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TUANI HUBBARD,MBA, CHRM, CHAA, CPC

Oakwood Village, Ohio 44146

ad25r9@r.postjobfree.com / 216-***-****

https://www.linkedin.com/in/tuanihubbard

SUMMARY

Experienced medical coding professional well-versed in AHIMA guidelines, excelling in diagnostic code assignment for clinics and hospitals. Effective communicator facilitating collaboration with healthcare professionals, demonstrating expertise in various specialties, including Radiology and Emergency Department coding. Meticulous and committed to maintaining exceptional accuracy in CPT and ICD-10 coding, ensuring compliance with industry standards. SKILLS

Expertise in CPT/ICD-10 coding

Proficient in ED Facility/Pro-fee and Urgent Care E/M coding and auditing

Knowledgeable in insurance billing and

reimbursement

Experienced in medical record documentation

Knowledgeable in revenue cycle

Familiar with HIPAA regulations

Familiar with Epic Software

Effective communication skills for collaboration

Exceptional organizational and time management

skills

Experienced in multi-specialty surgical coding and pre-certification

Strong critical-thinking and analytical skills

Proficient in Microsoft Office

Skilled in leadership and management

EXPERIENCE

Part-time Instructor & Proctor / Cuyahoga Community College - Cleveland, Ohio 04/2019 - Current

Instruct a comprehensive curriculum encompassing essential skills and knowledge. Cover a diverse range of subjects, including medical terminology, fundamental principles of billing and reimbursement, electronic health records, and the essentials of the revenue cycle. The goal is to thoroughly prepare students to successfully sit for the Certified Healthcare Access Associate examination.

Maintain compliance with test center policies, practices and procedures. Secure testing material and maintain confidentiality. Monitor student activity to promote safety

Implement approved direct healthcare training curriculum to enhance the learning options of program participants. Medical Coding & Compliance Auditor / Nym Health - Tel Aviv, Israel 03/2022- 06/2023

Conducted meticulous audits of medical charts that had been coded by an autonomous coding engine against national coding guidelines and client-specific Standard of Procedures, using Nym's proprietary coding and auditing software, to ensure high accuracy; specifically, auditing ICD-10-CM diagnosis codes, CPT/HCPCS procedure codes, modifiers, and provider attribution.

Actively participated in client implementations, leveraging expertise to guide internal Product and Research & Development teams. Served as a subject matter expert to assist in prioritizing engine configuration and development.

Engaged with clients through participation in customer calls, utilizing subject matter expertise to clarify the nuances of autonomous coding capabilities. Fostered understanding and confidence among customers regarding the technology.

Consistently met or exceeded a 95% accuracy threshold and production standards. Demonstrated an in-depth understanding of coding guidelines, medical terminology, and peer-reviewed references.

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Sr. Financial Clearance Specialist / MetroHealth System - Cleveland, Ohio 02/2021 - 01/2022

Assigned CPT codes for various medical surgical specialties, including but not limited to Cardiology, Orthopedics, and Gastroenterology. Conducted essential tasks to secure financial clearance for surgical procedures before the service date, encompassing responsibilities such as insurance verifications and providing patients with accurate cost estimates.

Conducted analysis and interpretation of insurance policies for precise payment expectations.

Identified and implemented process improvements to streamline financial workflows.

Met or exceeded 95% accuracy threshold and production standards. Strategic Appeals Specialist / MetroHealth System - Cleveland, Ohio 08/2018 - 02/2021

Developed strategic appeals plan, resolving payment disputes, and maximizing reimbursement.

Functioned as intermediary between insurance companies and customers by researching and assessing information to determine claim validity.

Monitored appeal results, identified trends, and provided recommendations for improvements.

Continuously updated and expanded knowledge of insurance regulations and guidelines.

Communicated effectively with stakeholders and insurers, negotiating resolutions.

Met or exceeded 95% accuracy threshold and production standards. Pre-Authorization Specialist / MetroHealth System - Cleveland, Ohio 05/2003 - 08/2018

Managed the referral processing system, ensuring precise assignment of CPT codes for various medical specialties, including but not limited to Radiology, General Surgery and Oral. Proactively obtained authorizations before the scheduled service date, showcasing efficiency and accuracy in navigating the authorization process.

Evaluated the medical necessity of requested procedures or treatments by reviewing medical documentation and assessing them according to insurance guidelines and clinical criteria.

Verified insurance coverage, ensuring compliance with payer requirements.

Precisely documented pre-authorization requests, approvals, and denials

Met or exceeded 95% accuracy threshold and production standards EDUCATION

MBA: Business Administration, Executive Management (Minor in Human Resource Management) Ashland University - Ashland, Ohio

BBA- Organizational Management, Tiffin University - Tiffin, Ohio CERTIFICATIONS

Certified Healthcare Access Associate (CHAA) January 2011

Certified Professional Coder (CPC)December 2020

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