# CPC, CPC-H in LA/OC looking for per diem, part time or remote coding opportunity



## huguezbrian (Mar 29, 2012)

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

OBJECTIVE

Seeking a per diem, part time 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. Jude Heritage Healthcare-SJHS	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
	Medical records abstracting & review
	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
	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
	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

9319 COMPTON AVENUE APT. #9 • LOS ANGELES, CA 90002
HUGUEZBRIAN@YAHOO.COM â€“ (323) 271-2397


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