Octavia Tirado
Lehigh Acres
Summary
Committed medical coding expert with over four years of experience in risk adjustment analysis and coding compliance. Proficient in ensuring data accuracy, executing audits, and upholding healthcare regulations, fostering substantial enhancements in billing accuracy and quality assurance.
Overview
20
20
years of professional experience
1
1
Certification
Work History
Risk Adjustment Coder
Sanitas Medical Center
Miami
11.2020 - Current
- Clarified coding requirements through collaboration with healthcare providers and analysis of documentation.
- Ensured data accuracy by documenting risk adjustment codes in electronic health record systems.
- Compiled and processed medical records of hospital and clinic patients per healthcare regulations.
- Classified medical concepts, including diagnoses and procedures, into industry-standard coding systems.
- Reviewed medical records for compliance with ICD-10 and other coding standards.
- Assigned accurate diagnosis codes using ICD-10, CPT, and HCPCS systems to ensure precise billing.
- Conducted audits of coded records to verify compliance with established coding standards.
- Delivered training on coding guidelines and reimbursement policies to healthcare providers.
Medical Coder
Conviva Care Centers
Tamarac
05.2019 - 02.2020
- Reviewed medical documents for accuracy and compliance with coding regulations.
- Assigned appropriate codes for diagnoses and procedures using coding software.
- Collaborated with healthcare providers to resolve documentation and coding inquiries.
- Maintained up-to-date knowledge of CPT and ICD-10 coding principles and government regulations.
- Achieved high accuracy rates in daily production of completed reviews.
- Verified correct coding, sequencing of diagnoses, and procedural accuracy.
- Entered coded data into electronic health record systems while ensuring patient confidentiality per HIPAA.
- Interpreted medical reports to apply appropriate ICD-9, CPT-4, and HCPCS codes.
Risk Adjustment Coder
Wellmax Medical Center
Pembroke Pines
01.2018 - 06.2019
- Reviewed medical records for compliance with ICD-10 and CMS guidelines.
- Assisted in identifying risk adjustment opportunities through documentation analysis.
- Collaborated with healthcare providers to clarify coding requirements and ensure accuracy.
- Maintained up-to-date knowledge of coding standards and regulatory changes.
- Conducted quality assurance checks on coded data entries to ensure accuracy.
- Compiled reports summarizing findings from risk adjustment activities for management review.
- Developed educational materials on coding guidelines for providers and staff.
- Documented risk adjustment codes in electronic health record systems, ensuring precision.
Medical Coder
Pediatric Associates Hollywood
Pembroke Pines
11.2005 - 10.2017
- Reviewed patient medical records for accuracy and compliance with coding regulations.
- Assigned accurate codes for diagnoses and procedures using advanced coding software.
- Collaborated with healthcare providers to resolve documentation and coding inquiries.
- Conducted audits of coded records to ensure adherence to established standards.
- Educated staff on best practices for efficient documentation and coding processes.
- Maintained current knowledge of CPT, ICD-10 coding principles, and payer requirements.
- Monitored coding error trends to enhance overall accuracy in assignments.
- Entered coded data into electronic health record systems for streamlined claim processing.
Education
Aapc
Miami, FL03-2006
High School Diploma -
Cornerstone Christian School
Hollywood, FL06-2000
Skills
- Coding compliance and risk adjustment
- ICD-10 documentation and proficiency
- Medical record auditing and billing accuracy
- Healthcare regulations knowledge
- Electronic health records management
- Quality assurance processes and practices
- Clear communication skills
- Diagnostic coding accuracy
- HIPAA compliance expertise
- HCC coding experience
- CMS guidelines understanding
- Risk adjustment principles application
- Medical terminology mastery
- Anatomy and physiology knowledge
- Procedural coding precision
- Clinical documentation review skills
- Certified medical coder credentials
- Records management systems expertise
- Electronic filing system organization
Languages
English
Professional
Spanish
Professional
Certification
AAPC - CRC CDEO CMPA CRC
Timeline
Risk Adjustment Coder
Sanitas Medical Center
11.2020 - Current
Medical Coder
Conviva Care Centers
05.2019 - 02.2020
Risk Adjustment Coder
Wellmax Medical Center
01.2018 - 06.2019
Medical Coder
Pediatric Associates Hollywood
11.2005 - 10.2017
Aapc
High School Diploma -
Cornerstone Christian School