Raul Velazquez
Belle Mead,NJ
Summary
Seeking Per Diem or Contract Inpatient Coding/DRG Validation
Overview
48
48
years of professional experience
Work History
Inpatient DRG Coding Validation/Inpatient Coding (Contract)
St. Joseph Medical Center
11.2019 - Current
- Review patient medical records thoroughly, ensuring accurate recording of diagnoses and procedures according to ICD-10-CM and ICD-10-PCS guidelines.
- Verify DRG assignments based on coded diagnoses and procedures, ensuring reflection of the patient's clinical scenario and resource usage. Recommend DRG changes
- Provide feedback and education to coders, clinicians, and relevant staff to prevent discrepancies in the future.
Director of DRG/CDI Validation
Hull Resource Management Group
01.2008 - Current
- Provide comprehensive oversight of physician reviewers, RN reviewers, and CCS coders to ensure accuracy and efficiency in coding practices.
- Delivered thorough in-service education sessions to staff members on ICD-10-CM/PCS coding guidelines and updates from AHA Coding Clinic.
- Craft tailored in-service programs for client hospital CDI nurses and inpatient coders to optimize their skills and streamline coding processes.
Founder
Health Record Systems Management
07.1989 - Current
- Specialized in DRG Validation and Coding, servicing clients including Robert Wood Johnson University Hospital, Lawrence Hospital, Columbia Presbyterian, and others.
- Negotiated deals with 3M to promote encoding software and enhance clinical analyzer performance.
- Provided monthly reports and educational resources to increase DRG reimbursement.
- Developed strong partnerships with HIM staff to allow for collaboration and more significant opportunities for growth.
- Delivered exceptional customer service by addressing client concerns promptly and effectively resolving issues.
Assistant Director Medical Records
New York Presbyterian Medical Center
09.1986 - 07.1989
- Improved hospital case mix, elevating DRG CMI from 1.2 to 1.9 within 8 months.
- Managed staff of 70 employees, enhancing communication and implementing a computerized Attestation program.
Assistant Administrator
New York Hospital
07.1985 - 09.1986
- I Implemented a computerized Attestation program for DRG submission tracking.
- Trained coders and developed an intermediate/advanced coding program for Touro College.
- Developed job descriptions for staff members, verified DRG assignments, and ensured coding accuracy.
Director Medical Records
Union Hospital of the Bronx
06.1984 - 07.1985
- Achieved a significant reduction in delinquent medical records.
- Authored comprehensive job descriptions and enhanced communication for regulatory compliance.
- Implemented a computerized Attestation program in preparation for DRG submission tracking
Director Medical Records/Utilization Review Department
Prospect Hospital
01.1982 - 06.1984
- Achieved a remarkable reduction in delinquent medical records.
- Led organization through Joint Commission Accreditation.
- Authored comprehensive job descriptions and enhanced communication for regulatory compliance.
- Worked with the Medical Chief of Staff and nursing department to assess the quality of care provided by practitioners to identify areas for improvement and ensure that patients received high-quality services.
- Engaged in educational activities to inform healthcare providers about best practices, standards of care, and regulatory requirements.
Director of Medical Records
Catholic Charities of Brooklyn/Queens
06.1981 - 01.1982
- Led organization through Joint Commission Accreditation.
- Authored comprehensive job descriptions and enhanced communication for regulatory compliance.
Inpatient Coder
Prospect Hospital
09.1976 - 04.1980
- Reviewed patient medical records, ensuring accurate Coding of diagnoses and procedures in ICD8 and ICD9-CM
Education
ICD10-CM/PCS Coding
AHIMA
01.2013
No Degree - Business Management
City University of New York
New York1980
Skills
- Accuracy and Precision
- Effective Communication
- Quality Management Systems
- Regulatory guidelines
Accomplishments
- Elevated client hospital's CMI from 1.5 to 2.1 through effective DRG validation.
- Led successful strategic implementation of 3M Health Information Systems software at Columbia Presbyterian University Hospital, improving data processing efficiency by 70%, eliminating manual errors, and significantly enhancing staff satisfaction.
Timeline
Inpatient DRG Coding Validation/Inpatient Coding (Contract)
St. Joseph Medical Center
11.2019 - Current
Director of DRG/CDI Validation
Hull Resource Management Group
01.2008 - Current
Founder
Health Record Systems Management
07.1989 - Current
Assistant Director Medical Records
New York Presbyterian Medical Center
09.1986 - 07.1989
Assistant Administrator
New York Hospital
07.1985 - 09.1986
Director Medical Records
Union Hospital of the Bronx
06.1984 - 07.1985
Director Medical Records/Utilization Review Department
Prospect Hospital
01.1982 - 06.1984
Director of Medical Records
Catholic Charities of Brooklyn/Queens
06.1981 - 01.1982
Inpatient Coder
Prospect Hospital
09.1976 - 04.1980
ICD10-CM/PCS Coding
AHIMA
No Degree - Business Management
City University of New York
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