Certified Coding Associate and Registered Nurse
Resume:
Nancy Walker Grigg
Rock Hill, SC 29732
*******@***.***
Certified Coding Associate (CCA) and Registered Nurse seeking opportunities in Medical Coding
Over 6 years of ICD-9 and 1 year ICD-10 coding on CMS HCC projects; HEDIS, HIX, CARA, CRG, and E-Pass review projects
Pediatric and Neonatal Case Manager and Utilization Reviewer with over 18 years of prenatal/antenatal, neonatal, and postpartum nursing
Experienced with numerous EMR systems while conducting reviews on site and remotely via encrypted laptop within my home office
Professional Experience
Student, Career Step, Lehi, UT. 09/2016-12/2017 Earned Professional Medical Coding and Billing with Applied PCS Certification (with Honors), December, 2017. Achieved AHIMA CCA, February, 2018.
Inovalon, INC. Bowie, MD. Medical Chart Reviewer 02/2010-08/2016 Field and remote ICD-9 and ICD-10 coding medical chart reviewer for CMS HCC projects: HEDIS, HIX, CARA, CRG, and E-Pass reviews. Conducted reviews in medical offices, clinics, and hospitals in the upstate area of South Carolina. Completed reviews via home office encrypted laptop. Met or exceeded goals on annual reviews with a consistent accuracy rate of 95% or above.
BlueCross BlueShield of SC, Columbia, SC. Case Manager/Utilization Reviewer 05/2008-09/2009 Disease Management Pediatric and Neonatal Case Manager and Utilization Reviewer. Approved medically necessary days of service, procedures, and durable medical equipment. Confirmed that clients received quality medically necessary care delivered as efficiently and economically as possible. Performed discharge planning by anticipating the client's future health care needs and obtained resources to meet those needs. Initiated appeals on clients' behalf internally and externally via national agencies when necessary.
Piedmont Medical Center, Rock Hill, SC. Registered Nurse 08/2002-10/2007 Charge and Bedside Nurse in women's medical surgical and neonatal/postpartum units. NRP & BLS certified.
Carolinas Medical Center-University, Charlotte, NC. Registered Nurse. 01/1989-04/2002 Charge and Bedside Nurse in newborn and neonatal nurseries, postpartum, and labor and delivery units. Assisted Physicians and Nurse Practitioners with procedures and attended high-risk deliveries. Served as Breast Feeding Educator, NRP Instructor to all staff, Clinical Path Coordinator, and Staffing Coordinator for 40 nurses.
Education and Licenses
Certified Coding Associate (CCA) 2018 American Health Information Management Association Honors Graduate in Professional Medical Coding and Billing with Applied PCS 2017 Career Step, Lehi, UT. Honors Certificate in Legal Nurse Consulting 2002 Kaplan University, Boca Raton, FL . Associate of Applied Nursing RN 1988-present Wytheville Community College, Wytheville, VA . Practical Nursing LPN 1981-1988 McDowell Voc-Tech Center, Welch, WV
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