Risk Adjustment Quality Assurance

Janet Gress CPC

**** ********* **. *****: 317-***-****

Lebanon, IN 46052 Email:*****-*****@*********.***

Professional Summary:

Certified Professional Coder with 19 years experience in ICD-9 and ICD 10 coding, 17 years of that being HCC Risk Adjustment. Very dependable, self- disciplined and highly motivated. Able to verify diagnosis coding to highest specificity, HEDIS reviews, Hierarchical Condition Category (HCC), ER coding with remote experience. Very knowledgeable in EMR program along with HIPPA privacy and security regulations by appropriately handling patient information.

Credentials:

Certified Professional Coder (CPC)

Skill Highlights:

Experienced in ICD-9 and ICD 10 and CPT Microsoft Word, Excel and Outlook HEDIS experience ER coding

Hierarchical Condition Category (HCC) Excellent organization skills

Quality Assurance experience (QA) Typing and 10 key touch

RADV (Risk Adjustment Data Validation) HCC Auditing

ICD-10 certified

HCC Coding Specialist (2024-Present) Virtix Health/Corrohealth

HCC coding.

Remote Risk Adjustment Coder (2023-2024) Judge Healthcare/Ciox Contract

HCC coding.

Professional Experience:

Remote Risk Adjustment Coder (2023-2023) CSI/Episource Contract

HCC coding.

Remote Risk Adjustment Coder (2023-2023) Gebbs Healthcare/Cognisight Contract

HCC coding.

Remote Risk Adjustment Auditor (2022-2023) Contract Position Medasource/Caresource

Audited other coders and provided feedback.

Remote Risk Adjustment Auditor (2022-2022) Contract Position w3r Consulting/Cognisight

Audited other coders and provided feedback.

Remote Risk Adjustment Auditor (2021-2021) Contract Position RCM/Apixio

Audited other coders and provided feedback.

Remote Risk Adjustment Coder (2021-2021) Contract Position Randstand Staffing/Cigna

Remote Risk Adjustment Coder/Auditor/HEDIS Abstractor (2019-2020) Optum/UHG

Remote HCC Coder/Auditor(2018-2019) RCM Health Information

Coding and Auditing medical charts for HCC projects. Project work.

Remote HCC Coder/Auditor (2017-2018) Himagine Solutions, Tampa FL

Coding and Auditing medical charts for HCC projects. Project work.

Remote HCC Coder (2014-2016) Verisk Healthcare, Richmond, VA

Coding medical charts for HCC projects.

Remote HCC Coder/Auditor HEDIS Abstractor (2013-2014) Record Flow, Santa Ana, CA

Reviewing records for HCC to the highest specificity. Experienced in Web-based system of reviewing

EMR and paper charts. Responsible for justifying and auditing codes submitted to CMS for payment. Reviewing records for HEDIS project along with Quality Assurance.

Contract Remote HCC Medical Coder/Auditor (2012-2013) Medsave, Hauppauge, NY

Responsible in Quality Assurance and Auditing of coders for accuracy in HCC coding and also HEDIS

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