Mildred Cruz
San Francisco,CA
Summary
Highly-motivated employee with desire to take on new challenges. Strong work ethic, adaptability, and exceptional interpersonal skills. adept at working effectively unsupervised and quickly mastering new skills.
Overview
23
23
years of professional experience
Work History
Pharmacy Technician
Kaiser PERMANENTE
05.2001 - Current
- Excellent knowledge of healthcare insurance and medical billing experience
- Processes ADAP (Aids Drug Assistance Program) billing and Medical TARs (Treatment Authorization Request) which require ICD-9-CM/ICD-10-CM
- Review patient Medical Record to identify diagnoses)
- Performed data entry functions accurately within the pharmacy information system
- Utilize knowledge of pharmaceutical terminology, abbreviations symbols and measurements to properly fill prescriptions
- Assisted Pharmacists with compounding IV admixtures including chemotherapy agents, antibiotics, and total parenteral nutrition solutions
- Accurately entered new patient data into the computer system while verifying existing information against available sources
- Demonstrated ability to accurately calculate dosages and interpret prescriptions for inpatient pharmacy orders
- Prepared medications and pharmaceuticals supply to nursing stations and Operating Room for surgery procedures
- Maintained up-to-date knowledge of oncology drugs, dosages, side effects, indications, contraindications, and therapeutic classes
- Providing feedback to management concerning possible problems or areas of improvement
MEDICAL BILLer/coder
integrated pain clinic
04.2018 - 01.2024
- Managed databases by performing data entry tasks
- Ensured compliance with applicable laws including HIPAA regulations governing the privacy of protected health information
- Utilized billing and coding software to verify accuracy of diagnosis and procedure codes assigned to patient accounts
- Identify and resolve coding related edits by reviewing the medical record and ensuring that all data and codes are consistent with ICD-10-CM Guidelines, CPT, and HCPCS
- Assess and examine patient’s medical record for proper sequence of documents, presence of authorized signatures, and sufficient data is documented that supports diagnosis, treatment administered, and results obtained
- Queried provider regarding missing, unclear, or conflicting health record documentation using approved templates
- Experience with data entry of codes into a database and/or software tool
- Organizes and prioritizes all work to ensure that records are coded, and edits are resolved, in a timely manner that will assure compliance with regulatory requirements
- Worked in high-volume medical coding and collections environment to maintain exceptional standards of excellence
- Performs other duties as assigned.
OUTPATIENT coder externship
AAPC
05.2023 - 11.2023
- Successfully completed continuing education courses related to coding changes and updates as required by American Academy of Professional Coders
- Efficient coded complex medical records for outpatient visits using ICD-10-CM and CPT coding systems
- Knowledge in outpatient facility surgical and medical specialties as assigned
- Identified trends in coding errors or discrepancies that could lead to increased revenue or cost savings opportunities
- Knowledge of the reimbursement systems, including but not limited to, Ambulatory Payment Classification (APCs); and the Resource-Based Relative Value Scale (RBRVS).
MEDICAL BILLING AND CODER INTERN
CCHCA
02.2018 - 04.2018
- Evaluate documentation to complete diagnosis coding and meet specificity requirements, supporting clinical indicators
- Helped review insurance denials related to diagnosis issue
- Demonstrated expertise in resolving coding issues and responding to inquiries from healthcare providers
- Resolved medical coding edits or billing item rejects in relation to code assignment.
Education
Medical Coder Comprehensive Course -
Absolute Medical Coding Institute
01.2017
Medical Billing and Coding Certification -
Skyline College
01.2016
Pharmacy Technician Certification -
City College of San Francisco
01.1999
Bachelor of Science in Nursing -
Unciano College
01.1993
Skills
- Anatomy and Physiology Understanding
- Qualified Pain Management Coder
- ASC Coder
- Proficiency in Microsoft Office Suite (Excel, Outlook, Word, PowerPoint)
- Knowledgeable in Epic, Practice Fusion and Kareo
- Data Entry
- Workflow Management
- HIPAA Compliance
Position
Secretary and Treasurer, AAPC San Francisco Chapter
Personal Information
Title: CPC, Cpht
Training
- Anatomy/Physiology
- Medical Terminology
- ICD-9-CM/ICD-10-CM
- CPT
- HCPCS
- Pharmacology
- Diseases processes
- CPC Practicode-A
- Certified Outpatient Coder
References
Available upon request
Timeline
OUTPATIENT coder externship
AAPC
05.2023 - 11.2023
MEDICAL BILLer/coder
integrated pain clinic
04.2018 - 01.2024
MEDICAL BILLING AND CODER INTERN
CCHCA
02.2018 - 04.2018
Pharmacy Technician
Kaiser PERMANENTE
05.2001 - Current
Medical Coder Comprehensive Course -
Absolute Medical Coding Institute
Medical Billing and Coding Certification -
Skyline College
Pharmacy Technician Certification -
City College of San Francisco
Bachelor of Science in Nursing -
Unciano College
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