Summary
Overview
Work History
Education
Skills
Certification
Timeline
Generic

Sandra Delgado

Tarpon Springs,FL

Summary

Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.

Overview

19
19
years of professional experience
5
5

Certifications

Work History

Senior Trainer

Optum
St. Petersburg, FL
07.2018 - 03.2022
  • Developed new clinician onboarding documentation training program.
  • Educated existing clinicians on documentation and coding guidelines.
  • Audited coders and oversaw Quality Assurance Auditors.
  • Educated new and existing coders on current coding guidelines.
  • Developed coding department policies and processes.
  • Supervised team of 8 FFS and hospitalist coders.
  • Educated clinicians on their quarterly compliance audits.
  • Assisted in development of documentation templates in EMR.

Documentation Compliance Auditor

Florida Medical Clinic, PA
Land O' Lakes, FL
06.2015 - 07.2018
  • Developed and managed Annual Clinician Coding Compliance audit program to ensure coding compliance in clinicians documentation.
  • Participated in new clinician and coder training and development programs.
  • Prepared reports for templates and maintained compliance database.
  • Analyzed all audit results and resolved all compliance issues.
  • Provided non-compliance related coding education to clinicians.
  • Reported any significant findings to Compliance Committee.
  • Worked directly with Medicare CERT department, providers , and Central Billing Office staff to verify provider's documentation supported services and diagnoses billed.
  • Supervised compliance staff.
  • Ensured HIPPA compliance.

Team Leader

BayCare Medical Group
Clearwater, FL
06.2003 - 06.2015
  • Reviewed denied claim documentation to verify that it supported all services billed.
  • Investigated and resolved patient inquiries and complaints in a timely and empathetic manner.
  • Conducted training and mentored team members to promote productivity, accuracy and completion of assigned duties.
  • Built strong relationships with customers through positive attitude and attentive response.
  • Implemented new working processes to deliver multiple improvements.
  • Initiated timely response to emails, voicemails and written correspondence.

Education

High School Diploma -

Flushing High School
Flushing, NY
06.1982

Skills

  • Course Materials Development
  • Attention to Detail, Organized and Critical Thinker
  • Orientation and Onboarding
  • Quality Assurance and Compliance Training
  • Problem Solving
  • Microsoft Office including Power Points, Visio and Excel

Certification

  • Certified Professional Coder (CPC) June 2008
  • Certified Professional Medical Auditor (CPMA) November 2016
  • Certified Evaluation and Management Coder (CEMC) December 2017
  • Certified Risk Adjustment Coder (CRC) May 2019
  • Certified Professional Coder Instructor (CPC-1) February 2021

Timeline

Senior Trainer

Optum
07.2018 - 03.2022

Documentation Compliance Auditor

Florida Medical Clinic, PA
06.2015 - 07.2018

Team Leader

BayCare Medical Group
06.2003 - 06.2015

High School Diploma -

Flushing High School

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Sandra Delgado