ISETTE ALVAREZ
Miami,FL
Summary
Medical coding professional with extensive experience in accurately coding patient records and ensuring compliance with healthcare regulations. Known for strong focus on team collaboration and achieving results, adaptable to changing needs. Skilled in utilizing coding software and maintaining detailed documentation, with reputation for reliability and precision.
Overview
29
29
years of professional experience
1
1
Certification
Work History
Medical Coder / Billing
Cano Health Inc.
Miami
01.2022 - 04.2026
- -Reviewed medical records documentation for primary care and specialists’ outpatient encounters and assign appropriate diagnosis, E/M codes and modifiers.
- -Collaborated with physicians to identify and clarify missing and conflicting or non-specific documentation related to diagnosis and procedures.
- -Performed post audit chart reviews improving the overall completeness of clinical documentation and evaluation of HEDIS measures, MRA and Hierarchical Conditions Category for Commercial Insurance and Medicare population.
- -Verify and ensure the accuracy and appropriate coding based on CMS HCC categories.
- Analyzed medical records for accurate coding and compliance with regulations.
- Collaborated with healthcare providers to clarify documentation and improve coding accuracy.
- Reviewed and resolved coding discrepancies to enhance operational efficiency.
- Led audits of coded data to maintain quality assurance and regulatory compliance.
- Advocated for updates in coding procedures based on evolving industry standards and practices.
- Correctly coded and billed medical claims for various hospital and nursing facilities.
- Reviewed patient charts to better understand health histories, diagnoses, and treatments.
- Applied official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services to assign diagnostic codes.
- Reviewed outpatient records and interpreted documentation to identify diagnoses and procedures.
- Ensured compliance with industry regulations and guidelines by staying up-to-date on the latest coding changes.
- Collaborated with physicians to obtain necessary documentation, improving claim approval rates.
- Supported the implementation of electronic health record systems, simplifying the coding process.
Pharmacy Technician
Cano Health Inc.
01.2017 - 01.2022
- Prepare medicine after doctor approval and prescription for patient and communicate with patients and doctors to ensure proper distribution.
Pharmacy Tech
Belen Medical Center
01.2016 - 01.2017
- Prepare medicine after doctor approval and prescription for patient and communicate with patients and doctors to ensure proper distribution.
Pharmacy Tech / Medical Billing Clerk
I.M.C.
01.2013 - 01.2016
- Assisted in the process of getting medicine to patients from prescription to delivery, including but not limited to interpreting doctor prescriptions, bottling, communicating with patients with medicine information and working on the logistics of delivery to patients home.
Medical Billing Clerk
DNA Billing
01.2009 - 01.2013
- Input coded information into systems for billing purposes and send information to patient's insurance for payment.
Pharmacy Technician / Billing Clerk
Pharma Express
01.2004 - 01.2009
- Assist pharmacist in the distribution of medicines to patient's prescriptions and OTC medications, assemble medicine for prescriptions and provide information to patients and other health care professionals. Support pharmacological services by stocking, assembling and distributing drugs. Interpret doctor issued prescriptions, count medications and work with customers to ensure quality services and meet any needs necessary. Input coded information into systems for billing purposes and send information to patients' insurance for payment. Prepare medicine after doctor approval, including bottling, label making, and specification printing for patient.
Pharmacy Technician / Billing Clerk
STAT Pharmacy
01.1997 - 01.2004
- Prepare medicine after doctor approval for patient, including bottling, label making, and specification printing for patient. Billing medicine costs to patient's insurance and completing any other necessary steps in insuring the patients receival of the medicine and proper billing of cost to insurance.
Education
Medical Coding and Billing Certification (CPC) -
01-2016
Pharmacy Technician License - undefined
01-2010
Speech Therapy License - undefined
01-1993
High School Diploma - undefined
01-1989
Skills
- I am knowledgeable in various Microsoft office programs including word and excel I am proficient in typing and program use I have experience working with the public in and out of medical facilities with both English and Spanish speakers I am organized, creative, punctual and responsible I have acquired the skills to abstract medical information and convert it into coding for medical billing reasons I can work in a team setting as well as on my own
- Medical terminology
- HIPAA compliance
- HCPCS coding
- Medical billing
- Data entry
- Insurance verification
- Insurance coding (ICD-9 and CPT)
- Clinical documentation
- Medical claims coding
- Regulatory guidelines
- Diagnostic coding
- Claims processing
- Continuing education
Certification
- CPC - Certified Professional Coder
Languages
Spanish
Native or Bilingual
English
Professional Working
Timeline
Medical Coder / Billing
Cano Health Inc.
01.2022 - 04.2026
Pharmacy Technician
Cano Health Inc.
01.2017 - 01.2022
Pharmacy Tech
Belen Medical Center
01.2016 - 01.2017
Pharmacy Tech / Medical Billing Clerk
I.M.C.
01.2013 - 01.2016
Medical Billing Clerk
DNA Billing
01.2009 - 01.2013
Pharmacy Technician / Billing Clerk
Pharma Express
01.2004 - 01.2009
Pharmacy Technician / Billing Clerk
STAT Pharmacy
01.1997 - 01.2004