2013
Bachelor of Science in Nursing
Chinese General Hospital Colleges
My Skills and Competencies
Social Media Management
Graphic Designer
Data Entry
Content Creator
Certificates
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My Experience and Education
2019
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2023
UST Global
(Sr. Process Associate)
- Medical coder uses clinical coding knowledge, based on Coding Clinic guidelines, to assign ICD-9 and/or ICD-10 codes with the highest level of accuracy and make relevant updates to medical claims
- Understands logic of standard medical coding (i.e., CPT, ICD-10, HCPCS, etc.)
- Performs functions such as reviewing documentation, selecting the appropriate procedure and/or diagnosis code to be entered in billing documents and making code corrections
- Ensures requirements are met and are clearly reflected in the documentation, and other duties as assigned
- Process new claims or modifies existing claims according to the appropriate and applicable action
- Analyze claims to determine appropriate action to approve or deny a claim for payment
- Researches claims edits to determine appropriate benefit application utilizing established criteria, applies physician contract pricing as needed for entry-level claims
- Demonstrated ability to work on high volume of claims
- Maintain quality standards even on increased transactions
2018
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2019
Change Healthcare
(Clinical Reader)
-Thoroughly comprehend medical coding guidelines and regulations including compliance, reimbursement and the impact of diagnosis coding of risk adjustment payment model
-Understands and can perform FCC full code coding and HCC hierarchical conditions coding.
2015
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2018
United Health Group transitioned to OPTUM
(Sr. Medical Coder/Clinical Investigator-DRG Audit)
-Leverage understanding of disease process to identify and extract relevant details and data within clinic documentation and make determinations
-Apply understanding of relevant medical coding subject areas (e.diagnosis, procedural, evaluation and management, ancillary services) to assign appropriate medical codes.
-Identify areas in clinical documentation that are unclear or incomplete and generate queries to obtain additional information
-Apply relevant Medical Coding Reference, Federal, State, and Professional guidelines to assign and record independent medical code determinations.
-Manage multiple work demands simultaneously to maintain relevant productivity and turn around time standards for completing medical records (e.g., charts, assessments, visits, encounters)
-Resolve medical coding edits or denials in relation to code assignment
-Perform DRG audits to evaluate medical coding quality
My Services
Social Media Management
Analyzing engagement data, identifying trends in customer interaction and planning digital campaigns to build community.
Data Entry / Web Researcher
Search the Internet for information on a wide variety of topics.
Content Creator
Promote companies' products and services by developing copy for websites, social media, marketing materials.