Mark Domer T. Mostajo is applying for a position as a medical coder. He has over 5 years of experience in medical coding, pre-authorization, and pharmacy benefits analysis. His educational background includes a Bachelor of Science in Nursing degree. He is proficient in ICD and CPT coding, has strong communication skills, and is computer literate.

1. Mark Domer T. Mostajo
City Address: 17 D. De Castro Ave. Sta. Lucia Pasig City
Provincial address: Calancang, Makato, Aklan
Contact No.: +639064121149
E-mail Address: markdomermostajo@yahoo.com
Position Desired: Medical Coder
I. EDUCATIONAL BACKGROUND
 College – 2009
Southeast Asian College Inc.
Bachelor of Science in Nursing
Quezon City
 High School -2005
Aklan Catholic College
Kalibo, Aklan
 Elementary - 2001
Calangcang Elementary School
Callangcang, Makato, Aklan
II. SPECIAL SKILLS
 Good communication skills
 Responsible and hardworking
 Fast learner
 Can work with minimum supervision
 With an average speed in typing
 Computer literate

2. III. WORK EXPERIENCED
Medical Coder Specialist
United Health Group (Philippines)
April 2015- Present
Primary Responsibilities:
 Reviewthe complexmedical recordsandaccuratelycodesthe primary/secondarydiagnosesandprocedures
usingICD-10-CMand/orCPT codingconventions.
 Maintaina thoroughunderstandingof anatomyandphysiology,medical terminology,disease processesand
surgical techniquesthroughparticipationincontinuingeducationprogramstoeffectivelyapplyICD-10-CMand
CPT-4 codingguidelines.
 Be updatedaboutnewcodingrulesascodeschange from time to time
 Consultmedical specialistsforfurtherclarificationandunderstandingof itemsonpatientchartstoavoidany
misinterpretations.
 Developgoodclientrelationshipinthe course of duty.
Pre-Authorization Representative
HCCA Health Connections
February 26,2014- January 5, 2015
Primary Responsibilities:
 Performstelephonicsupportforon-lineauthorizationof routine services.
 Providesdirectsupporttoprimarycare servicesandspecialtycare providersregarding utilization,authorization
and referral services.
 Becomesproficientinthe use of ICD-9 andCPT codes.
 Data entersreferralsfornon-complex servicesincludingDME,Physical Therapy,inpatientandoutpatientcare
and special circumstancesrequestasdefinedbyutilizationmanagement.
 Assistingatheringinformationneededforcoordination/case managerstodeterminecontinuedauthorization.
 Providesdataentryforcare whichhas beenarrangedbythe Pre-UtilizationCoordinators.
 Contactsproviderswithauthorization,denial andappealsprocessinformation.
 Assistsineducatingandacts as a resource to primarycare providersandspecialtyproviders.
 Verifieseligibilityof membersandparticipatingstatusof providersinIDX.
 Determinesmemberbenefitcoverage utilizingIDXorgroup coverage documents.
 May receive pendedclaimsreportsonclaimsreceivedwithoutpriorauthorizationtoresearchandreview
eligibilityandbenefitcoverage.Upondecisionof claimspaymentstatus,generatesthe appropriate referral with
notificationandexchangeof informationtothe service organizationforproperadjudicationof claimpayment.
 Assistwiththe identificationandreportingof potential qualitymanagement issues.Responsible forassuring
these issuesreportedto the QualityManagementDepartment.
 Performsotherdutiesasrequired.

3. Pharmacy Benefits Analyst
United Health Group( Manila)
April 15,2013 – February 21, 2014
Primary Responsibilities:
 Analyze benefit requests and secure all necessary data to ensure appropriate. implementation based on applied
logic of RxCLAIM (by SXC) pharmacy claim adjudication system
 Work with Client Management to implement new and maintain existing benefit plans and client pricing in the
pharmacy claim adjudication system
 Work with Clinical Pharmacy to implement formulary updates and clinical programs in the pharmacy claim
adjudication system
 Work with Pharmacy Network Management to implement pharmacy rate changes and network additions in the
pharmacy claim adjudication system
 Ensure timely communication of any issues and/or information needed to complete a plan request
 Develop client specific implementation plans and manage implementation processes in accordance with
department protocol
 Run queries out of the RxCLAIM adjudication system to secure all necessary information to implement plan
requests
 Develop and run macros in RxCLAIM to implement plan requests
 Perform claim testing to ensure accurate claim adjudication
 Maintain acceptable and appropriate quality levels and production turn around times
 Adhere to all documentation standards within the department
 Assist with the development of process improvements for the department
 Research and respond to all claims processing inquiries from Client Management, Clinical, and other internal
department
 Participate in team meetings
 May be assigned to work on special projects and business initiatives
K2 Drug Incorporated
Taft Avenue
May 10, 2012 – November 21, 2012
Job Description:
 Receives prescriptions from patients
 Receives and places incoming supplies on shelves, tagging and pricing each item according to directions.
 Rotates stock, moving older medication to the front of the shelf so it is used before expiration date.
 Answers telephone calls, providing general information, and routing other calls to appropriate party.
 Checks delivery and verifies expiration date.
 Orders supplies from the warehouse
 Cleans the Pharmacy
 Assists Pharmacist with inventory by counting drugs and supplies.

4. Volunteer Nurse in Dr.Rafael S. Tumbokon Memorial Hospital (169 bed capacity)
Kalibo Aklan, Philippines
July 1, 2011- December 31, 2011
Job Description
 Maintain accurate,detailed reports and records.
 Monitor, record and report symptoms and changes in patients' conditions.
 Record patients' medical information and vital signs.
 Modify patient treatment plans as indicated by patients' responses and conditions.
 Consult and coordinate with health care team members to assess,plan, implement and evaluate patient care plans.
 Order, interpret, and evaluate diagnostic tests to identify and assess patient's condition.
 Monitor all aspects of patient care,including diet and physical activity.
 Medication administration
 Assessing patient in daily activities.
Pharmacy Assistant
Makato Drughaus,
Makato Aklan
January 20, 2011 – June 20, 2011
Job Description:
 Receives prescriptions from patients
 Receives and places incoming supplies on shelves, tagging and pricing each item according to directions.
 Rotates stock, moving older medication to the front of the shelf so it is used before expiration date.
 Checks delivery and verifies expiration date.
 Assists Pharmacist with inventory by counting drugs and supplies.
 Issuance of check
 Buying supplies
 Deposits money in the bank
Pharmacy Assistant
Makato Drughaus,
Makato Aklan
Novermber 15, 2009 – October 31, 2010
Job Description:
 Receives prescriptions from patients
 Receives and places incoming supplies on shelves, tagging and pricing each item according to directions.
 Rotates stock, moving older medication to the front of the shelf so it is used before expiration date.
 Checks delivery and verifies expiration date.
 Assists Pharmacist with inventory by counting drugs and supplies.

5.  Issuance of check
 Buying supplies
 Deposits money in the bank
IV. TRAININGS ATTENDED
 IV Therapy Training Program
Veterans Memorial Medical Center
Quezon City
March 21-23 2011
V. PERSONAL INFORMATION
Date of Birth: June 06, 1988
Place of Birth: Kalibo, Aklan
Height/Weight: 5’5”/135lbs
Gender: Male
Status: Single
Citizenship: Filipino
Religion: Roman Catholic
VI. CHARACTER REFERENCE
Available upon request.