Medical Quality Assurance

Avis Evans

**** ****** ******, *******, ** *****

Phone: 954-***-****

E-mail: ******@***.***

Objectives

Obtain a position with a secured healthcare entity whereby I can contribute my expertise and knowledge in coding, auditing, education and compliance. My extensive knowledge as a coder, auditor and provider educator will be an added asset to the team, in that I am well versed in the CMS documentation guidelines and requirements for an appropriate/complaint medical records.

Education

2011-present BROWARD COLLEGE

2012 AAPC Certified Professional Medical Auditor (CPMA)

2009 AAPC Certified Emergency Department Coder (CEDC)

2006 AHIMA Certified Coding Specialist – Physician Based (CCS-P)

2003-2004 Atlantic Technical Institute - Applied Technology Diploma Medical Coder/Biller

Experience

Medicare Risk Adjustment Coder (August 28, 2010 – present)

CarePlus HealthPlan (11420 NW 20 Street, Doral, Fl 33172)

Review medical records to identify and validate all appropriate coding based on CMS HCC categories.

Verify the accuracy and specificity of diagnosis codes based on services rendered by the provider.

Complete all appropriate paperwork/documentation regarding claim/encounter information.

Coding Specialist (December 14, 2009 – August 26, 2010)

Pediatrix Medical Group, Inc. (1301 Concord Terrace, Sunrise, Fl 33323)

Reviewed and Coded Neonatal Intensive care, Pediatric Intensive Care, Consultations, Newborns and Attendance at Delivery Medical records for diagnosis and procedures performed and documented.

Communicated to Physicians via electronic mail all discrepancies in coding based on medical record review.

Senior Coder/Coding Quality Assurance Reviewer/Documentation Specialist (May 2004 – December 9, 2009)

TeamHealth, Inc. (14050 NW 14 Street, Sunrise, Fl 33323)

Reviewed and Coded Emergency Department Medical Records for diagnosis and procedures.

Audit physicians records for deficiencies and report feedback to Medical Directors

Educate Physicians on CMS documentation guidelines, focusing on area of documentation deficiencies on case examples.

Skills

Microsoft Word/Excel/Outlook, Master Database, EMR, Claims Manager Database, SB term, CSC

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