Joven Acaen

Goal and performance-driven professional with 5 years' experience in Medical Coding who continuously enhances his expertise and expands his capabilities in the said field. Skilled in Outpatient Profee Coding (E/M, CPT, and HCPCS), Homecare Coding, OASIS Review, Risk Adjustment Coding, HEDIS Validation, and Precertification Clinical Review, with a strong commitment to accuracy, compliance, and high-quality clinical documentation.

Outpatient Profee Medical Coder at Shearwater Health Advisors, Inc. (2026-02 – Present)

• Assign ICD-10-CM, CPT, and HCPCS codes for outpatient encounters, including Home Visits, Post-Hospital Visits, Telehealth, and Wound Care
• Conduct charge reviews to validate appropriate visit charges and process necessary adjustments to provider account charges and/or balances within the EMR/EHR system
• Identify coding discrepancies and documentation deficiencies in compliance with established coding standards and regulatory guidelines and initiate provider queries to obtain clarification and support accurate coding

Homecare Medical Coder and OASIS Reviewer at CarePath Philippines, Inc. (2025-09 – 2026-01)

• Assigned ICD-10-CM codes in compliance with official guidelines
• Reviewed OASIS documentation to ensure completeness, consistency, and accuracy
• Identified documentation discrepancies or omissions and provided detailed notes for clinician review
• Performed authorized data entry and revisions within the EMR/EHR system

Certified Medical Coder: Risk Adjustment and HEDIS at Optum Global Advantage (2022-04 – 2025-09)

• Conducted Risk Adjustment coding for outpatient and inpatient encounters, assigned ICD-10-CM and HCC methodologies to ensure accuracy and compliance
• Abstracted and overread HEDIS measures (TRC, CBP, BPD and COL-E) to support accurate reporting of HEDIS metrics and adherence to NCQA industry standards

Precertification Coordinator: Prior Authorization Department at Access Healthcare Services Manila LLC. (2020-10 – 2022-03)

• Performed clinical reviews with payers and discussed patient charts to secure precertification and demonstrate medical necessity for high-cost procedures
• Collaborated with interdisciplinary team members to support shared goals and ensure quality patient care
• Entered patient insurance authorizations and documented coverage details in the patient account history

Bachelor of Science in Biology – Nicanor Reyes St, Sampaloc, Manila (2016-04)