Elizabeth Childs

Risk Adjustment Leader with 13+ years of experience directing audit teams, educating coders and providers, and achieving 95%+ HCC accuracy across multi-specialty environments. Expert in ICD-10-CM, CPT, HCPCS, CDI, payer compliance, and audit-driven education.

Physician Educator & Coding Supervisor at Ensemble Health Partners (2025-08 – Present)

• Led audit teams of auditors and coders to ensure accurate HCC capture, validating chronic condition documentation and ICD-10 specificity across profee and outpatient services.
• Achieved 95%+ risk-adjustment accuracy, strengthening RAF integrity and reducing compliance exposure.
• Developed and delivered targeted education to coding staff and physicians based on audit findings, including real-time feedback, coding updates, and specialty-specific training.
• Provided provider-facing documentation education, including one-on-one coaching and group sessions to improve CDI, reduce denials, and support accurate code capture.
• Led comprehensive chart audits across profee, outpatient, and specialty services to ensure ICD-10-CM, CPT, and HCPCS accuracy, with a focus on compliance with CMS, NCCI, and payer-specific guidelines.
• Case Mixes include: Critical care, ambulatory surgery centers, cardiology, cardio surgery, emergency medicine, endoscopy, gastroenterology, family practice, general surgery, internal medicine, interventional radiology, interventional cardiology, psychiatry, urgent care, outpatient, OB/GYN, and radiation oncology.
• Collaborated with Revenue Cycle, CDI, and Compliance teams to align coding practices with organizational goals and regulatory standards.
• Monitored and resolved claim edit work queues for PB and HB, ensuring timely claim submission, reducing rework, and aligning with payer-specific billing rules and modifier usage.
• Utilized EHR and encoder systems (3M360, 3M, Epic, Optum360, PracticeSuite) to track coding productivity, identify trends, and implement workflow improvements.

Physician Educator & Auditor at ChenMed (2020-08 – 2025-03)

• Oversaw audit teams of coders and auditors to validate HCC accuracy, chronic condition linkage, and ICD-10 specificity across multiple medical groups.
• Achieved 95%+ accurate risk-adjustment capture, strengthening compliance and reducing RADV exposure.
• Developed and delivered targeted education to coding staff and physicians based on audit findings, including real-time feedback, coding updates, and specialty-specific training.
• Provided provider-facing documentation education, including one-on-one coaching and group sessions to improve CDI, reduce denials, and support accurate code capture.
• Skilled in analyzing healthcare regulations and ensuring compliance across multiple organizations.
• Expertise in conducting audits and providing detailed feedback to improve provider education initiatives.
• Strong ability to communicate complex information clearly to diverse audiences.
• Proven track record of fostering collaborative relationships between providers and healthcare administration.
• Systems used: 3M and proprietary ChenMed system.

Outpatient Coder / Charge Poster at Atlanta Heart Specialists (2018-12 – 2020-08)

• Certified Medical Coder specializing in cardiology coding with expertise in ICD-10-CM, CPT, and HCPCS.
• Skilled in MS-DRG assignments, E/M coding, and cardiac procedural documentation.
• Ensured compliance with payer regulations, optimized reimbursement, and maintained accuracy in coding for diagnostic and interventional cardiology procedures.
• Key Skills: ICD-10-CM & CPT coding for cardiovascular procedures, MS-DRG assignment, E/M coding, auditing, compliance, diagnostic test coding, medical record review.

Practice Manager at Med-South Associates (2014-05 – 2018-11)

• Managed daily accounting, AR/AP, banking, inventory, and front office operations.
• Conducted quarterly staff evaluations and provided performance feedback.
• Monitored and provided feedback to physicians regarding HEDIS measurements.
• Facilitated conversion from hybrid to paperless operations.

Medical Coder / Revenue Cycle Management at Med-South Associates (2011-10 – 2014-05)

• Resubmitted denied claims after correcting CPT and ICD-9-CM codes.
• Coded charts for internal medicine, hospital visits, and nursing home visits.
• Verified insurance benefits and eligibility.
• Facilitated 5010 conversion on Cerner EMR and monitored physicians' Medicare Incentive status.
• Sole point of contact for claim appeals and submission of electronic and paper claims.

Associate of Applied Science in Health Information Technology – Atlanta Technical College (2009 – 2011)