Gemma D. Bernales, CPC, CHONC
OKLAHOMACITY,OK
Summary
Dedicated Certified Coding Specialist known for adaptability and professionalism. Strong skills in coding accuracy and compliance contribute to improved revenue cycle operations and reduced errors. Ready to drive positive outcomes in healthcare coding and billing processes.
Overview
17
17
years of professional experience
Work History
Certified Coding Specialist
OU Health Science Center
Oklahoma City, OK
03.2018 - 06.2024
- Reviewed and assigned appropriate ICD-10 and CPT codes for medical and surgery procedures to maintain compliance and coding accuracy.
- Monitored coding regulation changes, assessed compliance impact, and communicated updates to the team to maintain adherence to state and federal requirements.
- Managed precise code assignment practices to improve code quality, reducing errors and limiting later adjustments.
- Maintained current knowledge of insurance guidelines and coding regulations to reduce insurance claim denials.
- Collaborated with colleagues to drive cross-specialist contributions for complex cases, improving overall productivity across organization.
- Coordinated cross-training across multiple specialties to maintain task assignment flexibility and meet team needs through adaptable workforce coverage.
- Partnered with physicians and clinical staff to verify documentation accuracy aligned with billing requirements.
- Coordinated documentation clarification efforts with healthcare providers to enhance coding accuracy and strengthen revenue cycle operations.
Certified Coding Specialist
OU HSC College of Internal Medicine
Oklahoma City, OK
08.2017 - 02.2018
- Reviewed and assigned appropriate ICD-10 codes for various medical procedures to ensure compliance and accuracy.
- Collaborated with healthcare providers to clarify documentation and improve coding accuracy, enhancing revenue cycle efficiency.
- Reduced claim denials by maintaining up-to-date knowledge of insurance guidelines and coding regulations.
- Optimized workflow efficiency through cross-training in multiple specialties, enabling flexibility in task assignments according to team needs.
Certified Coding Specialist
Stephenson Cancer Center
Oklahoma City, OK
03.2015 - 02.2018
- Assigned ICD-10 codes for medical procedures to maintain compliance and accuracy.
- Collaborated with healthcare providers to clarify documentation and improve coding accuracy, enhancing revenue cycle efficiency.
- Analyzed reports on coding discrepancies, providing insights that informed strategic decisions for operational improvements.
- Reduced claim denials by maintaining up-to-date knowledge of insurance guidelines and coding regulations.
- Collaborated with physicians and clinical staff to ensure accurate documentation for proper billing purposes.
Billing Specialist (Part Time)
Fedcare - The Broadway Clinic
Oklahoma City, OK
04.2014 - 10.2015
- Charge Entry
- Payment Posting
- Negotiated with insurance companies to resolve disputed claims, securing rightful payments.
- Filing Form 19 & Collection
- Physical Lien Preparation
Medical Assistant (Part Time)
Advanced Pain Management
Oklahoma City, OK
11.2012 - 03.2015
- Coordinated patient scheduling to optimize clinic workflow and reduce wait times.
- Educated patients on treatment plans and post-procedure care instructions for enhanced compliance.
- Assisted in patient assessments and documented vital signs for accurate medical records.
Medical Billing Specialist
The Broadway Clinic
Oklahoma City, OK
04.2007 - 03.2015
- Reviewed patient accounts to identify discrepancies, resolving issues to improve overall billing efficiency.
- Analyzed billing workflows, recommending improvements that reduced errors and expedited collections.
- Posted and adjusted payments from insurance companies.
- Identified and resolved patient billing and payment issues.
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
- Collected payments and applied to patient accounts.
Medical Billing Specialist; PT Tech (Part Time)
Advanced Physical Therapy
Oklahoma City, OK
04.2007 - 03.2015
- Processed insurance claims and patient billing with accuracy and attention to detail.
- Coordinated with healthcare providers to resolve billing discrepancies and ensure timely payments.
- Audited and corrected billing and posting documents for accuracy.
- Used data entry skills to accurately document and input statements.
- Performed modalities such as electrical stimulation, ultrasound, hot/cold packs, paraffin.
Medical Assistant (Part Time)
Interventional Spine Services
Oklahoma City, OK
04.2008 - 03.2014
- Obtained client medical history, medication information, symptoms, and allergies.
- Directed patients to exam rooms, fielded questions, and prepared for physician examinations.
- Assisted physicians with minor surgeries, including preparing operating room and sterilizing instruments.
- Optimized appointment scheduling processes to minimize conflicts and maximize physician availability for patients.
- Sanitized, restocked, and organized exam rooms and medical equipment.
Education
Bachelor of Science - Nursing
Urdaneta City University
Urdaneta City, Philippines10-1991
Medical Coding - Medical Coding / ICD 10
Metro Norman Technology Center
Oklahoma City, OK06-2014
Skills
- Professional ethics
- Time management capabilities
- Time management
- Continuous learning mindset
Timeline
Certified Coding Specialist
OU Health Science Center
03.2018 - 06.2024
Certified Coding Specialist
OU HSC College of Internal Medicine
08.2017 - 02.2018
Certified Coding Specialist
Stephenson Cancer Center
03.2015 - 02.2018
Billing Specialist (Part Time)
Fedcare - The Broadway Clinic
04.2014 - 10.2015
Medical Assistant (Part Time)
Advanced Pain Management
11.2012 - 03.2015
Medical Assistant (Part Time)
Interventional Spine Services
04.2008 - 03.2014
Medical Billing Specialist
The Broadway Clinic
04.2007 - 03.2015
Medical Billing Specialist; PT Tech (Part Time)
Advanced Physical Therapy
04.2007 - 03.2015
Medical Coding - Medical Coding / ICD 10
Metro Norman Technology Center
Bachelor of Science - Nursing
Urdaneta City University