Libermis Minguez Ramirez
Miami,USA
Summary
Skilled Medical Biller and Coder with comprehensive experience in healthcare billing, coding procedures, insurance claims, and payment processing. Possess strong knowledge of medical terminology, ICD-10 codes, HCPCS and electronic health records. Known for high accuracy rates in coding and billing operations while ensuring compliance with industry regulations. Previous roles highlighted by improved efficiency in medical record management and enhanced revenue recovery efforts.
Overview
6
6
years of professional experience
1
1
Certification
Work History
Patient Support Medical/Medical Biller and Coder
Felicidad Medical Research LLC
Miami, FL
10.2023 - Current
- Meticulously verified patient demographic information, insurance details, diagnosis and procedure codes utilizing ICD-10 and CPT coding system.
- Processed medical claims by verifying and validating supporting documentation provided by HCPs or patients, interpreting EOB/CMS1500, and evaluating the eligibility of the claim for payment or rejection.
- Worked closely with pharmacies and providers to optimize information sharing processes, leading to expedited claim resolutions.
- Enhanced billing efficiency by optimizing the interpretation of Primary Insurance EOBS and EOPs, facilitating better coordination of benefits.
- Processed claims meticulously following CMS guidelines for procedures and diagnosis codes.
- Exceeded 24-hour turnaround times consistently.
- Assigned patients to diagnosis-related groups using appropriate computer software.
- Read through patient health data, histories, physician diagnoses and treatments to gain understanding for coding purposes.
- Maintained current CPT, HCPCS codes library as well as ICD-9, 10 CM diagnostic codes.
- Reviewed received payments for accuracy and applied to intended patient accounts.
Billing/Executive Medical Coder
Felicidad Medical Center Inc
Miami, USA
04.2021 - 09.2023
- Served as a coding support, providing education and training on quality of documentation, level of service, and diagnosis coding in conformity with established guidelines.
- Enhanced the accuracy of claims through thorough preparation of documents and reports, while consistently updating corresponding files.
- Reviewed medical record information to determine suitable coding according to CMS HCC categories..
- Executed a comprehensive approach utilizing a combination of phone calls, emails, and letters to enhance collection effectiveness for overdue accounts.
- Interpreted medical terminology and pharmacological information to translate information into coding system.
- Interpreted physician orders, notes, lab results, radiology reports. for appropriate code assignment.
- Tracked details such as authorizations, pre-certifications or referrals required prior to service delivery.
Medical Assistant
Imed
Burjassot, Valencia
01.2019 - 02.2021
- Verified appointment times with patients, preparing charts, pre-admission and consent forms.
- Organized charts, documents and supplies to maintain team productivity.
- Measured vital signs and took medical histories to prepare patients for examination.
- Filed insurance claims forms in accordance with applicable regulations.
Education
High School Diploma -
IPVC JOSE MACEO
GUANTANAMO07-1999
Skills
- Critical analytical and interpretative skills
- Medicare Risk Assessment
- Strategic Issue Resolution
- Multitasking and Organization
- Medicaid and Medicare Knowledge
- Strong organization and process management skills
- Proficient in Microsoft Word and Excel
- Medical billing procedures
- Diagnostic coding
- HIPAA compliance
- UB-04 form completion
- Medical coding expertise
- HCPCS level II coding
- CMS-1500 form completion
Certification
Certified Professional Coder (CPC), 02/12/2025, Pioneered a comprehensive medical auditing system, enhancing accuracy in diagnostic identification and eliminating duplicate claims. Partnered with insurance policy agents to review custom-made policies, ensuring alignment with client needs and company standards.
Languages
- English
- Spanish
Languages
English
Full Professional
Spanish
Native/ Bilingual
References
References available upon request.
Timeline
Patient Support Medical/Medical Biller and Coder
Felicidad Medical Research LLC
10.2023 - Current
Billing/Executive Medical Coder
Felicidad Medical Center Inc
04.2021 - 09.2023
Medical Assistant
Imed
01.2019 - 02.2021
High School Diploma -
IPVC JOSE MACEO
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