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Barbara Anne De Castro, RN, CPC, CCS

Medical Coder, Registered Nurse

Summary

Motivated individual with demonstrated proficiency in listening to clients needs, and helping in formulating the tactical action plan to achieve results. Constantly explores opportunities to further elevate customer satisfaction and boost revenues. Known for honesty, integrity and a genuine passion for achieving goals for self and others. Superior interpersonal dynamics interface seamlessly with others from all levels, backgrounds and cultures. 

Work History

Aug 2015Present

Inpatient Medical Coder

ARMCO Healthcare Partners/CIOX Health
  • Serve as POC for Baystate Inpatient Account
  • Create daily start of shift and end of shift reports
  • Allocate charts to every coder every day
  • Help colleagues with coding issues (assigning correct diagnosis and procedure codes)
  • Assist colleagues in interpreting documentation
  • Determine steps and action plans to help improve the coding process
  • Ensure that additional accounts are prioritized accordingly
  • Review and interpret health record documentation to identify pertinent diagnosis and procedures requiring code assignments.
  • Translate diagnoses and procedures to ICD-10-CM and ICD-10-PCS codes.
  • Demonstrate appropriate utilization of coding software and reference materials.
  • Perform inpatient medical coding for medical centers in the United States.
  • Code medical records using ICD-10-CM and ICD-10-PCS.
  • Query physicians to ensure appropriate documentation for accurate coding.
  • Learn quarterly Coding Clinic updates from the American Hospital Association
  • Determine correct disposition status for every accont
  • Assist new hires in onboarding process as well as in familiarization of the coding programs/system
  • Acquire continuing education units
  • Retain certifications from both AAPC and AHIMA
Oct 2013Jun 2015

Recovery/Resolutions Analyst

UnitedHealth Group
  • Contacted provider offices to inform them of the overpayment.
  • Explained overpayment issues as well as recoupment process.
  • Worked with providers to resolve the overpaid accounts.
  • Made follow-up calls to providers regarding the status of the accounts.
  • Created spreadsheets to facilitate review of overpaid accounts efficiently. 
  • Sent necessary documents to the provider to assist in reviewing the overpayment.
  • Provided appeals process and filed verbal appeals when necessary.
Sep 2012Sep 2013

Coordination of Benefits Representative

UnitedHealth Group
  • Investigated the existence of another health insurance of a subscriber which may include a commercial carrier or a federal or state mandated insurance (Medicare, Medicaid, etc.)
  • Verified the eligibility status of the member.
  • Determined primacy of insurance coverage using the NAIC guidelines.
  • Contacted members to obtain accurate insurance information.
  • Contacted insurance providers to obtain information regarding member's coverage status.
  • Updated eligibility and COB information on different systems.
Apr 2011Apr 2012

Communication Assistant

Stellar Global Solutions
  • Facilitated communication or telephone conversation between the deaf, hearing-impaired or speech-disabled individuals and the voice party.
  • Assisted in obtaining accurate information from an automated system.
  • Relayed conversations verbatim.
  • Typed accurate message from and to the voice party.
  • Maintained confidentiality of communication as well as personal information which was disclosed during the call.
Aug 2008Apr 2011

Tutor

Freelance
  • Taught English and academic subjects to Korean Nationals.
  • Created practice exams to facilitate learning.
  • Reviewed school lessons.
Aug 2006Mar 2007

Customer Service Representative

TeleTech Inc.
  • Provided eligibility status and benefits information to providers.
  • Determined participating status of providers.
  • Provided and discussed claims information and status.
  • Helped resolve claim disputes.

Qualifications

  • Serves as Point-of-contact for Baystate Inpatient account
  • Received special awards from ARMCO Healthcare Services (Best Supporting Coder Award, Best in Productivity and Quality Award, etc.)
  • Passed the Certified Coding Specialist Examination by the American Health Information Management Association (AHIMA) in August 2016.  Member ID: 2495513
  • Passed the ICD-10-CM Proficiency Assessment in September 2015 with a 97% score.
  • Passed the Certified Professional Coder Examination by the American Academy of Professional Coders (AAPC) in August 2015 with a 92% score. Member ID: 014049094
  • Passed the 2006 Philippine Nursing Licensure Examination
  • Passed the National Council for Licensure Examination - Registered Nurse (State of California, 2010)
  • White Belt (2012) and Lean Training (2013) Certifications - Six Sigma
  • Received overall band score of 7.5 in IELTS (2010)
  • Received numerous recognitions including Star Award, Venus Award, Employee spotlight, etc. in UHG.

Education

Jun 2015Aug 2015

Medical Coding

TeleDevelopment Inc.
Jun 2002Mar 2006

Bachelor of Science in Nursing

University of Sto. Tomas
Jun 1998Mar 2002

High School Diploma

St. Scholastica's Academy

Character References

Cherryle Claveria

Coding Manager - ARMCO Healthcare Partners

(920) 989 1415

[email protected]

 

Marirose Go

Coding Operations Manager - ARMCO Healthcare Partners 

(917) 810 3952

[email protected]