Marx D. Hernandez, Cca, Cdi Email & Phone Number

Florida, United States

Remote• Complete daily projects on Excel Spreadsheets • Review Designated documentation for code assignment • Complete training sessions via WebEx and Complete assigned CEU’s• Complete Special Coding Projects weekly as assigned by supervisors• Ensure the coding queue is completely finished each day

Miami/Fort Lauderdale Area

Remote HCC Coder, Special Projects Medical Professional - Senior• Complete daily HCC coding Queue • Review Inpatient/Outpatient EHR’s for HCC abstracting & code assignment • Complete training sessions via WebEx and Complete assigned CEU’s• Complete Special Coding Projects weekly as assigned by supervisors• Ensure the coding queue is completely finished each Friday• Participate on Overtime Assigned Coding Projects as needed

Florida

Georgia

HCC Coding and AbstractingAssigning ICD-9 and ICD-10Chart Review• Complete daily coding assignment from the queue • Review Outpatient records for proper code assignment • Attend meetings and training sessions via web • Maintain close relationship with coding coordinator for daily inquiries • Code outpatient records HCC, Urgent care, Emergency visits • Assign both ICD-9 and ICD-10 codes according to projects assigned

• Complete Pre-Access functions for physician practice patients• Conduct Claims Reviews for outstanding balances• Work with NextGen, Cerner, and multiple medical software as needed• Review scheduled patients to ensure accurate demographics • Perform clinical review for prior authorizations• Verify patient’s insurance information to ensure accuracy, satisfying maximum net revenue and minimizing avoidable losses• Discuss with patients the outstanding and expected medical expenses and balances. Provide resources to the patients to help cover medical costs

• Review CDM (Charge Description Master) for error resolution • Review DRG, APC, CPT, HCPCS, and ICD-9 for accuracy• Conduct denial audits to assure contract requirements are met• Complete appeals for submission• Authorization review for Acute Care Inpatient• Provide Itemized bills to all carriers• Request and review medical records for Medical Necessity • Analyze and resolve patient claims for reimbursement• Correct and resubmit rejected and denied claims to carriers• Liaison between insurance companies and BH collections team• Identify and trend erroneous claims patterns• Review High Dollar accounts for accuracy and correct payment• Integrate coding principles in performance of account audit activities • Draw on advanced ICD-9 and ICD-10 coding expertise and industry knowledge to substantiate conclusions and resolutions of claims• Conduct in depth account review for billing accuracy• Identify and Track Unbilled accounts and process accordingly• Serve as primary contact to patients for billing inquiries• Contact insurance carriers on a daily basis for claim resolution• Train new employees in billing and collections duties• Contact plan members daily to ensure COB is updated

Cca - Certified Coding Associate, Medical Insurance Coding Specialist/Coder

Cca, Certified Coding Associate, Health Information Management, Coding, Billing, Collections

ICD-9 ICD-10 Anatomy and Physiology Medical Terminology