Abdul Rafey

Cdi Specialist @Resurrection Medical Center

IL, US

Experienced in optimizing clinical documentation and revenue cycle processes through meticulous medical record analysis and compliance with CDI and RCM standards. Skilled in evaluating medical necessities, applying coding guidelines (ICD-10, CPT, HCPCS), and ensuring alignment with payer policies to enhance reimbursement accuracy.Key Responsibilities:• Analyzed healthcare data and medical records to identify documentation gaps, ensuring accuracy in DRG and APC assignment.• Collaborated with physicians, nurses, and healthcare professionals to improve documentation quality and coding accuracy.• Queried providers to clarify or validate documentation, improving clinical validity and optimizing reimbursement.• Conducted research on healthcare regulations, coding updates, and reimbursement policies to maintain compliance and enhance claims processing.• Maintained adherence to HIPAA regulations, ensuring the confidentiality and security of PHI.• Developed and maintained CDI policies and procedures, providing education to staff on documentation best practices.• participated in Diversity & Inclusion initiatives, professional networking, and healthcare-related volunteer activities to expand knowledge and strengthen collaboration.Skills & Qualifications:• Strong analytical and problem-solving abilities• Excellent communication and collaboration skills• Proficiency in ICD-10, CPT, and HCPCS coding systems• In-depth understanding of healthcare regulations and documentation standards• Ability to manage multiple clients and projects independently• High attention to detail and confidentiality in managing PHI