Nicolas G Jimenez MD, CCDS, CCDS-O
Jacksonville,Florida
Summary
Experienced medical professional with a proven track record of delivering valuable insights and strategic solutions to diverse clients. I leverage strong analytical skills and deep industry knowledge to drive impactful outcomes. Recognized for fostering team collaboration and adapting to dynamic environments, ensured project success and client satisfaction.
Overview
13
13
years of professional experience
Work History
CDI & Reimbursement Strategies Consultant
The CPR Doc, LLC
Jacksonville, FL
01.2021 - Current
- Assisted clients private practice in achieving accurate documentation, CPT & ICD-10 coding and quality metric reporting for various contracted payers, resulting in increased revenue.
- Acted as a liaison between insurance companies and clients office to resolve documentation discrepancies, promoting collaboration and maintaining the integrity of medical records.
- Developed customized processes and workflows that targeted specific challenges faced by clients, improving their understanding and regulatory and compliance guidelines.
- Troubleshot data-related problems and coordinated maintenance or modifications to correct defects.
- Utilized advanced data analytics tools to monitor the impact of implemented CDI strategies on overall performance metrics, guiding future improvements as needed.
- Supported the design and implementation of a robust business intelligence infrastructure, enabling real-time reporting capabilities.
- Streamlined staff workflows across multiple departments for increased efficiency and reduced processing time.
- Automated repetitive tasks, freeing up team members to focus on strategic initiatives.
- Provided expert consultation on complex cases that required specialized knowledge of HCC coding rules and guidelines, offering guidance for optimal code assignment strategies.
- Streamlined communication between patients and healthcare providers, ensuring timely responses to inquiries and concerns.
- Acted as office care coordinator for patients seeking information about community resources and support services available to them in their healthcare journey.
- Collaborated closely with physicians regarding treatment plans, ensuring continuity of care and seamless transition between care providers.
Clinical Documentation Integrity Specialist
Baptist Medical Center
Jacksonville, FL
01.2017 - 01.2021
- Review inpatient/outpatient medical records to identify opportunities to clarify missing or incomplete documentation.
- Collaborate with providers, case managers, coders, and other healthcare team members to facilitate comprehensive health record documentation that reflects clinical treatment, decisions, diagnoses, and interventions.
- Conducted regular audits of posted queries to ensure that compliance and regulatory guidelines were met.
- Develop provider education strategies to promote complete and accurate clinical documentation and correct negative trends.
- Conduct independent research to promote knowledge of clinical topics, coding guidelines, regulatory policies and trends, and healthcare economics.
- Aid in identification and proper classification of complication codes (patient safety indicators/hospital-acquired conditions) by acting as the intermediary between coding staff and medical staff.
- Participate in CDI-related continuing education activities to maintain certifications and licensure's.
Student Physician: Patient Care Coordinator
Emed Multispecialty Group
Jacksonville, FL
01.2014 - 01.2017
- Coordinated patient referrals with specialists for optimal continuity of care throughout treatment process.
- Enhanced clinic efficiency by streamlining processes and implementing electronic health record systems.
- Evaluated previously prescribed interventions for successes or failures and adjusted strategies.
- Instructed patients and families on medical diagnoses and treatment options.
- Documented interactions using correct format, codes and facility standards for optimal medical care.
- Conducted thorough physical examinations for accurate diagnosis, leading to effective treatment strategies.
- Trained support staff in patient care strategies, intake requirements.
Physician Internship-General Surgery, Internal Med
Hospital Central De La Fuerzas Armadas
Santo Domingo, Dominican Republic
01.2012 - 01.2013
- Observed, assisted and documented complex surgical procedures.
- Preoperative and Postoperative Patient Monitoring.
- Perfected Suturing Techniques.
- Delivered emergency treatment on-site and responded appropriately in urgent or emergency situations.
- Improved patient outcomes by developing comprehensive treatment plans tailored to individual needs.
- Educated patients on preventative measures, contributing to a decrease in hospital readmissions.
- Managed high-stress situations effectively during emergency procedures, providing life-saving interventions when needed.
Physician Internship- Genecology
Hospital General Dr. Marcelino Velez Santana
Santo Domingo, Dominican Republic
01.2012 - 01.2013
- Completed basic in-office procedures with local or topical anesthetic.
- Collaborated with multidisciplinary teams to ensure cohesive patient care and successful recovery.
- Instructed patients and families on medical diagnoses and treatment options.
- Counseled female patients on birth control methods, cervical and breast cancer and answered questions or concerns.
- Performed advanced surgical procedures, such as laparoscopic hysterectomies and dilation and curettage operations, leading to enhanced patient outcomes.
- Kept detailed records of patient treatments and needs throughout medical processes.
- Explained test results to patients to help each make decisions about lifestyle choices, future healthcare, and treatments for gynecologic or obstetric issues.
- Provided post-operative care for patients who underwent surgical procedures, ensuring proper healing, pain management, and follow-up appointments to monitor progress.
Physician Internship- Pediatrics
Hospital Materno Infantil Santo Socorro
Santo Domingo, Dominical Republic
01.2012 - 12.2012
- Exhibited excellent problem-solving skills when encountering complex medical cases, collaborating with physicians and other healthcare professionals to determine the most appropriate course of action for optimal patient outcomes.
- Streamlined clinic workflow by collaborating closely with physicians, nurses, and support staff.
- Conducted physical examinations to assess patients' health and current condition for optimal treatment.
- Ordered and interpreted diagnostic testing to confirm diagnosis and implement accurate treatment plans.
- Performed therapeutic procedures such as injections, immunizations, and infection management.
- Ensured accurate diagnoses by ordering appropriate diagnostic tests and interpreting results efficiently.
Education
Santo Domingo, Dominican Republic, 2007-2013
Doctor of Medicine
Universidad IberoamaericanaCertified Since 2019 -
(CCDS) Certified Clinical Documentation Specialist
Certified Since 2022 -
(CCDS-O) Certified Clinical Doc Spc Outpatient
Licensed Training Provider (CPR/BLS/AED) - Licensed Since 2021
American Red Cross
Skills
- Bilingual: English and Spanish
- Documentation Compliance
- Payer Regulations
- Clinical Practice Process Improvements
- CPT/HCPCS, ICD-10 CM & PCS
- Exemplary Communication Skills
- Training and Mentoring
- Anatomy & Medical Terminology
- HIPAA requirements
- Record Auditing
- Regulatory Compliance
- Administrative Coordination
Timeline
CDI & Reimbursement Strategies Consultant
The CPR Doc, LLC
01.2021 - Current
Clinical Documentation Integrity Specialist
Baptist Medical Center
01.2017 - 01.2021
Student Physician: Patient Care Coordinator
Emed Multispecialty Group
01.2014 - 01.2017
Physician Internship-General Surgery, Internal Med
Hospital Central De La Fuerzas Armadas
01.2012 - 01.2013
Physician Internship- Genecology
Hospital General Dr. Marcelino Velez Santana
01.2012 - 01.2013
Physician Internship- Pediatrics
Hospital Materno Infantil Santo Socorro
01.2012 - 12.2012
Santo Domingo, Dominican Republic, 2007-2013
Doctor of Medicine
Certified Since 2019 -
(CCDS) Certified Clinical Documentation Specialist
Certified Since 2022 -
(CCDS-O) Certified Clinical Doc Spc Outpatient
Licensed Training Provider (CPR/BLS/AED) - Licensed Since 2021
American Red Cross