ROGIELYN VALLEJO
Long Beach,US
Summary
Dedicated health care professional with extensive expertise in ICD-10 coding, OASIS review, plan of care coordination, and documentation compliance. Poised to leverage skills in quality assurance and medical record review to contribute effectively to a new team. A proven track record of enhancing patient care outcomes while ensuring strict regulatory adherence underscores a commitment to excellence in health services. Knowledgeable in home health and hospice coding, complemented by a solid background in quality assurance coordination, successfully implementing process improvements that enhance product reliability and minimize errors. Demonstrated proficiency in problem-solving and quality control methodologies further supports a focus on delivering high-quality care.
Overview
24
24
years of professional experience
Work History
ICD-10 Coder / OASIS Specialist / Plan of Care
RPV Consulting
01.2015 - Current
- Documentation Review: Evaluate patient care documentation for consistency and accuracy with the Comprehensive SOC/RC/ROC/DC OASIS Assessment and Plan of Care. Ensure the discipline frequency aligns with assessment data.
- OASIS Management: Process all OASIS submissions in a timely manner, including data transfers, ROC, RC, follow-up visits, and OASIS discharges. Ensure data accuracy and compliance with established standards.
- Quality of Care Review: Monitor charts for quality of care rendered, including orders followed and appropriate contact with physicians and other disciplines. Resolve any charting issues promptly.
- Policy Compliance: Monitor adherence to policies and procedures, particularly those related to clinical documentation and best practices. Ensure familiarity and compliance with HIPAA regulations.
- Proficiency in ICD-10 Coding and OASIS E: Demonstrate proficiency in diagnosis coding using ICD-10 and OASIS E to ensure accurate and compliant documentation.
- Issue Resolution: Identify and resolve charting and documentation issues in a timely and effective manner to maintain high standards of patient care.
- Staff Training and Development: Participate in the development of in-services and individual clinician training sessions. Assist in training staff on new or improved clinical practices and ensure understanding and compliance with quality standards.
- Continuous Improvement: Collaborate with clinical and administrative teams to identify areas for improvement in clinical practices and processes. Provide feedback and recommendations for enhanced quality and efficiency.
- Conduct detailed audits on a regular basis as defined by compliance requirements and provide additional education or training as necessary.
Quality Assurance Coordinator
Comfort Home Health Care, Inc.
03.2003 - 09.2015
- Plan of care completion, OASIS reviewer
- Ensure compliance with healthcare regulations and improve patient care outcomes
- Ensure accurate and timely billing and documentation
- Data accuracy and adherence to regulatory standards and CMS 485 forms in accordance with agency policies and Medicare requirements
- Provide education and training to clinical staff
- Coordinate to improve documentation quality and enhance patient service delivery
- Ensure timely completion and compliance with Medicare and agency standards
- Coordinated and improved overall quality of patient care documentation
Quality Assurance Coordinator
Vision Plus Home Health Care
03.2002 - 03.2003
- Developed and maintained documentation for quality assurance processes and procedures.
- Conducted quality inspections to ensure compliance with industry standards and specifications.
Education
Bachelor of Science - Pharmacy
University of Santo Tomas
Manila, Philippines03-1992
Doctor of Medicine - Doctor of Medicine
De LaSalle College of Medicine
Manila, Philippines10.1996
Skills
- Experienced in ICD-10 coding
- OASIS evaluation specialist
- Development of care plans
- Experience with CMS 485 documentation processes
- Clinical documentation analysis
Accomplishments
- Billing Accuracy Improvement: Improved billing accuracy by through ICD-10 compliance.
- Patient Care Efficiency: Streamlined patient care plans, reducing processing time.
- Staff Training Success: Trained staff, increasing documentation compliance.
- Documentation Error Reduction: Enhanced CMS 485 form submission, reducing errors.
LANGUAGES
English Advanced
Tagalog Advanced
Timeline
ICD-10 Coder / OASIS Specialist / Plan of Care
RPV Consulting
01.2015 - Current
Quality Assurance Coordinator
Comfort Home Health Care, Inc.
03.2003 - 09.2015
Quality Assurance Coordinator
Vision Plus Home Health Care
03.2002 - 03.2003
Bachelor of Science - Pharmacy
University of Santo Tomas
Doctor of Medicine - Doctor of Medicine
De LaSalle College of Medicine