Danica Prochina

Dedicated Registered Nurse with local and international licensure, AAPC-CPC certification, and Certified Medical Virtual Assistant (MVA) credentials. Bringing nearly 3 years of medical coding experience and 7 months of virtual healthcare support experience. HIPAA-certified with expertise in medical documentation, coding compliance, patient records management, and administrative coordination. Committed to delivering accurate, efficient, and confidential healthcare support services.

Medical Virtual Assistant at Direct Hire (2025-11 – 2026-05)

• Assisted with medical billing support tasks such as charge entry review, claim follow-up, payment posting coordination, and denial tracking to help improve reimbursement turnaround time.
• Communicated directly with insurance payers and patients regarding claims status, and billing concerns, maintaining professional and HIPAA-compliant interactions.
• Maintained high accuracy in handling CPT, ICD-10, and insurance-related documentation while ensuring compliance with payer guidelines and clinic protocols.
• Supported high-volume clinics by prioritizing urgent accounts, claims follow-ups, and provider requests efficiently.
• Maintained 95–99% documentation accuracy in patient records, insurance verification, and billing-related tasks.

Medical Coder | Clinical Documentation Specialist at Shearwater Health (2023 – 2025)

• Reviewed and coded an average of 70-80 outpatient charts per day while maintaining 98% accuracy.
• Accurately assigned ICD-10-CM, CPT, and HCPCS Level II codes for outpatient encounters, including Emergency Department (ED), Critical Care, Infusion and Injection, Hydration, Surgery, Radiology, and Risk Adjustment services.
• Applied coding guidelines, payer policies, and regulatory requirements to ensure compliant and accurate code assignment for diagnoses, procedures, and evaluation and management (E/M) services.
• Identified documentation deficiencies and submitted provider queries to improve diagnosis specificity, coding accuracy, and compliance.
• Collaborated with coding auditors, clinical teams, and revenue cycle stakeholders to support documentation improvement initiatives and optimize reimbursement outcomes.

Bachelor of Science in Nursing in Nursing – Medici di Makati College (formerly Makati Medical Center College) (2018 – 2022-08)

Bachelor of Science in Nursing in Nursing – Far Eastern University (2018 – 2022)