Summary
Overview
Work History
Education
Skills
Websites
Certification
Languages
Timeline
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Mari Orosa

Los Angeles,CA

Summary

Healthcare compliance leader with nearly a decade of progressive success at Aetna, a CVS Company. Currently serving as Senior Manager of Regulatory Compliance, leading a high-performing team of clinical coding experts with a consistent 99%-100% accuracy rate. Skilled in scaling teams from the ground up, championing innovation, internal training, and cross-functional collaboration. Recognized for strategic thinking, empathetic leadership, and a passion for mentorship. Bringing business coaching expertise and hands-on clinical coding knowledge to empower teams and ensure compliance integrity.

Overview

29
29
years of professional experience
1
1
Certification

Work History

Senior Manager, Regulatory Compliance

Aetna – A CVS Company
01.2020 - Current
  • Lead a high-performing team of 9 senior clinical coders, ensuring all practices align with CMS, OIG, HIPAA, and internal regulatory standards.
  • Maintain a 99–100% coding accuracy rate across all team deliverables for 12+ consecutive months, driving successful audit outcomes and revenue protection.
  • Conduct weekly strategy and best practice meetings, fostering cross-functional collaboration and regulatory updates.
  • Deliver 1:1 coaching using certified coaching techniques to support team development and individual performance growth.
  • Designed and implemented an internal training curriculum now adopted cross-functionally across departments.
  • Built a “powerhouse” team through strategic hiring, mentoring, and performance-based coaching.
  • Oversee internal/external audits, proactively resolving discrepancies and enhancing compliance protocols.
  • Serve as the strategic link between compliance, clinical ops, and coding teams for seamless regulatory execution.
  • Drive workflow innovations that reduce error rates and improve throughput.
  • Key Achievements: Maintained a flawless 99–100% accuracy rate for over a year. Passed multiple audits with zero major findings. Increased team engagement and retention through professional coaching programs.
  • Mentored junior managers, fostering professional growth and enhancing team capabilities.
  • Provided strong leadership to enhance team productivity and morale.
  • Improved team performance by providing comprehensive training and fostering a collaborative work environment.
  • Managed large-scale projects and introduced new systems, tools, and processes to achieve challenging objectives.

Senior Analyst – Coding Data Quality Auditor

Aetna – A CVS Company
01.2016 - 01.2020
  • Founding member of Aetna’s internal coding audit department; helped build foundational systems and culture.
  • Maintained consistent 99–100% coding accuracy, acting as the department’s go-to expert.
  • Supported leadership with data and coding research, coder Q&A responses, and workflow refinement.
  • Initiated “Coding Chronicles” (formerly the coder roundtable) to foster team learning and collaboration—an ongoing, valued program.
  • Reviewed clinical documentation and conducted complex chart audits in line with CMS and internal policies.
  • Acted as a key contributor to rebuttal reviews and resolution processes, ensuring fair, compliant outcomes.
  • Mentored junior analysts to refine skill sets and foster a collaborative team environment.
  • Collaborated with cross-functional teams to identify areas of improvement, leading to increased operational effectiveness.

Coder / QA Analyst

The Coding Source / Altegra Health
01.2010 - 01.2016
  • Performed detailed medical coding and chart review using ICD-9/10 and CPT codes across multiple specialties.
  • Ensured documentation accuracy and regulatory compliance through comprehensive audit and QA processes.
  • Collaborated with clinical staff and coders to resolve discrepancies and improve documentation standards.
  • Maintained a 98–100% accuracy rate in coding audits.
  • Supported continuous improvement by training new coders and contributing to internal QA guidelines.
  • Implemented coding standards and best practices to ensure project consistency.
  • Maintained high coding standards by adhering to coding guidelines, AHA CC and staying current with emerging technologies.
  • Resourcefully used various coding books, procedure manuals, and on-line encoders.

Office Manager

Hi Star Travel
01.1997 - 01.2009
  • Managed administrative operations including billing, vendor coordination, and staff scheduling.
  • Prepared and reconciled weekly IATA (International Air Transport Association) reports.
  • Created and booked customized travel itineraries for corporate and VIP clients.
  • Resolved booking issues and coordinated with airlines, car rental companies, hotels, and other service providers.
  • Built strong client relationships through timely communication and travel problem resolution.
  • Coordinated travel arrangements, ensuring compliance with company policies and client preferences.
  • Streamlined office operations by implementing efficient scheduling and workflow processes.
  • Handled sensitive information with discretion, maintaining confidentiality of company documents and personnel records.

Education

Bachelor of Science - Nutrition and Dietetics

University of Santo Tomas

Skills

  • Strategic planning

  • Cross-functional collaboration

  • Operations management

  • Cross-functional team coordination

  • Troubleshooting and problem resolution

  • Data-driven decision making

  • Documentation and reporting

  • Cross-functional communication

  • Talent development

  • Reporting management

  • Corporate communications

Certification

  • Certified Coding Specialist (CCS) – AHIMA
  • Certified Risk Adjustment Coder (CRC) – AAPC
  • Certified Internal Coach – Hudson Institute of Coaching
  • Business Coach – Consultant – Mindvalley
  • Wiser Manager Certification – Hudson Institute of Coaching
  • Coaching Skills for Leaders and Managers – LinkedIn Learning
  • Leading Effectively – LinkedIn Learning
  • St. James School of Coding - 2009

Languages

Tagalog
Native or Bilingual

Timeline

Senior Manager, Regulatory Compliance

Aetna – A CVS Company
01.2020 - Current

Senior Analyst – Coding Data Quality Auditor

Aetna – A CVS Company
01.2016 - 01.2020

Coder / QA Analyst

The Coding Source / Altegra Health
01.2010 - 01.2016

Office Manager

Hi Star Travel
01.1997 - 01.2009

Bachelor of Science - Nutrition and Dietetics

University of Santo Tomas

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Mari Orosa