Susel regalado
Miami Gardens,FL
Summary
Professional with deep expertise in medical coding and risk adjustment. Proven track record in analyzing and interpreting complex medical records to ensure accurate coding and compliance with regulatory standards. Strong team collaborator focused on achieving measurable results and adapting to evolving requirements. Skilled in ICD-10, CPT, and HCC coding, with keen eye for detail and commitment to maintaining high standards of accuracy and efficiency.
Overview
6
6
years of professional experience
1
1
Certification
Work History
Risk Adjustment Coder
Caremax Medical Centers
11.2021 - Current
- Achieved high levels of coder productivity by consistently meeting or exceeding established benchmarks for daily coding volume and accuracy rates.
- Supported quality initiatives by conducting regular audits, identifying areas of improvement, and providing targeted training.
- Increased overall team performance through active participation in peer review processes and sharing expertise with colleagues as needed.
- Upheld high standards of ethical practice when dealing with sensitive patient information or navigating complex billing issues.
- Demonstrated flexibility and adaptability in response to changes in coding guidelines, software systems, or departmental priorities.
- Supported the onboarding of new team members by providing mentorship and guidance as they learned the intricacies of risk adjustment coding.
- Strengthened interdepartmental relationships by participating in meetings, sharing insights from coding audits, and offering solutions for improved documentation practices.
- Reduced coding errors through rigorous attention to detail, thorough knowledge of ICD-10-CM guidelines, and continuous professional development.
- Verified accuracy of patient information in medical records.
- Used critical thinking to break down problems, evaluate solutions and make decisions.
Certified Medical Coder
First Choice Neurology
05.2019 - 10.2021
- Guarded against fraud and abuse by verifying coded data accurately reflected services provided.
- Maintained updated knowledge of coding requirements, through continuing education and certification renewal.
- Verified, coded and added modifiers to diagnoses.
- Reviewed outpatient records and interpreted documentation to identify diagnoses and procedures.
- Supported company''s financial stability by precisely identifying trends and patterns related to coding errors, denial reasons, and reimbursement delays.
- Reviewed, analyzed, and managed coding of diagnostic and treatment procedures contained in outpatient medical records.
- Correctly coded and billed medical claims for various hospital and nursing facilities.
- Monitored changes in coding regulations to provide recommendations for compliance.
- Passionate about learning and committed to continual improvement.
Education
High School Diploma -
IPUE Miguel Diosdado Perez Pimentel
07-2000
Skills
- Self-motivation and discipline
- ICD-10 proficiency
- Leadership qualities
- HIPAA compliance
- Medical coding expertise
- Risk adjustment principles
- Claims processing
- Medical documentation
- Computer proficiency
- Medical terminology
Certification
- Certified Risk Adjustment Coder(CRC)-American Academy of Professional Coders(AAPC).
- Certified Professional Coder (CPC) - American Academy of Professional Coders (AAPC).
- Certified Professional Medical Auditor (CPMA)
Languages
Spanish
Native or Bilingual
English
Professional Working
Timeline
Risk Adjustment Coder
Caremax Medical Centers
11.2021 - Current
Certified Medical Coder
First Choice Neurology
05.2019 - 10.2021
- Certified Risk Adjustment Coder(CRC)-American Academy of Professional Coders(AAPC).
- Certified Professional Coder (CPC) - American Academy of Professional Coders (AAPC).
- Certified Professional Medical Auditor (CPMA)
High School Diploma -
IPUE Miguel Diosdado Perez Pimentel
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