Customer Service Risk Adjustment

Chanleakhena Holder

*********@*****.*** 205-***-****

Summary

Extensive experience in customer service relationships and education specifically to ICD-10 coding. Exceptional communication and interpersonal skills, organized, and driven for success.

Education

University of Alabama at Birmingham

May 8, 2004 Bachelor of Science in Health Sciences (Healthcare Administration)

American Academy of Professional Coders via Jefferson County Medical Society

May 1, 2010 Certified Professional Coder

Experience

Cigna 2 Chase Corporate Drive, Birmingham, AL 35244

Provider Education Specialist 3/7/2011 – 12/09/2023

Train and educate physicians and staff on health plan coding initiatives, guidelines, and requirements of the Risk Adjustment program to ensure correct coding and documentation, conduct chart reviews and assist in special audits such as CMS Risk Adjustment Data Validation projects, evaluate documentation to ensure that diagnosis coding is supported and meets specificity requirement to support clinical indicators, HEDIS and STARS quality measures, query providers regarding missing or conflicting health record documentation, analyze data to prioritize provider educational reviews, work closely with internal representatives for needs and support for the success of our providers and health plan in order to achieve quality care for our customers.

Practice Partners in Healthcare 1 Chase Corporate Drive, Ste. 200, Birmingham, AL 35244

Coding Specialist 01/02/2011 – 3/1/2011

Coded and entered data for CPT and ICD-9 coding for various contracted clients.

Hope Health Center 4614 Carnegie Avenue, Fairfield, AL 35064

Practice Coordinator 04/15/2003 – 12/31/2010

Various tasks including but not limited to duties in office administration extending from staff scheduling to financial responsibilities, patient care assistance, physician assistance, lab assistance, IT, implementation of EMR and writing EMR templates for physicians. Assisted in daily needs of clinic in all duties where needed.

Competencies

Extensive knowledge and adherence to ICD-10 and CPT coding principles and guidelines, excellent understanding of medical terminology, disease process and anatomy and physiology, strong computer skills (i.e. MS Office, Tableau), ability to present to large groups of physicians, action oriented, approachable, boss relationship, compassion, composure, courage, cross-cultural, agility/sensitivity, customer focus, drive for results, ethics and values, functional/technical skills, integrity and trust, interpersonal savvy, learning and applying quickly, listening, managing and measuring work, managing vision and purpose, organizational agility, organizing, peer relationships, perseverance, personal learning, perspective, planning, priority setting, problem solving, tactful, understanding others.

Additional Information

Certified Professional Coder, AAPC, 05/01/2010-present

Dale Carnegie Graduate, High Impact Presentation Course, 6/8/2012

Served as both Education Officer and Member Development Officer, AAPC Birmingham Chapter, 2013

Serving as PTO Treasurer, Hoover City Schools- Shades Mountain Elementary School, 08/1/2020-08/1/2022

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