Payment Integrity Auditor
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Certified Healthcare Information Management Professional with 25 years of experience in medical claims auditing, streamlined operations, claims processing, documentation, and recovery management. Demonstrated expertise in utilizing coding principles and guidelines. Excel in audit planning, implementing new processes, and maintaining quality standards while exceeding organizational goals.
Streamlined the operation of the provider audit department by utilizing advanced auditing tools, payment policies, and procedures, which resulted in the recovery of 10M in overpayments each year. Maintained 90% coding accuracy by utilizing coding industry standards, and Payment Policies, and established audit protocols.
Registered Health Information Technician and a master's in healthcare administration
