Jose Roberto Diaz
Lake Mary
Summary
Certified Medical Coding Specialist with 12+ years of experience in inpatient and outpatient coding, specializing in accurate assignment of ICD-10-CM, ICD-10-PCS, CPT, and HCPCS Level II codes. Extensive experience reviewing complex medical records, ensuring compliance with CMS regulations, Official Coding Guidelines, and payer requirements. Proven ability to maintain high productivity and accuracy in remote coding environments while collaborating with CDI, physicians, and revenue cycle teams to improve documentation and optimize reimbursement.
Overview
14
14
years of professional experience
1
1
Certification
Work History
Medical Coding Specialist
Gebbs Healthcare Solutions
12.2017 - 03.2026
- - Assigned ICD-10-CM, CPT, and HCPCS Level II codes for outpatient and professional fee encounters.
- - Reviewed patient medical records to abstract diagnoses, procedures, and services for accurate claim submission.
- - Ensured compliance with CMS regulations, payer guidelines, and national coding standards.
- - Collaborated with billing and revenue cycle teams to resolve coding discrepancies and reduce claim denials.
- - Maintained high productivity and coding accuracy while meeting established departmental metrics.
- - Participated in coding education programs and regulatory updates to remain current with industry changes.
Inpatient Coding Specialist
IKS Health
12.2015 - 01.2026
- - Reviewed complex inpatient medical records to assign accurate ICD-10-CM and ICD-10-PCS codes for diagnoses and procedures.
- - Analyzed operative reports, physician notes, diagnostic results, and discharge summaries to ensure complete and accurate coding.
- - Maintained compliance with CMS regulations, Official Coding Guidelines, and payer policies.
- - Submitted physician queries to clarify incomplete or conflicting documentation.
- - Maintained high coding accuracy and productivity standards in a fast-paced remote coding environment.
Medical Office Manager
Bayamón Medical Center
05.2015 - 02.2019
- - Managed daily operations of a busy medical office, including staff scheduling, patient flow, and administrative oversight.
- - Implemented office policies and procedures to maintain compliance with healthcare regulations.
- - Supervised and trained administrative staff to ensure efficient operations and quality patient service.
- - Managed EHR systems and patient documentation processes.
- - Coordinated with healthcare providers, insurance companies, and vendors to streamline workflow.
Medical Records Clerk
Triple-S Inovalon
05.2012 - 02.2014
- - Performed medical record audits to evaluate coding accuracy and documentation quality.
- - Identified coding discrepancies and potential compliance risks.
- - Ensured claims met payer requirements and CMS guidelines.
- - Prepared audit reports and recommendations to improve coding processes.
- - Provided documentation education and feedback to providers and coding staff.
Education
Bachelor of Science - Biology
University of Puerto Rico
San Juan01-2007
Skills
- - ICD-10-CM Diagnosis Coding
- - ICD-10-PCS Procedure Coding
- - CPT / HCPCS Level II Coding
- - Inpatient Coding & DRG Assignment
- - Outpatient Coding
- - Medical Record Review & Abstraction
- - Physician Query Process
- - CMS Compliance & Official Coding Guidelines
- - Clinical Documentation Improvement (CDI) Collaboration
- - Electronic Health Records (EHR)
- - Coding Quality Audits
Certification
- Certified Professional Coder (CPC) – AAPC
- Certified Documentation Expert – Outpatient (CDEO) – AAPC
Languages
English
Full Professional
Spanish
Native or Bilingual
Timeline
Medical Coding Specialist
Gebbs Healthcare Solutions
12.2017 - 03.2026
Inpatient Coding Specialist
IKS Health
12.2015 - 01.2026
Medical Office Manager
Bayamón Medical Center
05.2015 - 02.2019
Medical Records Clerk
Triple-S Inovalon
05.2012 - 02.2014
Bachelor of Science - Biology
University of Puerto Rico