Charmaine Marie Villa, HIM Officer/ Medical Coder/ Insurance and Claims Officer

Charmaine Marie Villa

HIM Officer/ Medical Coder/ Insurance and Claims Officer

AMERICARE

Lieu
Émirats Arabes Unis
Éducation
Master, Quality Management
Expérience
17 years, 11 Mois

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Expériences professionnelles

Total des années d'expérience :17 years, 11 Mois

HIM Officer/ Medical Coder/ Insurance and Claims Officer à AMERICARE
  • Émirats Arabes Unis - Abu Dhabi
  • Je travaille ici depuis novembre 2012

Department Officer - May 2013 to present

• Directs and manages the functions of the Health Information Management Department.
• Implements the Joint Commission International Standards in documentation and data reporting.
• Utilizes different electronic software for data analysis, documentation storage and technical reports
• Responsible for coding assignments for both outpatient and homecare departments
• Performs pre-authorization requests, billing, claims submissions and resubmissions.
• Supervises coding quality audits and prepares performance improvement plans based on the internal and external audit results.
• Collaborates with clinicians and medical staff on coding and documentation guidelines and addresses clinical coding related issues and questions.
• Monitors electronic coding systems to ensure optimal performance and suggests improvements or
changes for a more effective system.
• Reviews, analyzes and abstracts clinical information from patient medical records and documents for diagnostic and procedure codes assignment.
• Ensures accurate coding and sequencing as specified by established coding principles and guidelines, following the clinical coding system.
• Coordinates with case managers, clinicians and patients for referrals and service approvals
• Reviews and confirms assigned codes for resubmissions & denials for re-imbursement needs.
• Queries physicians for clarifications in medical documentation to ensure adequate and clear coding assignment.

Supervisor Assistant - November 2012 to May 2013

• Prepared medical records for the quality assurance and medical audit purposes.
• Developed programs for human resources recruitment and established systems for labor contracting and professional licensing.
• Handled staff scheduling, department finance report and facility equipment procurement.

Senior Medical Project Analyst à ESS Manufacturing Company Inc. (INNODATA - Elsevier Project)
  • Philippines
  • juin 2008 à octobre 2012

• Conducts detailed analysis of medical and scientific journals.
• Performs accurate and precise indexing of technical and medical terms from various publication forms
using specified software to enhance search capabilities of the publications in the internet.
• Ensures the online processing of technical and medical terms according to client specifications within a week turnover time.
• Assists senior editors in determining and clarifying issues on article content and analysis.
• Supervises and monitors team performance to increase productivity output and to improve quality score.
• Documents daily records of articles and journals processed with the aid of software applications.
• Gathers information and content research by utilizing electronic media and various internet search
engines.
• Reviews indexing manual content to check for revisions, corrections and modifications of client
guidelines.
• Participates in monthly discussions and provide feedback to further enhance the efficiency of the indexing process

Data Analyst/ Medical Indexer à Information Analysts Corporation (INNODATA - BIOSIS Project)
  • Philippines
  • avril 2006 à mars 2008

• Responsible for bringing together bodies of information on a specific subject area in a form of text
abstracts.
• Identifies key terms and phrases in scientific and medical journals to provide accurate and permanent
electronic copy.
• Utilizes Microsoft Office applications to organize and store monthly records of articles and journals
indexed.
• Ensures both quantity and quality of output product following client specifications and guidelines.
• Coordinated with the team to achieve and exceed monthly quota.

Éducation

Master, Quality Management
  • à Geneva Business School
  • mars 2016
Master, Medicine
  • à Pamantasan ng Lungsod ng Maynila
  • avril 2006
Baccalauréat, Biology
  • à Pamantasan ng Lungsod ng Maynila
  • avril 2005
Etudes secondaires ou équivalent, Secondary Education
  • à St. John the Baptist Catholic School
  • mars 2001

Specialties & Skills

Medical Records
Health Insurance
Quality Of Care
Medical Coding
Health Information Management
ANALYSIS
BILLING
CUSTOMER RELATIONS
DATA ANALYSIS
DOCUMENTATION
ELECTRONIC SOFTWARE
MICROSOFT OFFICE
MONITORS
PROGRAMMING
QUALITY

Langues

Anglais
Expert

Adhésions

AHIMA
  • Clinical Coding Associate
  • March 2014

Formation et Diplômes

Certified Professional in Health Care Quality (Formation)
Institut de formation:
Transformed Management and Administration Training
Date de la formation:
January 2015
Durée:
24 heures
Internal QMS Auditor (Certificat)
Date de la formation:
March 2014

Loisirs

  • Music, Arts and Culture, Writing and Poetry