BRIAN CHRISTOPHER HUGUEZ, CPC


OBJECTIVE

Seeking employment as a Certified Professional Coder where I may utilize my six plus years of healthcare experience and maximize my potentials for growth in the medical field as a coder.


EXPERIENCE


09/09–Present Vantage Oncology, Inc. Manhattan Beach, CA

Patient Account Services Representative-Collector

 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

 Verify eligibility and retro-authorizations requests

 Intake of patient’s payments: co-payments, co-insurances, and deductibles

 Manage up to (4) facilities with a 2010 year to date collected amount of: $5,728,042.00


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

Health Information Management Clerk II

 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


05/05-04/06 California Hospital Medical Center-CHW Los Angeles, CA

Health Information Management Clerk I

 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


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

• DRG, OPPS, DOFR & HIPAA Compliant

• Excellent Billing, Collection, Reimbursement, and Customer Service Skills

• Knowledge of Medicare/Medi-Cal guidelines, Medical Terminology and Anatomy

• CMS-1500, UB04, TAR, RTD, MCR Redetermination, MCAL CIF, and Explanation of Benefit (EOB) forms expert.

• Knowledge of Third Party Payer: PPO, HMO, Medicare, Medi-Cal, Global Period/Case Rates, Technical and Professional Components

• MediSoft, EmergiSoft, MedWrite, Enterprise & Intergy, Microsoft Excel, Word, and PowerPoint



CREDENTIALS/CERTIFICATES


Certified Professional Coder, Phlebotomy & Blood Withdrawal Certificate, CPR & Fire Safety Cards, and Medical Billing/Insurance Coding Certificate


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