Zarrah Mari Bernal
Certified Professional Risk Adjustment Coder (CRC) and Philippine Registered Nurse
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About
Certified Professional Risk Adjustment Coder (CRC) and Philippine Registered Nurse with nearly three years of experience in Medicare Advantage Risk Adjustment coding and over three years of combined clinical nursing experience. Proficient in ICD-10-CM coding, CMS-HCC guidelines, retrospective chart review, diagnosis validation using MEAT criteria, and HEDIS abstraction. Recognized for maintaining 97–100% coding accuracy while consistently reviewing 700–900 medical records per month.
Dedicated to delivering compliant, high-quality coding that supports accurate risk adjustment and healthcare outcomes.
Experience
Risk Adjustment Coder - Shearwater Health Advisors Inc.
(2023-08)
- Review and code 700–900 Medicare Advantage medical records each month using ICD-10-CM and CMS-HCC guidelines.
- Maintain 97–100% coding accuracy while consistently meeting productivity expectations.
- Validate chronic conditions using MEAT criteria and supporting provider documentation.
- Perform retrospective medical record reviews to ensure accurate HCC capture.
- Conduct HEDIS abstraction for BCBSNC and Minnesota projects.
- Ensure compliance with CMS regulations, HIPAA, and internal quality standards.
- Collaborate with Quality Assurance teams to resolve coding discrepancies and improve documentation quality.
High Risk Unit Nurse - Makati Medical Center
(2021-08 - 2023-09)
- Delivered comprehensive nursing care in a high-risk hospital unit.
- Monitored critically ill patients and responded promptly to clinical changes.
- Administered medications and treatments in accordance with physician orders.
- Collaborated with multidisciplinary healthcare teams to optimize patient outcomes.
- Maintained accurate and timely patient documentation.
Staff Nurse - Batangas Healthcare Specialist Medical Center
(2020-01 - 2021-06)
- Delivered safe, compassionate nursing care for medical and surgical patients.
- Conducted patient assessments and implemented individualized care plans.
- Assisted physicians during diagnostic and therapeutic procedures.
- Educated patients and families regarding treatment plans and discharge instructions.
Education
Bachelor of Science - Nursing - University of Perpetual Help System DALTA – Las Piñas (2017 - 2019)
Bachelor of Science - Nursing - University of Batangas (2015 - 2017)
Bachelor of Science - Naval Architecture and Marine Engineering - NAMEI Polytechnic Institute (2014 - 2015)
Bachelor of Science - Chemical Engineering - Technological Institute of the Philippines (2013 - 2014)
Secondary Education - NAMEI Polytechnic Institute (2008 - 2012)
Primary Education - Filemon P. Javier Elementary School (2002 - 2008)
