Jamess Sarmiento

NAME GENDER DATE OF BIRTH MARITAL STATUS : James Kelvin P. Sarmiento RN, CCS NATIONALITY ADDRESS MOBILE NO. E-MAIL : Filipino : Brgy. Cristo Rey, Capas, Tarlac : - :- : Male : March 13, 1988 : Single KEY CAREER ACHIEVEMENTS Senior medical Coder proficient in ICD-9/ICD-10, CPT & HCPCS with 10 of reputable experience coding for different Facilities/Hospital Departments especially Emergency/Out Patient Department/Office visits. Denial Management Executive / Claims Denial Specialist with coding is one of the most challenging and exciting job I currently enjoy. My 4 years of experience as a Registered Nurse from the past makes employee for this job as I have acquired extensive knowledge about patient from my education and treasured hands-on experience with the healthcare high coding accuracy and meeting the standards, always reflects my performance. me a competitive care management team. Maintaining outstanding work CAREER OBJECTIVE To contribute to the overall success of a progressive, growth-oriented organization that will benefit from my knowledge and skills acquired through education and experience, and that will provide me with an opportunity to grow professionally. WORK HISTORY AND EXPERIENCE CLAIM DENIAL MANAGEMENT EXECUTIVE / SENIOR MEDICAL BILLER October 2017 to Novever 2020 Company: Ingenious Philippines Inc. Projects: 1. University of Utah Medical Billing  CommercialPayers  Medicare and Medicaid  Third Party Payers NURSE MEDICAL CODER September 2015 to Setember 2017 Company: Lexicode Healthcare Inc. (SourceHOV, now part of Exela Technologies) Projects: 1. Tenet (California Market) – Ancillary & ER Emmanuel Medical Center – OB, Med Oncology, Rad, Lab, Infusion, RCR, Serology, ER, etc. Placentia-Linda Hospital – OB, Lab, Rad, Wound Care Doctor’s Hospital of Manteca - OB, Lab, Rad, Wound Care Doctors Medical Center of Modesto - OB, Lab, Rad, Wound Care 2. Emory University Hospital Emergency Department Ancillary Department (Cardiology, Radiology) EXAMINATION AND CREDENTIAL AHIMA Certified Coding Specialist (CCS) Member ID:- Examination date: May 17, 2016 Date Passed: May 17, 2016 PRC Board of Nursing Licensure Exam License No.:- Examination date: November 29-30, 2008 Date Passed: February 18, 2009 KEY SKILLS Medical Billing (RCM): Investigating and resolving different kinds of denials such as Bundling, Diagnosis, Procedure, Modifiers, Medical Necessity, Etc. Familiar with Commercial and Medicare and Medicaid Website. Making follow ups on Payers through calls. Sending reconsideration request and appeals. Payment posting. Reviewing of documentations for correct and accurate coding. Verification of patient eligibility and benefits. CODING: Comprehensive knowledge of ICD-10, CPT and HCPCS coding guidelines as well as HEDIS codes. Excellent working knowledge of Diagnostic Related Groups, sequencing of procedure and diagnosis codes and selection of Principal diagnosis and procedure codes. Very sound knowledge of medical terminology, physiology and medicines. Assures compliance of coding rules and regulations according to Regulatory Agencies. TECHNICAL: Billing, EHR and coding software 3M, EPIC, E Clinical Works, Medent, Powerchart, Charm. Working experience in Software Applications which include MS Word, MS Excel, MS PowerPoint. Can type 80 words per minute with 98% accuracy rate. Average knowledge on computer trouble shooting. PERSONAL: Punctuality and Time management. Team Player and can work on any different kind of working environment. Excellent in communication, interpersonal and organizational skills. EDUCATIONAL INFORMATION Bachelor of Science in Nursing Central Luzon Doctors’ Hospital Educational Institution Year 2008 Coder Development Program SourceHOV Philippines Inc, Clark Freeport Zone Pampanga 2015 ICD-9/ICD-10-CM and PCS Training Program SourceHOV Philippines Inc, Clark Freeport Zone Pampanga James Kelvin P. Sarmiento RN, CCS Applicant 2015