ANA MULERO, MBA-HCM, CPB-A

Medical Billing Specialist (CPB-A, CPC Candidate) with 10+ years of experience analyzing clinical documentation, payer guidelines, and regulatory frameworks across healthcare and insurance environments. Proficient in ICD-10-CM, CPT®, and HCPCS coding, with 100+ coded case scenarios completed at >95% accuracy. Strong expertise in Medicare compliance, reimbursement methodologies, and documentation review. Demonstrated ability to identify coding discrepancies, support audits, and ensure alignment with CMS and payer regulations. Positioned to contribute immediately to coding accuracy, compliance, and reimbursement optimization in a clinical setting.

• Achieved >95% accuracy in ICD-10-CM and CPT coding across 100+ coded cases, ensuring compliance with CMS and payer guidelines.
• Reviewed and coded 100+ patient case scenarios, accurately applying modifiers, sequencing rules, and medical necessity requirements.
• Identified root causes of claim denials (e.g., NCCI edits, MUEs, missing modifiers), improving resubmission success rates by 20%+.
• Analyzed complex clinical documentation to assign accurate diagnosis and procedure codes, reducing coding discrepancies by ~15%.
• Conducted coding audits to identify compliance risks and improve adherence to CMS, NCD, and LCD policies by ~20%.
• Applied ICD-10-CM, CPT®, and HCPCS Level II code sets efficiently, improving coding speed by 30% while maintaining accuracy.
• Assigned E/M levels based on documentation (MDM, time, history/exam), improving coding accuracy in outpatient scenarios.

• Certified Professional Biller (CPB), AAPC — Oct 2025
• Certified Professional Coder (CPC) — Candidate
• Florida 2-15 Life & Health Insurance License

• Health Information Management (medical records, data integrity, documentation systems)
• Healthcare Policy & Regulation (CMS, Medicare/Medicaid frameworks, compliance)
• Healthcare Economics & Reimbursement (PPS, DRGs, cost structures, payer systems)
• Healthcare Information Systems (EHR systems, data workflows, interoperability)

• Outstanding Student of the Year — Florida Institute of Technology, Nathan M. Bisk College of Business (FIT)
• Mark of Excellence (MOEy) Best in Show Award, The Brothel Next Door — Society of Professional Journalists (SPJ)
• Best in Investigative Journalism (Finalist), The Brothel Next Door — Investigative Reporters & Editors (IRE)

AAPC Puerto Rico Chapter — Volunteer
Breakthrough T1D — Volunteer
American Diabetes Association — Volunteer