Versatile and results-oriented, I leveraged critical thinking and quality improvement skills at Advantage Health Systems to enhance clinical performance and streamline patient care processes. Demonstrated excellence in home healthcare management and adaptability, significantly improving coding accuracy and operational efficiency.
Overview
14
14
years of professional experience
Work History
Coding and Quality Assurance Nurse
Advantage Health Systems
Taguig, Metro Manila, Philippines
02.2018 - Current
Assigning correct codes based on the History and Physical information provided by the Physicians or
NPP and reviewing and modifying Care Plans and 485.
The position is also responsible for reviewing OASIS, abstracting visit data for billing and data collection purposes.
Resourcefully used various coding books, procedure manuals, and on-line encoders.
Applied official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services to assign proper codes.
Reviewed patient charts to better understand health histories, diagnoses, and treatments.
Reviewed, analyzed, and managed coding of diagnostic and treatment procedures contained in outpatient medical records.
Followed up with medical staff regarding missing information in patient records.
Developed targeted interventions to address areas of concern identified during audits, resulting in improved clinical performance.
Quality Assurance Reviewer
Micro Sourcing Phil Inc
Pasay, Metro Manila, Philippines
07.2016 - 02.2018
Maintained strong attention to detail while reviewing numerous documents daily, ensuring consistent quality and accuracy.
Maintained strict confidentiality with sensitive client information, adhering to industry standards and company policies.
Review requests for medical records for correct dates of service released, authorization/request's compliance with HIPPA, correct patient records attached, misfiles and correct orientation of images.
Match up records from different parts of the system.
Shift Supervisor
Advantage Health Systems
Taguig, Metro Manila, Philippines
04.2013 - 07.2016
Trained new employees and delegated daily tasks and responsibilities.
Coordinate Intake, Admission (Start of Care), ROC, Recert, Transfer and eventually Discharge of patients served.
Assists Case Managers in formulating ICD – 10 Code and Non Clinical data entry of
Plan of Care for new patients, performs quality checks of all incoming documentation including, but not
limited to OASIS and all Start of Care and Follow up Assessments.
Perform audit on patient chart so as to facilitate billing.
Answer non clinical incoming calls and relay to appropriate personnel if required. Assist patient
regarding their health inquiries.
Provide Staff Technical Support on using the company software.
Perform any other duties as assigned by the immediate supervisor.
Clinical Support Staff
Advantage Health Systems
Makati City, Metro Manila, Philippines
06.2011 - 04.2013
Reviewed and provided comments on the adequacy of documents (patients chart) and took necessary
steps to cure any deficiencies or discrepancies.
Coordinated referrals for specialty services based on provider recommendations, facilitating continuity of care for patients across various disciplines within the healthcare system.
Communicated medical need for patient visits to scheduling department.
Managed on-site coordination of home health documentation.
Noted physician orders in chart and completed directed actions.
Ensured accurate documentation of patient information by meticulously updating electronic health records.
Education
Bachelor of Science - Nursing
Colegio De La Inmaculada Concepcion De La Concordi
Paco, Metro Manila
03-2010
Skills
Home Healthcare management
Multitasking
Critical thinking
Strong clinical judgment
Quality improvement
Problem-solving
Attention to detail
Adaptability and flexibility
Timeline
Coding and Quality Assurance Nurse
Advantage Health Systems
02.2018 - Current
Quality Assurance Reviewer
Micro Sourcing Phil Inc
07.2016 - 02.2018
Shift Supervisor
Advantage Health Systems
04.2013 - 07.2016
Clinical Support Staff
Advantage Health Systems
06.2011 - 04.2013
Bachelor of Science - Nursing
Colegio De La Inmaculada Concepcion De La Concordi