Remote Medical Coder

13781 Andele Way

Jose  Alano B.S., CPC

13781 Andele Way

Irvine, CA 92620

Tel. (949 697-0437)

E-mail: josefalano@gmail.com

 

Professional Summary:

 

Candidate is CPC(AAPC) certified,   with 5 years experience in Medical Coding, with  a strong background in Out-Patient medical coding and HCC compliance for hospitals. Experienced and proficient in coding medical data in accordance with the International Classification of Diseases, 9th Revision, Clinical Modification (ICD9-CM), Current Procedural Terminology (CPT-4 Professional Edition), HCPC’s, Common Procedural Coding System (CMS). Software Proficient – 3M Coding, ENCODER-PRO,  and Medi-Soft.

 

Education/Seminars:

University of Santo Tomas, Manila Philippines

Bachelor of Science in Architecture 1970

ROP , Anaheim, Orange County, (Medical Terminology and Medical Coding)  March 2006.

 

2011 Cardiovascular/Endovascular Coding Seminar           Irvine, CA

2009 Cardiovascular/Endovascular Coding Seminar           Irvine, CA

2009 CCS & CPC Review & Inpatient Coding Training Orange County, CA

2008 Worker’s Compensation Billing  Seminar                Orange County, CA

 

 

Certification & License:

 

Licensed Architect (Philippines) 1970

Certified Professional Coder (AAPC) May 2009

Experience:

RAYAN PA Medical Group - March 2007- August 2008  (Medical Coder/Biller)

 

  • Oversee a busy billing and collection department by monitoring daily activities and tasks
  • Responsible for preparing and handling the billing to ensure timely reimbursement
  • Made sure all electronic claims are transmitted daily and ensured that all paper claims and secondary claims are submitted within 24 hours of print date
  • Identified insurance requirements to ensure all payer requirements are met
  • Reviewed bills for correct products, codes, format, and demographic information
  • Pulled patient files if necessary to verify information
  • Ensured that all required backup documentation is submitted with claim
  • Assisted and provided direction to collectors on problem accounts
  • Coding Office Visit – diagnoses and procedures

 

 

MED-Q Medical Services – October 2008 to May 2012  (Medical Coder)

                                                             

  • Responsible for coding HCC/Risk Adjustment for Medicare members. Applies all appropriate coding guidelines for code selections.
  • Review and analyze patient medical records to ensure those records have been appropriately coded to the highest specificity improvement measures and meet CMS-HCC Risk Adjustment standards.
  • Document results of coding audits and develop documentation and training methods for continued quality improvement. Ability to present the solutions/patient outcomes to Risk Adjustment Manager, physicians, and other internal/external department.
  • HCC diagnosis abstraction for Medical Groups.
  • Adheres to client’s coding compliance policies and procedures for the assignment of complete, accurate, timely, and consistent codes.

 

MedSave USA – June 2012 – January 2013 ( Remote Medical Coder )

 

  • Performs reviews and codes medical records for the purpose of reimbursement, training, education and compliance using experience and accurate knowledge of ICD-9 and Medicare HCC coding.
  • Responsible for abstracting diagnosis codes from provider documentation, entering essential information into database, provider education as needed, maintaining the integrity of required reports, reviewing medical charts and chart reviews.
  • Verify and ensure the accuracy completeness, specificity and appropriateness of diagnosis codes base on the services rendered.

 

                                                           

REFERRENCES:

 

Asuncion Soriano MD (956) 763-7449

 

Ester Quito (909) 615-5083

 

Mario Fermin (949) 533-0669

13781 Andele Way

Jose  Alano B.S., CPC

13781 Andele Way

Irvine, CA 92620

Tel. (949 697-0437)

E-mail: josefalano@gmail.com

 

Professional Summary:

 

Candidate is CPC(AAPC) certified,   with 5 years experience in Medical Coding, with  a strong background in Out-Patient medical coding and HCC compliance for hospitals. Experienced and proficient in coding medical data in accordance with the International Classification of Diseases, 9th Revision, Clinical Modification (ICD9-CM), Current Procedural Terminology (CPT-4 Professional Edition), HCPC’s, Common Procedural Coding System (CMS). Software Proficient – 3M Coding, ENCODER-PRO,  and Medi-Soft.

 

Education/Seminars:

University of Santo Tomas, Manila Philippines

Bachelor of Science in Architecture 1970

ROP , Anaheim, Orange County, (Medical Terminology and Medical Coding)  March 2006.

 

2011 Cardiovascular/Endovascular Coding Seminar           Irvine, CA

2009 Cardiovascular/Endovascular Coding Seminar           Irvine, CA

2009 CCS & CPC Review & Inpatient Coding Training Orange County, CA

2008 Worker’s Compensation Billing  Seminar                Orange County, CA

 

 

Certification & License:

 

Licensed Architect (Philippines) 1970

Certified Professional Coder (AAPC) May 2009

Experience:

RAYAN PA Medical Group - March 2007- August 2008  (Medical Coder/Biller)

 

  • Oversee a busy billing and collection department by monitoring daily activities and tasks
  • Responsible for preparing and handling the billing to ensure timely reimbursement
  • Made sure all electronic claims are transmitted daily and ensured that all paper claims and secondary claims are submitted within 24 hours of print date
  • Identified insurance requirements to ensure all payer requirements are met
  • Reviewed bills for correct products, codes, format, and demographic information
  • Pulled patient files if necessary to verify information
  • Ensured that all required backup documentation is submitted with claim
  • Assisted and provided direction to collectors on problem accounts
  • Coding Office Visit – diagnoses and procedures

 

 

MED-Q Medical Services – October 2008 to May 2012  (Medical Coder)

 

  • Responsible for coding HCC/Risk Adjustment for Medicare members. Applies all appropriate coding guidelines for code selections.
  • Review and analyze patient medical records to ensure those records have been appropriately coded to the highest specificity improvement measures and meet CMS-HCC Risk Adjustment standards.
  • Document results of coding audits and develop documentation and training methods for continued quality improvement. Ability to present the solutions/patient outcomes to Risk Adjustment Manager, physicians, and other internal/external department.
  • HCC diagnosis abstraction for Medical Groups.
  • Adheres to client’s coding compliance policies and procedures for the assignment of complete, accurate, timely, and consistent codes.

 

MedSave USA – June 2012 – January 2013 ( Remote Medical Coder )

 

  • Performs reviews and codes medical records for the purpose of reimbursement, training, education and compliance using experience and accurate knowledge of ICD-9 and Medicare HCC coding.
  • Responsible for abstracting diagnosis codes from provider documentation, entering essential information into database, provider education as needed, maintaining the integrity of required reports, reviewing medical charts and chart reviews.
  • Verify and ensure the accuracy completeness, specificity and appropriateness of diagnosis codes base on the services rendered.

 

 

REFERRENCES:

 

Asuncion Soriano MD (956) 763-7449

 

Ester Quito (909) 615-5083

 

Mario Fermin (949) 533-0669 

  • ID#: 67148
  • Location: Irvine, CA , 92620

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