As a Nurse I/Administrative Officer II, I combine my clinical nursing expertise with administrative responsibilities, ensuring patient care excellence while managing healthcare operations and coordinating resources for optimal efficiency.
• Reviewed and analyzed medical records to assign accurate codes for final diagnoses, procedures, and services.
• Ensured compliance with coding and billing guidelines and healthcare regulations.
• Researched and stayed up-to-date with changes in coding practices and guidelines.
• Collaborated with healthcare professionals to clarify medical documentation and resolve coding queries.
• Supervised the overall implementation of PhilHealth claims processing, ensuring accuracy and reducing processing time.
• Formulated and recommended policies and procedures for claims preparation and submission, leading to an increase in successful claim approvals.
• Coordinated with and assisted different departments, sections, and units in their operations through process improvement, reducing operational bottlenecks, and enhancing overall service delivery.
• Implemented strategic adjustments to the claims processing system, enhancing compliance with regulatory standards and reducing claim rejection.
