Renalie A. Cruz
Lubbock
Summary
- Certified Professional Coder (CPC) with 8 years of experience in outpatient coding in multi-specialty healthcare.
- Organized and professional registered nurse with seven years of hands-on experience in clinical settings.
- Looking for employment where best opportunities for career advancement are highly encouraged and to acquire professional growth and development.
Overview
18
18
years of professional experience
4
4
Certifications
Work History
MEDICAL CODER / RESUBMISSION ANALYST
Sadd Maareb Medical Center
Baniyas
05.2022 - 11.2025
- Outpatient Coding: Coding medical records as per coding and HAAD guidelines, and providing the quality and quantity work as per the standards for specialty clinics like Internal Medicine, OB & Gyn, ENT, GP, Pediatrics, Dermatology, Dental.
- Effectively manages Daily Submission for good revenue cycle.
- Experienced in working with UAE's top insurance companies, such as Thiqa, Daman, ADNIC, NAS, Neuron, FMC, Almadallah, Iris, and Next Care.
- Good communication with doctors and allied staff during the query process.
- Taking prior approval for various procedures from payers. (Through DHPO, Website, Fax and Telephone).
- Denial Management: Download and compile the rejected claims from the Shafafiya portal.
- Categorizes denials based on root cause findings as medical necessity, non-medical necessity, and administration denials, with timely filing and reporting.
- Resubmitting the rejected claims before the deadline to insurance Companies with appropriate actions taken and detailed Resubmission comments.
MEDICAL CODER / RESUBMISSION ANALYST
Health line Day Care Surgery L.L.C
Baniyas
08.2017 - 05.2022
- Audited patient records ensuring accurate coding and regulatory compliance.
- Updated coding guidelines according to changes in healthcare regulations and policies.
- Utilized electronic health record systems for efficient coding and data entry.
- Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements.
- Maintained positive working relationship with fellow staff and management.
- Collaborated with medical staff to streamline administrative processes and enhance efficiency.
STAFF NURSE
Ahmed Abu Sharia Medical Center
Abu Dhabi
06.2015 - 07.2017
- Monitored patient vital signs and reported changes to healthcare team.
- Administered medications and treatments per physician's orders.
- Maintained accurate and timely documentation of patient records.
- Monitored vital signs and documented changes in a timely manner.
- Assisting the doctors during procedures.
STAFF NURSE Dental and Dermatology Department
First Medical Center
Abu Dhabi
05.2013 - 05.2015
- Prepare the patients file.
- Get the medical history.
- Assisting the doctors during the procedures.
- Preparing and cleaning the instruments.
- Preparing pre and post approval for the insurance of dental patients.
- Sending and making follow up call for the approvals from insurance.
- Receiving appointments from patients and giving follow up call for the next session.
STAFF NURSE‐Medical & Surgical Ward
Madonna General Hospital Incorporated
04.2008 - 02.2013
- Assist physicians when examining patients; carry out doctor’s order; administer and charts ordered/stat medications (parenteral, oral, inhalation and intravenous through tubing) and patient’s reaction to medication.
- Educate patients/ families on health care needs, conditions and other options; interprets to patients and families their roles in promoting successful therapy and rehabilitation.
- Dressing change/ wound care
- Tracheostomy care, NGT feeding
Education
Bachelor of Science in Nursing -
Colegio De Kidapawan
Philippines05-2007
Skills
- Outpatient coding
- Denial management
- Electronic health records
- Time management
- Clinical documentation
- Proficiency in Cortex by Safecare Technology, 3M
- Medical documentation
- Effective communication
Certification
NCLEX- RN ( Texas State)- June 22,2023
TRAININGS AND CERTIFICATION
- ICD 10- CM 2026: Updates, Insights and amp; Impact- AAPC- October 25,2025
- AI in Medical Coding and Billing- AAPC- July 23, 2025
- Basic Life Support- AHSI- July 06, 2024
Timeline
MEDICAL CODER / RESUBMISSION ANALYST
Sadd Maareb Medical Center
05.2022 - 11.2025
MEDICAL CODER / RESUBMISSION ANALYST
Health line Day Care Surgery L.L.C
08.2017 - 05.2022
STAFF NURSE
Ahmed Abu Sharia Medical Center
06.2015 - 07.2017
STAFF NURSE Dental and Dermatology Department
First Medical Center
05.2013 - 05.2015
STAFF NURSE‐Medical & Surgical Ward
Madonna General Hospital Incorporated
04.2008 - 02.2013
Bachelor of Science in Nursing -
Colegio De Kidapawan