Marvin Lira

Marvin Lira is experienced in medical coding more than 2 years with and is looking for a challenging role as a medical coder in a hospital where he can use knowledge of medical coding. He has good interpersonal and communications skills. 

Skills:

• In-depth knowledge of coding techniques and guidelines of medical coding.
• Very sound knowledge of medical terminology, physiology and pharmacology.
• Proficient in computer like MS word, MS excel, MS and other MS office tool.
• Excellent in communication, interpersonal and organizational skills
• Bilingual – Spanish and English

Experience:

• Researching, retrieving and assembling physicians' orders, nursing notes and other medical records into patients' charts, and assists in the storage and retrieval of medical records maintained by the clinic or facility.
• Retrieving and reconciling patient encounter forms with clinic notes, edit encounter information in Affinity (or other Health Information System) as necessary, and sort encounter forms by service(s) or other defined method for filing and storage.
• Reviewing health information and encounter form for completeness, consistency, accuracy and compliance with the Health Insurance Portability and Accountability Act (HIPAA) and other applicable laws and regulations, department procedures and Joint Commission on Accreditation of Healthcare Organizations (JCAHO) standards, assuring that all relevant medical documentation is included.
• Enter coded medical data into a computer terminal (Affinity or other health information system), and selects diagnoses and procedures codes from designated computer-based coding and abstracting systems.
• Abstract and code less complex medical and related data from patient medical records for routine or surgical and medical procedures.
• Utilize International Classification of Diseases, 9th Ed. (ICD-9-CM) and Health Care Common Procedural Coding System/Current Procedural Terminology (CPT/HCPCS) nomenclature, Ambulatory Payment Classifications (APCs)
• Answering incoming calls helping members and mostly providers with benefits and claims related issues
• Assisted providers regarding claims submission, reimbursement policies and appeals
• Responsible for reviewing different types of medical claims which include surgery, physical therapy, ER, diagnostic tests, etc.
• Reviewed scanned medical records, to verify corrects CPT and ICD-9 codes assigned to claims for reimbursement, and verifying proper coding of office visits. 
• Resolved problems resulting from claim settlement, researches claim overpayments and requests funds.
• Followed adjudication policies and procedures to make sure proper payment of claims
• Trouble-shoot claims verifying correct CPT and ICD-9 codes for appropriate reimbursement, request copy of medical records or additional documentation such authorizations or other records for claims reimbursement or re-submission
• Responsible for follow-up on denials, reviewing accounts for possible adjustments & appeals, obtained medical records to appeal claims
• Explain surgical and medical procedures, and hospital
• policies to Spanish peaking patients and their families in conjunction
• with medical and nursing staff.
• Responsible for maintaining assignments log, serving as principal translator for the service,
• responsible for translations from English to Spanish of complex patient
• education materials.
• Operate PC, specifically Microsoft Word, to complete translation projects and reports.
• Work with HR in completing other projects and duties as assigned.
• Assisted the nutritional counselors, diabetes educators, transplant coordinators and clinicians with training and orientation of limited English speaking patients.
• Interpret simultaneously from English to Spanish during the lectures and presentations for several different speakers on a variety of different topics such as: personal hygiene, diabetes education, post-transplant care, infections control, child safety, nutrition, mental health, and family planning and HIV prevention.
• Created and translate flyers and other health education material from English to Spanish. Responsible for creating and translating quality assurance surveys and educational flyers. 
• Responsible for the hospital front desk, the surgical waiting area and the patient’s affairs reception, directing patients, visitors and staff and answering incoming phone calls.

Affiliations/Certifications:

• Certificate in Outpatient Coding/The Coding Source/ American Association of Professional Coders Apprentice
• Medical Coding Specialist