Maricela Obregon Morales
Pharr,TX
Summary
Certified Medical Coder known for productivity and efficiency in task completion. Possess in-depth knowledge of medical coding guidelines, expertise in ICD-10-CM, CPT, and HCPCS Level II coding systems, alongside proficiency in electronic health records (EHR) software. Excel at time management, adaptability to new regulations, and clear communication, ensuring accurate and timely billing processes.
Overview
9
9
years of professional experience
1
1
Certification
Work History
Certified Medical Coder
UTRGV School of Medicine
Edinburg, TX
04.2024 - Current
- Reviewed medical records and assigned appropriate codes to diagnoses, treatments, procedures, and services rendered by healthcare providers.
- Reviewed clinical data from medical records to assign ICD, CPT, and HCPCS codes.
- Analyzed patient data for accuracy and completeness of information.
- Researched coding guidelines and regulations to ensure accurate coding practices.
- Maintained up-to-date knowledge of medical terminology and coding systems.
- Provided assistance with insurance claims processing including verifying coverage eligibility.
- Collaborated with physicians, nurses, other healthcare professionals to resolve questions regarding code selection or documentation requirements.
- Monitored changes in reimbursement policies affecting medical coding activities.
- Performed quality assurance reviews on all coded data prior to submission.
- Educated staff members on proper coding techniques according to industry standards.
- Submitted corrected claim forms when necessary due to errors found during review process.
- Maintained updated knowledge of coding requirements, which included continuing education and certification renewal.
- Accurately assigned codes using software and official print copy of code book.
- Interpreted medical terminology and pharmacological information to translate information into coding system.
- Applied coding rules established by American Medical Association and Centers for Medicare and Medicaid Services for assignment of procedural codes.
- Reviewed account information to confirm patient and insurance information is accurate and complete.
- Assigned value codes and modifiers to provide specific information for services provided.
- Collaborated with billing team to confirm no additional diagnosis codes available for LCD and NCD coverage.
- Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements.
- Maintained high accuracy rate on daily production of completed reviews.
- Verified proper coding, sequencing of diagnoses, and accuracy of procedures.
- Read through patient health data, histories, physician diagnoses and treatments to gain understanding for coding purposes.
- Participated in coding team meetings to discuss challenges and best practices.
- Analyzed patient charts and records to extract relevant coding information.
- Kept abreast of updates and changes in coding guidelines and reporting requirements.
- Managed coding for multiple specialties, ensuring specific codes are accurately applied.
- Coordinated with billing department to clarify billing issues related to coding.
- Utilized coding software and tools efficiently to expedite the coding process.
Data Authorization Entry
Maximus Federal Services
Pharr, TX
04.2019 - 09.2019
- Worked successfully with diverse group of coworkers to accomplish goals and address issues related to our products and services.
- Worked with cross-functional teams to achieve goals.
- Prioritized and organized tasks to efficiently accomplish service goals.
- Collaborated closely with team members to achieve project objectives and meet deadlines.
- Maintained updated knowledge through continuing education and advanced training.
Receptionist/Coder
McAllen Primary Care Clinic
McAllen, TX
07.2015 - 04.2019
- Greeted and checked in patients, updating patient information in computer system.
- Verified insurance coverage for appointments and collected co-payments as required.
- Answered incoming calls, responding to inquiries from patients and other medical offices.
- Scheduled patient appointments, verifying accuracy of appointment times with providers.
- Prepared charts for new patients, ensuring all necessary forms were completed correctly.
- Assisted with filing of medical records and documents, maintaining accurate electronic files.
- Performed data entry tasks related to billing and collections procedures.
- Processed referrals for specialist care when requested by physicians or patients.
- Called patients to confirm scheduled appointments and obtain additional details.
- Entered insurance, demographics and health history into patient database.
- Answered multi-line phone system and directed callers to requested personnel and departments.
- Protected patients by observing strict HIPAA guidelines.
- Took messages from patients and promptly relayed to appropriate staff.
- Delivered high-quality administrative and customer service to sustain patient and work flows.
- Photocopied insurance cards, documented details and verified patient coverage for upcoming procedures or appointments.
- Informed patients of financial responsibilities prior to rendering services.
- Conducted patient intake interviews to collect medical information and insurance details.
- Adhered to HIPAA requirements to safeguard patient confidentiality.
Education
Medical Coding and Billing Certificate and Health Information Technology - Medical Insurance Coding
The College of Health Care Professions
McAllen05-2017
Some College (No Degree) - Health Information Technology
South Texas Community College
McAllenSkills
- Medical claims coding
- Coding Error Resolution
- Critical thinking abilities
- Patient data compilation
- Anatomy and physiology understanding
- Medical billing procedures
- Medicare insurance regulations
- Continuing education
- Proficiency in Athena, Cerner, EPIC, Medisoft, and MaxRVU
- Medical coding and abstracting
- Medical Billing
- Medical Terminology
- ENT, General Surgery, Trauma coding
- Healthcare claim coding
- Knowledgeable in Microsoft Office
- Training and mentoring
- Coding appeals
- HIPAA Compliance
Certification
- The American Academy of Professional Coders (AAPC)
- Certified Professional Coder Member ID # 01587348
- Active member since 2020
Languages
Spanish
Native/ Bilingual
Timeline
Certified Medical Coder
UTRGV School of Medicine
04.2024 - Current
Data Authorization Entry
Maximus Federal Services
04.2019 - 09.2019
Receptionist/Coder
McAllen Primary Care Clinic
07.2015 - 04.2019
- The American Academy of Professional Coders (AAPC)
- Certified Professional Coder Member ID # 01587348
- Active member since 2020
Medical Coding and Billing Certificate and Health Information Technology - Medical Insurance Coding
The College of Health Care Professions
Some College (No Degree) - Health Information Technology
South Texas Community College
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