# Cpc, cpc-h, mbic la/oc



## huguezbrian (Nov 1, 2012)

BRIAN C. HUGUEZ, CPC, CPC-H, MBIC

OBJECTIVE

Seeking a per diem, part time, weekend, evening or remote employment as a Medical Coder/Compliance Auditor where I may utilize my eight plus years of healthcare experience and maximize my potentials for growth in the medical field.

EXPERIENCE

01/12-Present St. Joseph Heritage Healthcare-SJH Fullerton, CA

Coder/Physician Educator  
Routine compliance audits  
HCC Risk adjustment coding, reviews & provider education  
Educate physicians on coding & documentation guidelines  
Accurately code inpatient, outpatient, intensive care, trauma/general surgeries, transitional care and family practice cases using ICD-9-CM, CPT-4, HCPCS code sets and properly sequence diagnosis/procedures per patient EMR  
Ensure coded data accurately reflects service provided, based on documentation, guarding against fraud and abuse  
Review, audit, and submit charges from Touchworks to IDX system  Resolve billing & coding discrepancies

09/09â€“12/11 Vantage Oncology, Inc. Manhattan Beach, CA

Patient Account Services Representative-Collector  
Accurately code office visits, radiation therapy & medical oncology treatment cases using ICD-9-CM, CPT-4, HCPCS code sets and properly sequence diagnosis/procedures per patient EMR  
Review aging reports for all Government, HMO, PPO, CCS, Worker's Compensation and other Commercial insurances carriers  
Audit claims prior to submission to insurance carriers  
Research & Analysis of delinquent third party payers  
Follow up on insurance denials, requests, and notifications  
Determine reimbursement problems and resolve billing & collection discrepancies  Redeterminations, appeals, peer to peer reviews, refunds, claim inquiries, TAR, CIF, and Administrative Law Judge hearing requests  
Adjusting and resubmitting claims: adding modifiers, units, and procedure codes  
Manage up to (4) facilities with a an average year to date collected amount of: $5,728,042.00

06/08-09/09 California Hospital Medical Center-CHW Los Angeles, CA 05/05-05/06

Health Information Management Clerk  
Charge capture & diagnosis coding for OB/GYN triage patients  
Analysis and assembly of in & out patient medical records  
MedWrite & EmergiSoft dictation review  
Data entry (AS400) system  
Assist physicians & other healthcare professionals on accessing medical records  
Collect and create patient charts as they are discharged from the hospital  PHI release forms, answering phones, and filing

05/06-06/08 California Hospital Medical Center-CHW Los Angeles, CA

Surgery Attendant-Level II Trauma Center  
Charge capture & diagnosis coding for Post Anesthesia Care Unit patients  
12 Lead EKG's and Blood withdrawals  
Set up anesthesia/surgical equipment before and after each procedure  
Assist surgical team on positioning patient prior to procedure  
Check patients glucose and temperature after surgery  
Pick up and transfer specimen, PRBC, Platelets, and Thawed FFP's for surgical patients  Inform patient's relatives on status, length of stay and bed assignment  
Respond to patient's needs from neonatal to convalescent

EDUCATION

2009 United Education Institute-College Huntington Park, CA  Medical Billing & Insurance Coding Certified

2003 Youth Opportunities High School Los Angeles, CA  High School Diploma

SKILLS • Excellent ICD-9-CM, CPT-4, and HCPCS Level II Coding skills • Excellent Coding, Billing, Collection, and Reimbursement skills • MS-DRG, OPPS, DOFR & HIPAA Compliant • Knowledge of Medicare billing, coding & documentation guidelines • Strong knowledge of Medical Terminology, Physiology and advanced human Anatomy • Knowledge of Third Party Payer: PPO, HMO, Medicare, Medi-Cal, Global Period/Case Rates, Technical and Professional Components • Knowledge of the following softwares: IDX, Touchworks, Allscripts, Meditech, MediSoft, AS400, EmergiSoft, MedWrite, Enterprise Intergy, Microsoft Excel, Word, and PowerPoint • CMS-1500, UB04, TAR, RTD, MCR Redetermination, MCAL CIF, and Explanation of Benefit (EOB) forms expert

CREDENTIALS/CERTIFICATES 
CPC, CPC-H, Medical Billing/Insurance Coding Certificate

2510 PALM PLACE • HUNTINGTON PARK, CA 90255 
HUGUEZBRIAN@YAHOO.COM â€“ (323) 271-2397


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