Rosio Medina
West Covina,CA
Summary
Highly efficient and detail-oriented professional seeking a Medical Coding position to utilize and enhance industry knowledge, coding experience, and education in a growth oriented company.
Overview
25
25
years of professional experience
1
1
Certification
Work History
Remote Coder
City Of Hope
06.2017 - Current
- Process in/out patient E&M services while ensuring that the E&M codes are accurately assigned and supported by the clinical documentation.
- Determine appropriate CPT codes for minor procedures in Oncology, Hematology, Urology, Gynecology, ENT, Pulmonology, Dermatology, Gastroenterology, Pain Management, Cardiology, Orthopedic, and more.
- Investigate and resolve claim denials related to coding errors, perform charge corrections, and re-billing as required for resolution of coding denials.
- Send query to physicians to clarify any incomplete or unclear documentation.
- Review documentation for split/share, incident-to, and teaching physician attestation.
- Correctly coded E&M's for POS 11,19, 22, 21, and able distinguish the coding guidelines and rules for each POS.
- Determine proper usage of modifiers, review NCCI edits, and LCD requirements.
- Awarded Circle of Excellence in Coding multiple times by my manager.
Front Office Manager
Pasadena Medical Center/ Hany K. Zaki, M.D., Inc
09.2009 - 05.2017
- Monitored financial transactions at the front desk, ensuring accurate billing procedures and minimizing discrepancies.
- Enhanced patient satisfaction by efficiently managing front office operations and addressing patient concerns promptly.
- Responsible for verifying health plan eligibility and. benefits.
- Maintain confidentiality of all information and follow HIPPA guidelines.
- Allowed to authorize pharmacy medication refill requests.
- Complete prior authorization forms for non-covered prescriptions and assign adequately ICD-10 codes with pertinent medical documentation to support coverage.
- Responsible for medical record release, subpoenas, and Health CAre Effectiveness Data and Information Set (HEDIS) data collection.
- Conduct audits on measurements for colorectal screening, blood pressure, hyperlipidemia, diabetes mellitus, and chronic kidney disease.
- Awarded by the IPA/Medical Group Health Care Partners four years in a row best customer service voted by patients.
Patient Care Coordinator
Le Reve Med Spa
05.2007 - 05.2017
- Greet clients entering establishment; determine nature and purpose of visit and direct or escort them to specific destinations.
- Operate telephone switchboard top answer, screen, or forward calls and provide information, take messages, and schedule appointments.
- Assist in coordinating open houses.
- Collaborate with other medical spa staff to determine treatment plans with special requirements.
- Provide skin care services.
- Collect and post payments.
Medical Assistant
Hany K. Zaki M.D.
01.1999 - 09.2009
- Played a pivotal role assisting the physician open the practice as the sole employer for three years and was able to manage the office while multi-tasking multiple job duties.
- Coordinate credentialing and re-credentialing applications.
- Responsible for managed care and PPO provider applications.
- Take patient histories and vital signs.
- Clean and sterilize instruments.
- Venipuncture, injection administration, operate EKG, and other equipment to administer routine diagnostic test.
- Reacted calmly and effectively in emergency situations, and added personal, caring touch that immediately put patients at ease.
- Responsible for pre-operative surgery scheduling, coordinating care, and communicating with hospital and surgeons.
- Accountable for ordering and managing medical supplies.
- Answer multi-phone lines and complete all patient requests.
Education
Associate of Arts - Social And Behavioral Science
Pasadena City College
Pasadena, CA05.2010
No Degree - Health Information Technology
East Los Angeles College
Monterey Park, CA05.2009
No Degree - Medical Coding And Billing
Norwalk Adult School
Norwalk, Ca05.2007
Medical Assistant -
North West College
Pasadena, Ca05.1997
Skills
- Certified Professional Coder by the American Academy of Professional Coders since August 2009
- Strong understanding of ICD-10-CM and CPT coding requirements and guidelines
- Key strengths: Integrity and dependability; good time management and multi-tasking skills
- Excellent problem solving skills; ability to interpret, analyze, and abstract
- Over 20 years of experience in the medical field including seven years in a multi specialty hospital
- Extensive knowledge of anatomy, physiology, medical terminology, and pharmacology
- Good interpersonal skills, effective communicator, and positive attitude
- Computer skills: Epic, Word, Excel, Nextgen Electronic Medical Records
- Experience in all aspects of insurance health plans including Medicare, Medicaid, Managed Care and PPO insurance
- Ability to work as a team member or independently
Certification
- CPC - Certified Professional Coder, American Academy of Professional Coders (AAPC)
- Medical Assistant Certificate
- Medical Coding and Billing Certificate
Timeline
Remote Coder
City Of Hope
06.2017 - Current
Front Office Manager
Pasadena Medical Center/ Hany K. Zaki, M.D., Inc
09.2009 - 05.2017
Patient Care Coordinator
Le Reve Med Spa
05.2007 - 05.2017
Medical Assistant
Hany K. Zaki M.D.
01.1999 - 09.2009
Associate of Arts - Social And Behavioral Science
Pasadena City College
No Degree - Health Information Technology
East Los Angeles College
No Degree - Medical Coding And Billing
Norwalk Adult School
Medical Assistant -
North West College
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