Machine Learning Quality Assurance

John O'Reilly

Boston, MA (Open to Remote Work)

617-***-**** ****.*******.***@*****.***

AAPC Member ID: 02373387

Professional Summary

Certified Professional Coder (CPC) with hands-on training in ICD-10-CM, CPT, and HCPCS Level II coding systems. Completed 150+ coding scenarios using AAPC Practicode modules. Knowledgeable in HIPAA compliance, payer guidelines, and claim accuracy. Strong technical precision, confidentiality, and organizational skills. Highly knowledgeable regarding impending AI involvement in CPC-relevant positions. Ready to contribute to remote medical billing and coding teams with a high level of professionalism and attention to detail.

Certifications

• Certified Professional Coder (CPC) – AAPC, 2025

• HIPAA Compliance Training – 2024

Education

Medical Billing & Coding Certificate – Auburn University, AL (Expected May 2025) Relevant Coursework: ICD-10-CM, CPT, HCPCS, Health Insurance & Reimbursement, Medical Terminology, Anatomy & Physiology

Machine Learning Specialization – Stanford University (2020) Completed coursework in Python-based machine learning, using Artificial Intelligence applications in areas such as healthcare and data analysis under the tutelage of Dr. Anthony Ng of Stanford University. Master of Science in Engineering (MSE) – University of South Florida (1983) Focus: Control Systems and Systems Engineering

Technical Skills

• Medical Coding: ICD-10-CM, CPT, HCPCS Level II

• Insurance Billing: Medicare, Medicaid, Commercial Plans

• Compliance: HIPAA, PHI Privacy

• Software: Microsoft Office (Word, Excel, Outlook, PowerPoint)

• Advantages: Remote Work Ready Detail-Oriented Organized Time Management Professional Experience

Medical Coding Practicum (Simulated)

AAPC Practicode / Auburn University — Jan 2025 – Jul 2025

• Coded over 150 real-world scenarios in all sections and chapters of CPT and ICD-10-CM

• Assigned accurate ICD-10, CPT, and HCPCS codes to clinical cases

• Reviewed insurance payer rules and documentation standards for claim validity

• Completed multiple CPC mock assessments with instructor feedback Senior Systems Architect

CAE USA Inc. — Mar 1983 – Jun 2017

• Led architecture and integration for simulation software systems under federal contracts

• Supervised multi-disciplinary teams while maintaining regulatory compliance and data integrity

• Gained extensive experience in process documentation, quality assurance, and systems management

Career Break / Retirement

Jun 2017 – Feb 2024

• Reentered workforce by reskilling into medical coding and healthcare compliance Projects & Capstone Work

• Outpatient Surgery Coding: Applied 2025 CPT updates to sample operative reports

• Billing Simulation: Generated and resolved mock claims using industry-standard software

• HIPAA Audit Simulation: Participated in a group privacy review project on PHI handling Professional Affiliations

• Member, American Academy of Professional Coders (AAPC) – Boston Chapter References

Available upon request.

Contact this candidate