Adrienne Lewis
Fayetteville,GA
Summary
Strategic Revenue Integrity professional with 25 years of experience in optimizing healthcare revenue cycle performance and ensuring regulatory compliance. Expertise in auditing, coding validation, payer contract compliance, and denial prevention. Proven leader in productivity management and operational process improvement within complex health systems, holding multiple industry certifications in healthcare compliance and revenue cycle management.
Overview
12
12
years of professional experience
3
3
Certifications
Work History
Revenue Integrity Analyst/ CDM
Wellstar Heath System
Marietta, GA
11.2021 - Current
- Perform comprehensive CDM audits to ensure accurate charge capture and compliant billing practices.
- Partner with Revenue Integrity Analysts and revenue-producing departments to ensure ongoing coordination and consistency of the Charge Master and fee schedules.
- Oversee CDM maintenance including accurate descriptions, CPT/HCPCS coding alignment, additions, deletions, pricing updates, and regulatory changes.
- Analyze APC reimbursement methodology and validate CDM configuration for compliance and optimal reimbursement.
- Monitor and analyze NCCI edits in alignment with CDM configuration to ensure accurate charge capture, compliant billing, and appropriate modifier application.
- Develop and maintain Expected Allowed Payment (EAP) models to monitor payer contract compliance.
- Collaborated with coding, compliance, finance, and operational leadership to enhance charge governance processes.
Medical Coder
Wellstar Health System
Marietta, GA
12.2018 - 11.2021
- Assigned and validated ICD-10-CM and CPT/HCPCS codes across outpatient services to ensure accurate charge capture and compliant billing practices.
- Maintained a 98% coding accuracy rate through audit-driven quality review and continuous process improvement initiatives.
- Identified coding discrepancies impacting reimbursement and implemented corrective actions to mitigate revenue leakage.
- Supported clinical documentation improvement (CDI) initiatives to strengthen documentation integrity and reimbursement accuracy.
- Conducted compliance audits in alignment with CMS regulations, NCCI guidelines, and payer-specific requirements.
Revenue Cycle Variance Lead
Wellstar Health System
Marietta, GA
11.2015 - 11.2018
- Conduct detailed revenue variance analysis to evaluate payer reimbursement accuracy against contractual terms and APC/RVU methodologies.
- Developed and maintained Expected Allowed Payment (EAP) models to proactively identify payment discrepancies and enhance reimbursement accuracy.
- Perform financial and compliance audits to assess charge capture accuracy, coding alignment, and reimbursement integrity.
- Analyzed payer trends to uncover systemic reimbursement issues, implementing corrective action strategies to improve financial outcomes.
- Collaborated with managed care and compliance leadership to align CDM configuration with contract language, ensuring compliance and maximizing reimbursement integrity.
Senior Healthcare Consultant
Consulting Company
Atlanta, GA
10.2013 - 10.2015
- Delivered full revenue cycle consulting services to enhance clinical appeals, streamline revenue aging analysis, validate charge capture, and optimize reimbursement.
- Facilitated denial management and underpayment identification, driving effective revenue recovery strategies for organizations.
- Analyzed accounts receivable aging to identify revenue delays, root causes of denials, and workflow improvement opportunities.
- Evaluated payment posting processes for accuracy and compliance, ensuring effective reconciliation and adherence to contracts.
- Conducted coding and billing audits to validate regulatory compliance and ensure accurate claim submission.
Education
Bachelor of Science - BHA
Capella University
Minneapolis, MNSkills
- CDM management
- CDM Auditing & Governance
- Revenue Integrity Audits
- Coding Validation (CPT/HCPCS/ICD-10)
- Underpayment & Variance Analysis
- Medicare & Commercial Payer Guidelines
- Process Improvement
- EPIC, Vitalware, Excel
Certification
CPC
Accomplishments
NSLS National Honor Society
Timeline
Revenue Integrity Analyst/ CDM
Wellstar Heath System
11.2021 - Current
Medical Coder
Wellstar Health System
12.2018 - 11.2021
Revenue Cycle Variance Lead
Wellstar Health System
11.2015 - 11.2018
Senior Healthcare Consultant
Consulting Company
10.2013 - 10.2015
Bachelor of Science - BHA
Capella University