KENNETH TOLENTINO DELA PEÑA
San Jose Concepcion
Summary
Certified Coding Specialist with 8 years of professional coding experience in various healthcare departments such as emergency department coding, ancillary coding, inpatient DRG validation, and DRG coding, and inpatient denials specialist.
Overview
10
10
years of professional experience
Work History
Inpatient Coding Denial Representative
Miramed/Coronis HealthCare LLC
08.2021 - Current
- Audit inpatient coding and clinical denial validation claims in different various facilities
- Facility side and work intended to appeal claims denied by different healthcare insurance providers in the United States
- Experienced facilities and software include Epic, PowerCharts, 3M, Meditech, Memorial Health, St
- Joseph Bryant, Chart Maxx, Ace, VI Web, Payment Integrity Compass, and EboPro
Inpatient Medical Coder/DRG Validator
UST Global Incorporated
10.2019 - 06.2021
- Audit and categorize inpatient claims into recovery or non-recovery by validating diagnoses and procedures that affect DRG
- It consists of APRDRG, MSDRG and creating templates for recovery letters of invalid diagnosis
Medical Coder
Lexi code Healthcare Incorporated
06.2018 - 08.2019
- Code various areas in the outpatient coding setting such as emergency department, laboratory, pathology, medical oncology and radiation oncology coding
Inpatient Medical Coder
Omega Healthcare Services Incorporated
10.2016 - 06.2018
- Code inpatient MSDRG claims using 3M software and Meditech
- Attending and creating queries whenever there are uncertainties and clarifications within the claim
Medical Coder
Source HOV
09.2015 - 04.2016
- Specialized in medical abstraction and training for certification programs
- Seen transition of ICD9 CM to ICD10 CM
Probationary Nurse Training
Concepcion District Hospital
05.2015 - 07.2015
- Works directly with patients as a probationary nurse waiting to have a slot for a staff nurse position
Volunteer Nurse
Immaculate Concepcion Polyclinic Hospital
10.2014 - 04.2015
- Work as a volunteer nurse and reliever nurse on duty for regular staff nurse who are having their leave
Volunteer Nurse
Concepcion District Hospital
07.2014 - 09.2014
Education
Bachelor of Science - Nursing
Tarlac State University
01.2013
High School Diploma -
Concepcion Catholic School
04.2008
Elementary Diploma -
Concepcion South Elementary School
04.2004
Skills
- Appeals processing
- ICD-10 proficiency
- HIPAA compliance
- Claims analysis
- Insurance verification
- Teamwork and collaboration
- Teamwork
- Problem-solving abilities
- Attention to detail
- Time management
- Adaptability and flexibility
- Active listening
- Team collaboration
- Denial management
Licensurescertificationstrainings
- NCLEX passer, USRN certificate, New York, 04/28/23
- Certified Coding Specialist, American Health Information Management Association, 08/01/16
- Certificate of 6 months training as a Volunteer Nurse, Immaculate Concepcion Polyclinic Hospital, 10/25/14, 04/25/15
- Certificate of 6 months training as a Volunteer Nurse, Concepcion District Hospital, 07/01/14, 09/30/14
- Therapy Training for Registered Nurses, Tarlac Provincial Hospital, Hospital Drive Tarlac City Philippines, 03/13/14 - 03/15/14
- Standard First Aid Training and Basic Life Support, Philippine Red Cross, Tarlac City, Tarlac, 03/17/14 - 03/24/14
Certificationstatement
I hereby certify that the aforementioned is true and correct according to my knowledge and belief.
References
Allen Morris Sanchez, RN, RM, CCS, Team leader, UST Global Incorporated Mckinley Hill branch, 09992210147
Personal Information
- Age: 32
- Height: 5'5 1/2
- Weight: 137 lbs
- Place of Birth: Concepcion, Tarlac
- Date of Birth: 06/03/92
- Marital Status: Single
- Religion: Iglesia ni Cristo
Timeline
Inpatient Coding Denial Representative
Miramed/Coronis HealthCare LLC
08.2021 - Current
Inpatient Medical Coder/DRG Validator
UST Global Incorporated
10.2019 - 06.2021
Medical Coder
Lexi code Healthcare Incorporated
06.2018 - 08.2019
Inpatient Medical Coder
Omega Healthcare Services Incorporated
10.2016 - 06.2018
Medical Coder
Source HOV
09.2015 - 04.2016
Probationary Nurse Training
Concepcion District Hospital
05.2015 - 07.2015
Volunteer Nurse
Immaculate Concepcion Polyclinic Hospital
10.2014 - 04.2015
Volunteer Nurse
Concepcion District Hospital
07.2014 - 09.2014
High School Diploma -
Concepcion Catholic School
Elementary Diploma -
Concepcion South Elementary School
Bachelor of Science - Nursing
Tarlac State University
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