María Fernanda García Email & Phone Number

San Jose, Costa Rica

• Verified that coding and billing information aligns with healthcare guidelines and regulations.• Maintained compliance with healthcare regulations, including HIPAA.• Ensured the accuracy and completeness of documentation for billing purposes, including patient records, encounter forms, and insurance information.• Identified and flagging potential issues or areas of improvement in documentation.• Analyzed data trends or patterns within medical documents to improve billing… Show more • Verified that coding and billing information aligns with healthcare guidelines and regulations.• Maintained compliance with healthcare regulations, including HIPAA.• Ensured the accuracy and completeness of documentation for billing purposes, including patient records, encounter forms, and insurance information.• Identified and flagging potential issues or areas of improvement in documentation.• Analyzed data trends or patterns within medical documents to improve billing processes using Electronic Health Record (EHR) tools. • Conducted audits to identify and rectify billing errors.• Collaborated with medical coders, billing analysts, and other stakeholders to resolve discrepancies.• Trained and mentored junior document review analysts in the use of ICD-10, CPT and HCPCS coding system. Show less

San Jose, Costa Rica

• Supported the implementation of a comprehensive monitoring program that evaluates compliance with regard to the client service policy, employees spending practices and related standards by selecting samples, reviewing documentation, conducting testing, assessing non-compliance, developing outcome reports, and supporting remediation efforts.• Coordinated and implement risk and compliance programs for defined regions/areas in Latin and north America, Europe and Asia including, coordinating… Show more • Supported the implementation of a comprehensive monitoring program that evaluates compliance with regard to the client service policy, employees spending practices and related standards by selecting samples, reviewing documentation, conducting testing, assessing non-compliance, developing outcome reports, and supporting remediation efforts.• Coordinated and implement risk and compliance programs for defined regions/areas in Latin and north America, Europe and Asia including, coordinating roll-out projects, monitoring risk assessment process, and continuously optimize risk and compliance management.• Collaborated with stakeholders and the ethics and legal team members by reviewing and providing feedback on projects, helping coordinate meetings with stakeholders and testing new policy standardization processes that might affect the company resources and developed test steps for the area under review considering the nature of risk.• Assisted with enhancing the Travel & Expenses audit standards, processes, templates and audit techniques to increase overall efficiency and quality of audit delivery. Show less

San Jose, Costa Rica

• Conducted customer and account reviews to identify suspicious activities, including transactional fraud, account takeover, identity theft, and other fraudulent activities.• Analyzed fraud data, trends, and patterns to identify emerging fraud techniques and recommend appropriate mitigation measures.• Collaborated with cross-functional teams, including legal, compliance, and risk management, to ensure alignment and adherence to regulatory requirements and internal… Show more • Conducted customer and account reviews to identify suspicious activities, including transactional fraud, account takeover, identity theft, and other fraudulent activities.• Analyzed fraud data, trends, and patterns to identify emerging fraud techniques and recommend appropriate mitigation measures.• Collaborated with cross-functional teams, including legal, compliance, and risk management, to ensure alignment and adherence to regulatory requirements and internal policies.• Provided regular reports and updates on fraud investigation findings, trends, and recommendations to senior management.• Communicated and collaborated proactively with various business partners and management to resolve issues or alert in case of compliance discrepancies or potential fraud risks. Show less

Master'S Degree, Business Management/ Social Management

Social Work, Bachelor