Shiela Marie Arevalo CCS, RHIT

· Reviews and codes oncology medical records, including infusion charges, using ICD-10, CPT, and HCPCS codes.

· Accurately assigns codes for chemotherapy, immunotherapy, and infusion therapies, ensuring compliance with coding guidelines and payer requirements.

· Codes emergency department (ED) services, ensuring accurate and compliant coding for ED visits and treatments.

· Codes rehabilitation therapies, including occupational therapy (OT), speech therapy (ST), and physical therapy (PT), ensure proper documentation and billing.

· Handles and corrects insurance claims, addressing rejections, and resubmissions, and ensuring proper reimbursement.

· Abstracts and assigns codes from patient records for billing, ensuring compliance with medical necessity, NCD/LCD, and modifiers.

· Fixes coding edits to correct errors and ensure clean claims and proper reimbursement.

· Audits medical records for coding accuracy and adherence to federal and state regulations.

· Researches and resolves coding discrepancies, recommending and implementing corrective actions to prevent future errors.

· Serves as a subject matter expert, providing guidance to coding staff and offering feedback on documentation and coding practices.

· Assists in training and mentoring, supporting lead or supervisor in orienting new staff, and managing special projects.

· Proactively improves processes by leading coding compliance initiatives, such as developing a new checklist and conducting training, resulting in reduced errors and enhanced compliance.

· Handles returns for coding responsibilities, ensuring corrections and adjustments are made for accurate billing and reimbursement.

· Maintains up-to-date knowledge of coding guidelines and industry regulations through ongoing education and certification renewal.

· Provided accurate and transparent information to customers about products, services, and pricing, ensuring compliance with advertising and consumer protection regulations.

· Safeguard customer privacy by adhering to data protection laws when managing customer information.

· Ensured compliance with standard regulations during customer interactions and communications.

· Resolved customer complaints and issues in alignment with consumer rights and fair business practices, adhering to relevant compliance standards.

· Document customer interactions and transactions accurately to maintain compliance with record-keeping requirements and ensure a clear audit trail.

· Followed established procedures to ensure customer service activities met regulatory requirements.

· Improved service delivery by initiating a project to analyze client feedback and developing a system to collect and process consumer comments, which led to increased customer satisfaction and service quality.

· Proposed and implemented customer service training focused on empathy and active listening, enhancing team performance and customer care.

· Provided accurate and transparent information to customers about products, services, and pricing, ensuring compliance with advertising and consumer protection regulations.