partners
06.2018 - 07.2019
CCS - IN PROCESS -
Prima Coding Masters
CPC -
Ohana Medical Coding
BA in Global Studies -
UC Santa Barbara