Aasem Sulehria
Spring,TX
Summary
Performance-focused Compliance Auditor talented at managing coders and conducting internal audits for acute care teaching facilities. Expertise in mitigating risks and interpreting policies. Committed to monitoring compliance with regulations and policies.
Overview
10
10
years of professional experience
1
1
Certification
Work History
Internal Compliance Auditor
eClinicalWorks
Remote
07.2022 - 09.2023
- Performed internal audits of general controls against application controls
- Provided full scope resolution of all evidence based audits including all standard operating procedures
- Analyzed global coders for second level review of compliance control requirements.
Coding Services – Quality Auditor
Corro Health
Remote
11.2021 - 07.2022
- Performed complex, concurrent and retrospective analysis of medical record documentation for Tenet through ACS
- Provided full scope resolution on 80+ charts daily, reoccurring OP visits including Observation and Inpatient carve out times for Injection and Infusions capture in line with CMS guidelines
- Analyzed global coders for second level review of compliance for ICD-10 and CPT code sets in line with NCCI and LCD edits.
Level I Trauma Teaching Facility Coding Compliance Auditor
Memorial Hermann Healthcare System
Houston, Tx
11.2016 - 11.2021
- Verified all coded data accurately by meeting AHA and CMS guidelines
- Reviewed for second level reviews outpatient records and interpreted documentation to identify all diagnoses and procedures through prospective and retrospective audits for charts using 3M encoder
- Audited specialties such as Surgery, Ancillary, ER including Cancer for acute care hospital, 427 bed, multi-specialty encounters for multiple complex accounts
- Successfully audited Injections and Infusions coding, ophthalmology, obstetrics and trauma charts including using the modifiers 59 and 25 for leveling in e-CHARMS during process change into E-valuator auditing system
- Managing remote teams for auditing during COVID including conducting provider education for vaccines.
Level II Trauma Teaching Facility ER Outpatient Coder and Auditor
Natividad Medical Center
11.2015 - 09.2016
- Reviewed, analyzed and managed coding of diagnostic and treatment procedures contained in outpatient medical records
- Coded for acute care hospital, 172 bed, multi-specialty encounters for entry level and multiple complex accounts
- Conducted coding use with CPT modifiers as indicated through Local Coverage Determinations including NCCI
- Quality Assurance scores of over 95% with exceeding of weekly production standards.
Certified Healthcare Consultant
Hewlett Packard
Medicaid client
05.2013 - 06.2015
- Executed coding compliance management for team of eleven for contract partner Medicaid
- Audited and coded outpatient claims for physician settings for upload into a new system Interchange for Medicaid claims.
Certified Business Analyst
State of Colorado
Medicaid
11.2014 - 03.2015
Corro
- Achieved 95% success in automation by analyzing claim operations, data and system issues to identify discrepancies for troubleshooting and corrective action through Trackwise medical claims auditing
- Evaluated physician 1500 claim forms including UB04 claim accounts and audited for trends to understand competitive environments and assess current strategies for RVU units and modifier usage.
Education
Bachelors of Science - Human Services
Metropolitan State University of Denver
Denver, COSkills
- Managing Remote Teams
- Provider Education
- MS Office Suite
- System Development
- Process improvement
- Finance Researching Reimbursement Knowledge
- Regulatory Compliance Oversight
- Risk Analysis
- Process Management
- Audit Support
- Medical Coding Educator
Certification
- CPMA | Certified Professional Medical Auditor, AAPC Certificate # 01336247 Active
- CPC | Certified Professional Coder, AAPC # 01336247 Active
- IT Audit Complete Course | Course Completed
- SOC 1/SOC2 | Course Completed
Affiliations
- Table Tennis
- Badminton
References
References available upon request.
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Quote
You only have to do a few things right in your life so long as you don’t do too many things wrong.
Warren Buffett
Timeline
Internal Compliance Auditor
eClinicalWorks
07.2022 - 09.2023
Coding Services – Quality Auditor
Corro Health
11.2021 - 07.2022
Level I Trauma Teaching Facility Coding Compliance Auditor
Memorial Hermann Healthcare System
11.2016 - 11.2021
Level II Trauma Teaching Facility ER Outpatient Coder and Auditor
Natividad Medical Center
11.2015 - 09.2016
Certified Business Analyst
State of Colorado
11.2014 - 03.2015
Certified Healthcare Consultant
Hewlett Packard
05.2013 - 06.2015
Bachelors of Science - Human Services
Metropolitan State University of Denver