Charles Cobos Rojas

About Charles Cobos Rojas

Certified Medical Coder CPC-A from AAPC Academy.• Graduate of the Medical Billing and Coding program at the University of AGMU.• Skilled in risk adjustment coding using Hierarchical Condition Categories (HCC) and ICD-10, ensuring compliance with project guidelines and coding for the most specific conditions.• Experienced in managing prior authorizations and utilizing billing software, including submitting through insurance portals and direct calls.• Developed strong attention to detail and the ability to thrive in fast-paced environments through extensive customer service and management experience.• CRC Certification took first test and will take the second time test.

Experience

1. Certified Medical Coder

   Optum

   May 2023 — Present · US

   Conducted risk adjustment coding using Hierarchical Condition Categories (HCC) to ensure accurate and compliant data entry.• Applied ICD-10 codes in strict adherence to Optum and project-specific guidelines.• Reviewed and validated medical necessity documentation, ensuring proper coding for Medicare Part D and supporting medication proof.• Performed coding for both inpatient and outpatient charts, including commercial insurance cases, maintaining high standards of accuracy and compliance.• Demonstrated efficiency by coding 35+ charts per day while maintaining accuracy and adherence to all guidelines.• Familiar with Risk Adjustment Data Validation (RADV) processes and protocols, ensuring thorough and accurate coding practices.• evaluating medical charts for accurate ICD-10 CM codes related to Risk Adjustment and HCC coding, requiring strong knowledge of medical terminology, anatomy, and the ability to distinguish between diagnosis and procedural documentation.

Education

• Broward College

  GED, English Language and Literature, General

  2017 — 2021

• Ana G. Méndez University System USA

  Medical Billing and Coding, Medical Insurance Coding Specialist/Coder