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.
