APRIL SALVADOR
Los Angeles,CA
Summary
Knowledgeable Health Information department with 20 years of experience in clinical database management. Adept at explaining medical terminology and data analysis with an extensive understanding EPIC and Optum 360 use and training. Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy.
Overview
16
16
years of professional experience
1
1
Certification
Work History
Medical Coder Analyst
Optum360
08.2022 - Current
- Identified and resolved problems through root cause analysis and research.
- Queried databases for information needed for report processing.
- Validated results and performed quality assurance to assess the accuracy of data.
- Reviewing and analyzing patient’s medical records after visits and translating information into medical procedures and diagnosis codes and sequenced appropriately that insurers use to process claims from patients
- Complying with medical coding guidelines and policies
- Confirming treatments with medical staff, identifying missing information submitting information to insurers for reimbursement.
- Implementing strategic procedures and choosing strategies and evaluation methods that provide
correct results. - Examining any medical malpractice that has been reported by analyzing and identifying medical procedures, and diagnoses events that lead to negligence.
Certified Medical Coder II
Cedars Sinai Hospital
03.2015 - 07.2022
- Reviewing a patient’s medical records after a visit and translating the information into ICD 10, CPT, and Modifiers codes that insurers use to process claims from patients.
- Maintained updated knowledge of coding requirements, through continuing education and certification renewal.
- Guarded against fraud and abuse by verifying coded data accurately reflected services provided.
- Responsible for review and resolution of department charge review WQ and CCI/NCCI edits.
- Interacted with physicians and other healthcare staff to ask questions regarding patient services.
- Abstracts and ensures accuracy data
- Concentration on Cancer Center accounts
- Diagnostic accounts when its needed
Certified Medical Coder
St. Joseph’s Health
10.2013 - 03.2015
- Concentration on Cancer center and rehab recurring accounts
- Reviewing a patient’s medical records after a visit and translating the information into ICD 10, CPT, and Modifiers codes that insurers use to process claims from patients.
- Maintained updated knowledge of coding requirements, through continuing education and certification renewal.
- Guarded against fraud and abuse by verifying coded data accurately reflected services provided.
- Responsible for review and resolution of department charge review WQ and CCI/NCCI edits.
- Interacted with physicians and other healthcare staff to ask questions regarding patient services.
- Abstracts and ensures accuracy data
- Diagnostic accounts when its needed
Certified Medical Coder
Codemed
08.2012 - 10.2013
- Handled Olive View Medical Center outpatient back-logs accounts.
- Reviewing a patient’s medical records after a visit and translating the information into ICD 10, CPT, and Modifiers codes that insurers use to process claims from patients.
- Maintained updated knowledge of coding requirements, through continuing education and certification renewal.
- Guarded against fraud and abuse by verifying coded data accurately reflected services provided.
- Responsible for review and resolution of department charge review WQ and CCI/NCCI edits.
- Interacted with physicians and other healthcare staff to ask questions regarding patient services.
- Abstracts and ensures accuracy data
- Utilized electronic medical record systems to store, retrieve and process patient data.
- Researched and resolved medical record discrepancies.
- Maintained accuracy, completeness, and security for medical records and health information.
Admissions Assistant
Los Angeles Hospice
03.2012 - 11.2012
- Assisted applicants with admissions packet and served as point of contact throughout admissions process.
- Verified insurance coverage and eligibility for medical services prior to scheduling appointments to prevent billing issues.
- Performed filing, billing and routing messages to appropriate people for office of
- Managed filing system, entered data and completed other clerical tasks.
- Completed forms, reports, logs and records to quickly handle all documentation for human resources.
- Created and maintained detailed administrative processes and procedures to drive efficiency and accuracy.
- Surpassed team goals by partnering with colleagues to implement best practices and protocols.
- Facilitated timely delivery of special projects to meet organizational and departmental objectives.
- Interacted with vendors, contractors and professional services personnel to receive orders, direct activities, and communicate instructions.
- Organized logistics and materials for each meeting and took detailed notes for later dissemination to key stakeholders.
Certified Medical Coder
Codemed
08.2011 - 03.2012
- Handle Mid-Michigan Medical Center outpatient back log accnts.
- Reviewing a patient’s medical records after a visit and translating the information into ICD 10, CPT, and Modifiers codes that insurers use to process claims from patients.
- Maintained updated knowledge of coding requirements, through continuing education and certification renewal.
- Guarded against fraud and abuse by verifying coded data accurately reflected services provided.
- Responsible for review and resolution of department charge review WQ and CCI/NCCI edits.
- Interacted with physicians and other healthcare staff to ask questions regarding patient services.
- Abstracts and ensures accuracy data
- Communicated with insurance companies to research and resolved coding discrepancies.
Medical Records Assistant
Alexandria Care Center
04.2009 - 08.2011
- Filed records for timely retrieval.
- Audited files for completion and accuracy.
- Posted medical records promptly upon accurate assembly and analysis.
- Communicated with doctors and insurance companies to resolve patient issues.
- Uploaded physician progress notes, history, and physicals into electronic medical records.
- Reviewed charts and flagged incomplete or inaccurate information.
- Maintained confidentiality of all medical records and sensitive information to comply with HIPAA regulations.
- Obtained necessary signatures on information release forms to obtain medical and treatment records from other service providers.
- Processed medical records requests from outside providers according to facility, state, and federal law.
- Analyzed complex medical records to identify discrepancies in accuracy and completeness.
Medical Records Associate
Los Angeles Hospice
11.2007 - 04.2009
- Maintained confidentiality of all medical records and sensitive information to comply with HIPAA regulations.
- Processed medical records requests from outside providers according to facility, state, and federal law.
- Scanned medical records in digital format for easy retrieval and accessibility.
- Supported medical staff by providing organized and accurate medical records.
- Reviewed charts and flagged incomplete or inaccurate information.
- Developed and maintained organized filing system for medical records to adhere to HIPAA regulations.
- Managed multiple schedules and prioritized tasks to meet demands of fast-paced work environment.
- Answered telephone calls to offer office information, answer questions, and direct calls to staff.
- Collaborated with healthcare staff to verify alignment of appointment scheduling with clinic protocols.
- Ordering of medical supplies and durable medical equipment needed by all patients living at
home, skilled nursing home and board and care.
Skills
- Data Research and Validation
- Complex Problem-Solving
- Patient Data Management Systems
- Proficient in ICD 10 and CPT
- Medical analysis
- Data entry
- Skilled in EPIC, Optum 360, Cener, Ecisa, Careb, and other health program
- Skilled microsoft office
Certification
- Certified Coding Specialist (CCS)- 12/09/10-12/31/24
Timeline
Medical Coder Analyst
Optum360
08.2022 - Current
Certified Medical Coder II
Cedars Sinai Hospital
03.2015 - 07.2022
Certified Medical Coder
St. Joseph’s Health
10.2013 - 03.2015
Certified Medical Coder
Codemed
08.2012 - 10.2013
Admissions Assistant
Los Angeles Hospice
03.2012 - 11.2012
Certified Medical Coder
Codemed
08.2011 - 03.2012
Medical Records Assistant
Alexandria Care Center
04.2009 - 08.2011
Medical Records Associate
Los Angeles Hospice
11.2007 - 04.2009