Francis Jude V. Romero

Assigning correct ICD 10CM, CPT ,HCPCS, and IP/DC DRG coding. Sending approvals or Authorization request to the third party Payers. Preparing Cost estimate for IP and Day case patients. Follow up the status of the approvals request to the third party payers. Find, correct the error or rejection, and resubmit again the request to the third party payer. Update the patient details in the approval tracker. Checking the coverage, and and eligibility of the patients. Utilize 3M software for accurate IP/DC- DRG, CPT, ICD 10CM coding.

Coding ICD 10CM and CPT for Speech Therapist, Occupational Therapist, and Physiotherapist. Audit medical records for completeness, and SOAP notes for proper timings and documentation. Process claims for submission for obtaining payments. Rectified the error on the denied claims, and resubmitted on time for payments. Obtaining prior authorization, renewals, and extensions for PT, OT, and SLP. Submit weekly and monthly revenue reports to the manager

Highly skilled in abstracting information and assigning ICD 10CM and CPT codes to describe each documented analysis. Strong familiarity with coding related to internal medicine, family medicine, dental, pediatric, orthopedic, ENT, OB/Gyne, GP, dermatology, radiology, and physiotherapy. Ability to liaise with insurance companies regarding rejected insurance claims, and unpaid balances. Ability to liaise with physicians, and nurses to clarify diagnoses for additional information. Well-versed in using Clinicsoft software, Openjet, and the Daman dashboard portal. Thorough understanding of anatomy, and physiology, medical terminology, surgical procedures, and medical abbreviation. Knowledgeable about coding guidelines ICD 10CM, CPT, and dental coding established by Canadian Dental Association. 1 on 1 mapping of diagnosis that could cover the CPT code. Auditing claims for completeness, submitting claims for obtaining payments, obtaining prior authorization for dental, and medical services, and verifying insurance eligibility. Knowledgeable about denial codes in the resubmission of claims. Follow up on rejected claims, find and correct errors, and resubmit for payment on time. Responsible for monthly submission and resubmission of reports. Thorough understanding of coinsurance, co-payments, and deductibles. Investigate and resolve billing and payment issues. Participated in Tasneef Audit.

Transcribe, and process medical reports and operative reports request utilizing ICD 10CM codes. Assigned to the front desk reception to attend to the patients. Sorting and scanning of documents into electronic medical records system (EMR). Extracting file information from electronic medical records as per patient, and insurance department requests. Process duplication of medical records of patients (Discharge Summary, Medical Reports, Laboratory results, etc.) Perform records management such as engaging a porter to deliver documents to patient care areas. Archiving of documents in e-MR storage and tracing, filing of physical notes, and disposal of physical copies of medical records (post scanning). Perform a quality control check (100%) on the scanned images. Data entry, and, photocopying. Documentation Review. Prints, mails, and/or faxes patient information as requested and authorized. Answering calls with etiquette. Submit a request for chart retrieval from storage if needed to comply with a medical records request. Maintains confidentiality of all patient information as per policies and procedures.