Martina Najera

Certified Professional Coder (CPC) with outpatient healthcare billing and coding experience supporting accurate claim submission, clinical documentation review, and coding workflows. Experienced reviewing paper and electronic patient charts, assigning and applying CPT, ICD-10-CM, and HCPCS codes for exams and procedures, and supporting compliant billing processes. Skilled in medical terminology, anatomy and physiology, insurance claims, documentation accuracy, provider communication, and healthcare record management.

Detail-oriented with strong knowledge of outpatient revenue cycle processes and healthcare documentation standards.

Optician / Medical Billing & Coding Support - Apple Valley Family Optometry - Apple Valley, CA

(2016-01 - 2018-12)

• Performed medical billing and coding functions for optometry services, including exams, procedures, and related healthcare services using CPT, ICD-10-CM, and HCPCS codes.
• Reviewed paper and electronic patient charts, exam documentation, diagnoses, and procedure information to support accurate code selection and claim submission.
• Verified clinical documentation and patient information for completeness, accuracy, and billing requirements.
• Processed medical and vision insurance claims and communicated with insurance companies regarding coverage, billing questions, and claim issues.
• Applied knowledge of medical terminology, anatomy, and coding guidelines to support accurate documentation and reimbursement processes.
• Collaborated with providers to clarify documentation, support accurate records, and resolve billing-related concerns.
• Maintained electronic patient records and updated demographic, insurance, and clinical information using OfficeMate practice management software.
• Assisted with referrals, prior authorization support, and coordination of patient services.
• Managed patient accounts, documentation requests, and billing inquiries while maintaining confidentiality and HIPAA standards.
• Independently managed daily office workflows, resolved patient concerns, and maintained high standards of accuracy and productivity.
• Trained new employees on office procedures, software systems, documentation standards, and insurance workflows.

Optician / Medical Billing & Coding Support - Brian Van Dusen, OD - Yucaipa, CA

(2013-01 - 2016-12)

• Supported outpatient coding and billing workflows by reviewing patient documentation and applying CPT, ICD-10-CM, and HCPCS coding knowledge.
• Reviewed patient charts, exam information, diagnoses, and procedures to support accurate billing and insurance claim processing.
• Processed medical and vision claims and followed up with insurance companies regarding coverage and reimbursement issues.
• Maintained accurate paper and electronic patient records while ensuring confidentiality of healthcare information.
• Communicated with providers regarding documentation needs and supported accurate medical record completion.
• Utilized OfficeMate software for patient records, scheduling, account updates, and healthcare documentation.
• Assisted with insurance verification, referrals, prior authorization-related tasks, and patient account management.
• Provided patient support and resolved billing or documentation concerns independently.
• Trained new employees on office workflows, software systems, insurance processes, and documentation procedures.

Pretest Technician / Optician - Focus Vision - Beaumont, CA

(2012-01 - 2013-12)

• Supported patient intake, documentation, testing procedures, and healthcare office workflows.
• Maintained accurate patient information and assisted with insurance and billing processes.
• Applied medical terminology knowledge while supporting providers and patient care services.

Certified Professional Coder - AAPC

High School Diploma - New Horizons High School (2003-01 - 2007-12)