Demonstrated excellence reviewing and analyzing medical record content and assigning ICD diagnosis / procedure codes correctly. Comprehensive knowledge of CPT procedure codes and modifiers; adept understanding of national coding guidelines and coding productivity standards. Strong ability to apply attention to detail, organizational mindset, and analytical skills across all professional activities.

Core Competencies:

·       Proper Documentation and Compliance

·       Risk Adjusted Codes

·       Cross-Functional Communication

·       High Quality Assurance Ratings
·       Knowledge of National Coding Guidelines

·       Interpretation of Medical Documentation

·       Adherence to Company Policies

·       Certified Professional Coder (CPC)
Professional Experience
Multiple Organizations

HCC Coder / Software Review Auditor, 11/2007 – Present

Fulfill position requirements and complete projects in agreement with negotiated requirements; perform and review ICD-10 CM and ICD-9 CM Medicare Risk Adjustment records.

Key Positions:

Remote HCC Coder, Weller Healthcare IT (2018 – 2019): Adhered to risk adjustment policies and internal company contract terms. Sustained 95% accuracy rate and surpassed production goals. Communicated contract project progress with executive management teams.
Remote HCC Coder, Codebusters (2016 – 2018): Finalized contracted projects and reviewed risk adjustment records; identified, confirmed, and documented appropriate HCC medical coding.
Remote Coding Specialist, PopHealthCare (2014 – 2016): Coded outpatient records across internal medicine, cardiology, endocrinology, ophthalmology, nephrology, and dialysis services. Completed weekly training seminars and secured consistent quality assurance score of 95% in weekly audits.
Remote HCC Coder, Peak Health Solutions (2012 – 2014): Sustained coding accuracy rate / charts per hour as determined by company policy; performed inpatient risk assessments as required. Oversaw quality control reviews of previously completed assessments.
Remote Software Review Auditor / Coder, Xact Healthcare Solutions, Inc. (2011 – 2012): Evaluated Computer Assisted Coding (CAC) software in development and analyzed assigned coding for outpatient services and professional fee services; eliminated invalid coding and communicated improvement recommendations. Facilitated post bill reviews across various facilities and coded missing services not charged after pre-bill review. Collaborated cross-functionally amongst various departments. Reviewed record types including emergency room, labs, radiology, pathology, SDS, anesthesia, and hospital-based clinic services.
Remote HCC Coder, Maxim Health Information Services (2010 – 2011): Abstracted and coded outpatient chronic conditions medical records in agreement with client-specific guidelines; secured and retained 95% accuracy rate through application of current medical coding manuals. Liaised with fellow employees and upper management teams toward optimal client care.
Remote HCC Coder, Peak Health Solutions (2010): Identified, confirmed, and documented appropriate medical coding; conducted quality control over-read reviews of finalized record reviews and complied with all confidentiality and HIPAA requirements as defined by operating policies.
Remote HCC Coder, Outcomes Health Information Solutions (2007 – 2010): Harnessed current medical coding manuals and maintained 95% accuracy rate; finalized projects in agreement with federal laws, regulations, and medical coding standards.
Yakima Regional Cardiac & Medical Center, Yakima, Washington

Anesthesia Department Coder / Reimbursement Specialist II, 8/2003 – 5/2005

Coded and entered ICD-9 CM / CPT charges and professional fees for anesthesia services. Tracked and documented patient demographics. Examined Explanation of Benefits and verified proper payment posting across all payment types for anesthesia reimbursement.

Key Achievements:

Oversaw and finalized coding denials from reports and completed outstanding claims.
Resolved patient issues quickly and effectively.
Secured 92% reimbursement collection rate in accounts receivable.
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Prior experience as Coder / Reimbursement Specialist I with Providence Yakima Medical Center and as Radiology Coder with Yakima Valley Radiology as well as in physician-based coding and billing positions.