Summary
Overview
Work History
Education
Skills
Languages
Timeline
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Walmys Hernandez Valdes

420 SW 12 Ave Apt 1101, Miami,FL

Summary

Certified Risk Adjustment Coder with background in healthcare coding and auditing. Demonstrated ability to accurately interpret medical documentation for appropriate risk adjustment coding, ensuring compliance with relevant regulations. Strengths include thorough understanding of ICD-10-CM guidelines and HCC categories, along with strong analytical skills and problem-solving abilities. Have consistently streamlined coding processes and improved data accuracy in previous roles.

Overview

12
12
years of professional experience

Work History

Coding Auditor

The Elevance Health Company, Inc
Miami, FL
05.2021 - Current
  • Conducted reviews of patient medical records to guarantee adherence to coding regulations while ensuring completeness. Precision in applying ICD-10-CM, CPT, and HCPCS codes for diagnosis and procedure coding while following CMS Medicare Risk Adjustment Coding Guidelines.
  • Engaged in reviewing lab results, operative reports, and discharge summaries as part of chart abstraction duties.
  • Proficiently employed coding software and tools to streamline the coding process.
  • Identified and researched any inconsistencies between documentation and billing details, promptly rectifying the issues prior to submission.
  • Ensured up-to-date understanding of coding changes, updates, and new rules.
  • Ensured documentation of accurate risk adjustment codes into EHR systems.
  • Collaborated with physicians to guarantee that an accurate assignment of diagnosis codes was achieved, based on information sourced from medical records.

Costumer Service

Publix Supermarket Customer Service
Miami, FL
02.2017 - 08.2021
  • Provided prompt customer service by greeting and answering inquiries regarding store merchandise and offerings.
  • Operated cash register efficiently and accurately, processed payments by cash, check, credit card, gift card or automatic debit.
  • Processed returns and exchanges of merchandise following store policies.
  • Balanced daily transactions on a computerized point-of-sale system.
  • Delivered exceptional customer service and boosted sales potential through promoting loyalty programs.
  • Managed large sums of money following company security guidelines.

Sales Assistant

Rainbow Apparel
Miami, FL
10.2012 - 02.2017
  • Played a role in enhancing product visibility through attractive displays.
  • Organized stockroom shelves, racks and bins according to store layout and product categories.
  • Performed periodic audits on merchandise prices for accuracy.
  • Leveraged technology to facilitate timely access to essential customer data, purchase orders & inventory.
  • Achieved efficient resolution of customer complaints and issues, thereby maintaining positive relationships.
  • Unboxed and restocked merchandise to create visually appealing and organized product displays.
  • Monitored and identified security risks and thefts to proactively address or manage incidents.

Education

Certified Professional Coder (CPC) -

AAPC
Miami, FL
12-2023

Certified Documentation Improvement Expert Outpatient (CDEO) -

AAPC
Miami, FL
11-2023

Certified Professional Medical Auditor (CPMA) -

AAPC
Miami, FL
12-2020

Certified Risk Adjusment Coder (CRC) -

AAPC
Miami, FL
08-2018

English Up To Level: 4 -

Miami Dade College
Miami, FL
11-2017

Network Security Specialist -

Segurmatica Institute
Havana, Cuba
07-1990

High School Diploma -

PreUniversitario Ciencias Exactas Vladimir I Lenin
Havana, Cuba
07-1987

Skills

  • Knowledge of Microsoft Word, Power Point and Excell
  • Attention to Detail
  • EMR Systems
  • Goal Setting
  • Data Entry
  • Conflict resolution techniques

Languages

Spanish
Native/ Bilingual
English
Limited

Timeline

Coding Auditor

The Elevance Health Company, Inc
05.2021 - Current

Costumer Service

Publix Supermarket Customer Service
02.2017 - 08.2021

Sales Assistant

Rainbow Apparel
10.2012 - 02.2017

Certified Professional Coder (CPC) -

AAPC

Certified Documentation Improvement Expert Outpatient (CDEO) -

AAPC

Certified Professional Medical Auditor (CPMA) -

AAPC

Certified Risk Adjusment Coder (CRC) -

AAPC

English Up To Level: 4 -

Miami Dade College

Network Security Specialist -

Segurmatica Institute

High School Diploma -

PreUniversitario Ciencias Exactas Vladimir I Lenin

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Walmys Hernandez Valdes