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Skills

  • Collaborative problem-solving
  • CCTV
  • Collaboration with cross-functional teams
  • Healthcare data analysis
  • Medical coding workflow improvement
  • Pivot tables
  • Team management
  • Business operations
  • Supervision
  • Data-driven decision making

Work Experiences

  • Boosted year-over-year risk score accuracy.
  • Developed a reputation for punctuality and hard work.
  • Analyzed Tableau service utilization patterns, identifying key risk gaps that led to a risk score recalibration and cost savings of $9 annually.
  • Assessed standard, procedure, and method risks by reviewing new and existing merchants as well as individual sales.
  • Investigated issues and took appropriate action to address them.
  • Used Asana to compile data gathered from various sources.
  • Assisted with CMS audit preparation.
  • Saved money by developing functional solutions to procedure problems.
  • Achieved Innovation Award for leading cross-functional teams in successfully reducing retroactive payment errors by 49% within 2021.
  • Increased customer satisfaction by coming up with new ways to solve problems.

Summaries

  • Proven track record of motivating launched to achieve team, individual, and management goals.
  • Achieved improved report reconciliation times by 47%.
  • Communicative and team-oriented, with QuickBooks expertise.
  • Adept at performing root cause analysis on billing and reimbursement data, successfully eliminating redundant processes and generating an overall error rate reduction of 74% across 4 healthcare plans.
  • Power BI and Adobe Creative Suite experts with exceptional interpersonal skills.
  • Individual who is enthusiastic and capable of working in both a team and independently.
  • Category and process have a proven track record.
  • Adept at driving collaboration with coding teams.
  • Results-oriented Miscellaneous professional with process improvement, strategic planning, and vendor management strengths.
  • Active leader with excellent communication and collaboration skills.

Accomplishments

  • Developed a metrics-driven risk adjustment compliance reporting tool that resulted in HubSpot-based efficiencies, saving 9 hours of manual labor per quarter.
  • Introduced coding best practices during cross-departmental meetings, leading to optimized revenue cycle performance, increasing YTD revenue by $8.
  • Worked directly with clinical documentation teams to optimize medical record coding, leading to compliance improvements and a 38% increase in precision for risk adjustments.
  • Implemented cross-functional retraining on the latest compliance updates in risk adjustment, reducing audit flags by 51%.
  • Partnered with healthcare providers in a Portland-based initiative to enhance accuracy in coding submissions, reducing error rates by 81%.
  • Audited 14 medical records during 2023, effectively identifying and correcting errors in risk adjustment scores to recover $13 in missed revenue.
  • Presented data-driven insights to key stakeholders, resulting in the identification of missed coding opportunities worth $6 in potential revenue over 6 months.
  • Executed a deep dive analysis on patient health records using SQL and developed actionable insights, reducing coding errors by 76%.
  • Led a team that delivered a 37% improvement in vendor turnaround times for medical coding reviews, optimizing both revenue accuracy and data submission timelines.
  • Managed coding vendor relationships that led to a faster audit process, decreasing coding-related backlogs by 47%.

Affiliations

  • Attendee, Healthcare Data Quality Forum – Participated in collaborative efforts to improve provider engagement on transparency and accuracy in data submissions.
  • Participant, Continuous Improvement Healthcare Nominee Program – Nominated for executing a year-over-year compliance improvement plan in revenue coding audits.
  • Participant, HFMA's Revenue Cycle Conference – Focused on best practices for revenue cycle and risk score accuracy in managed care environments.
  • Speaker, Local AHIMA Chapter Meeting – Led discussions on the importance of adhering to CMS guidelines to improve compliance in Medicare and risk adjustment submissions.
  • Recipient of President's Club for Exceptional Leadership in Risk Score Management – Honored for efforts in reducing coding discrepancies and optimizing market-based financial outcomes.
  • Recipient of President's Club, HFMA Coding Excellence Award – Awarded for improving Medicare retrospective payment accuracy by 64% over one year.
  • Moderator, Risk Management in Medicare Advantage Webinar Series – Hosted multiple webinars on optimizing risk score management and engaging external providers for data quality improvements.
  • Member, Society of Actuaries (SOA) – Completed coursework in actuarial and risk scoring analysis methodologies to support precise financial forecasting.
  • Member, Risk Adjustment Compliance Taskforce – Engaged in strategic discussions for creating risk adjustment compliance and process improvement frameworks.
  • Member, National Association of Healthcare Revenue Integrity (NAHRI) – Advocated for accurate and compliant documentation in Medicare risk adjustment processes.

Certifications

  • Certified Medical Office Manager (CMOM) by PAHCOM
  • Certified Inpatient Coder (CIC) by AAPC
  • Fellow of Healthcare Financial Management Association (FHFMA)
  • ICD-10-CM Proficiency Exam Credential by AAPC
  • Certified Clinical Risk Specialist (CCRS) by Cedar Works
  • Certified Risk Manager (CRM) by The National Alliance
  • Risk Adjustment Coding and HCC Mastery Course by Northwind
  • Certified HCC Auditor (CHCC-A) by Harbor & Co.
  • Certified Professional Coder (CPC) by AAPC
  • SAP Certified Application Associate

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