Jasmine Pagan
Bayonne,NJ
Summary
Detail-oriented Certified Professional Coder with over 10 years in professional fee coding and revenue cycle management. Expertise includes auditing codes, reviewing complex medical documentation, and applying ICD-10-CM and CPT guidelines. Skilled in identifying discrepancies, resolving claim edits, and investigating denials to secure accurate reimbursements.
Overview
1
1
Language
1
1
Certification
10
10
years of professional experience
Work History
PB Coder IV
Hackensack Meridian Health
Remote, NJ
02.2024 - Current
- Review and analyze medical records and clinical documentation to ensure accurate code assignment, medical necessity, and compliance with coding guidelines.
- Assign CPT, HCPCS, and ICD-10-CM codes for professional fee, inpatient, outpatient, and emergency department services, ensuring accurate reimbursement and regulatory compliance.
- Apply ICD-10-CM, CPT, HCPCS, DRG, and APC coding methodologies based on clinical documentation and applicable guidelines.
- Conducted coding for various specialties to ensure compliance and accuracy in billing. across Family Medicine, Internal Medicine, Pediatrics, Dermatology, Endocrinology, Podiatry, Gastroenterology, Pulmonology, and other specialties.
- Initiated and responded to physician queries to clarify documentation and ensure precise code assignment.
- Researched and resolved NCCI, NCD/LCD, payer, and coding edits to ensure accurate claim submission and maximize reimbursement.
- Abstracted and analyzed diagnostic and procedural data to enhance coding accuracy and optimize reporting and reimbursement.
- Maintain established productivity, quality, and accuracy standards while completing special projects and departmental initiatives.
Profee Coder
Omega Healthcare
Remote, NJ
02.2025 - 03.2025
- Validated CPT, ICD-10-CM, and modifier assignment for coding accuracy and compliance with payer requirements.
- Reviewed clinical documentation to verify medical necessity, coding accuracy, and proper code selection.
- Corrected coding discrepancies to support accurate reimbursement and minimize claim denials.
- Resolved Professional Fee coding edits and scrubber errors, ensuring clean claim submission.
Senior Coding Analyst
Optum
Secaucus, New Jersey
10.2016 - 01.2024
- Conduct denial coding reviews, investigate denial reasons, and identify coding discrepancies to safeguard revenue.
- Evaluate billed services and procedures for documentation accuracy, medical necessity, and payer compliance to support optimal reimbursement.
- Resolve claim edits, clearinghouse rejections, coding discrepancies, and registration issues to minimize payment delays.
- Perform Professional Fee (ProFee) coding and maintain Excel reports to track coding trends, denials, and revenue opportunities.
- Code Emergency Department, inpatient, and outpatient encounters using ICD-10-CM, CPT, HCPCS, DRG, and APC methodologies.
- Perform multispecialty coding for Family Medicine, Internal Medicine, Pediatrics, Dermatology, Endocrinology, Podiatry, Gastroenterology, and Pulmonology.
- Oversee pediatric revenue cycle processes, including patient registration, guarantor accounts, and front-end and back-end coding to ensure accuracy and compliance.
- Participate in coding education, webinars, audits, and special projects to remain current with coding guidelines and regulatory changes.
Education
Trade School - Medical Coding And Billing
Branford Hall Career Institute
Jersey City, NJ08-2015
Skills
- Professional Fee Coding ICD-10-CM CPT HCPCS
E/M Coding Modifiers Coding Audits Denial Management
Claim Edits Documentation Review Medical Necessity
Revenue Cycle Management Coding Compliance Physician Education
Claims Analysis Excel Reporting Coding Research - CPT coding
- Claim Reimbursement
- HCPCS coding
- ICD-10 coding
Languages
Spanish
Native/ Bilingual
Certification
- CPC
- CPEDC
Timeline
Profee Coder
Omega Healthcare
02.2025 - 03.2025
PB Coder IV
Hackensack Meridian Health
02.2024 - Current
Senior Coding Analyst
Optum
10.2016 - 01.2024
Trade School - Medical Coding And Billing
Branford Hall Career Institute