Alicia Waddell CPC CRC
Risk Adjustment Coding Specialist
Sparta,TN
Summary
Disciplined individual skilled and well-versed in medical terminology, coding and compliance procedures, investigative skills, and problem solving . Proficient at answering requests quickly and delivering exceptional results as well as adhering to quality and production expectations. Proficient in using medical terminology and classifying diagnostic procedures, treatments and medications. Dedicated to providing highest quality care to patients and clients.
Overview
16
16
years of professional experience
Work History
Risk Adjustment Coder
Change Healthcare/OptumInsight
Brentwood, TN
08.2022 - Current
- Remote position.
- Coding and abstracting of medical records for risk adjustment purposes utilizing full code capture at date of service level.
- Assigned appropriate supported diagnosis codes.
- Maintained 95% accuracy, completeness and security for medical records and health information.
- Skilled at working independently and collaboratively in a team environment.
- Self-motivated, with a strong sense of personal responsibility.
- Proven ability to learn quickly and adapt to new situations.
- Organized and detail-oriented with a strong work ethic.
Risk Adjustment Coder
PopHealthCare
Tempe, AZ
01.2016 - 06.2022
- Remote position.
- Coding and abstracting of medical records for risk adjustment purposes utilizing full code capture at date of service level.
- Assigned appropriate supported diagnosis codes.
- Maintained 95% accuracy, completeness and security for medical records and health information.
- Input data into computer programs and filing systems.
- Resourcefully utilize multiple resources such as coding books, ICD 10 guidelines as well as client specific guidelines, and online encoder.
- In addition, going above and beyond to lead team for monthly calibration chart review.
Risk Adjustment Coder
MedKoder, LLC
Mandeville, LA
05.2016 - 06.2021
- Remote position.
- Coding and abstracting of medical records for risk adjustment purposes utilizing full code capture at date of service level.
- Assigned appropriate supported diagnosis codes.
- Maintained 95% accuracy, completeness and security for medical records and health information.
- Input data into computer programs and filing systems.
- Resourcefully utilize multiple resources such as coding books, ICD 10 guidelines as well as client specific guidelines, and online encoder.
- In addition, going above and beyond to perform audits and answer team coding questions.
Risk Adjustment Coder
OptumInsight
Franklin, TN
10.2010 - 05.2016
- Remote position.
- Coding and abstracting of medical records for risk adjustment purposes utilizing full code capture at date of service level.
- Assigned appropriate supported diagnosis codes.
- Maintained 95% accuracy, completeness and security for medical records and health information.
- Input data into computer programs and filing systems.
- Resourcefully utilize multiple resources such as coding books, ICD 10 guidelines as well as client specific guidelines, and online encoder.
- In addition, going above and beyond to train and/or review offshore coders as group of coding expectations.
Operations Manager
Advantmed
Irvine, CA
05.2013 - 01.2016
- Remote Position.
- Established positive and effective communication among unit staff and organization leadership, reducing miscommunications and missed deadlines.
- Identified and resolved unauthorized, unsafe or ineffective practices.
- Set, enforced and optimized internal policies to maintain responsiveness to demands.
- Devised processes to boost long-term business success and increase profit levels.
- Reviewed shift reports to understand current numbers and trends.
- In addition, worked closely with Quality Manager performing audits, revising and updating guidelines, etc.
Coding Manager
MedSystems, LLC
Portsmouth, VA
2011.03 - 2013.10
- Participated in hiring and training coding team.
- Attended facility meetings and reported on performance.
- Developed and updated policies and procedures, maintaining compliance with guidelines relating to HIPAA, benefits administration and general liability.
- Designed and introduced leadership development, coaching and team management model, resulting in promotion of employees into increased levels of responsibility.
- Performed coding quality reviews and tracked, trended and managed coding quality performance.
- Spearheaded and implemented new projects to expand scope of engagement.
Accounts Receivable Specialist
Riverside Physician Group
Newport News, VA
2008.01 - 2011.03
- Developed and maintained positive relationships with clients to maximize collections.
- Generated monthly accounts receivable reports to submit developments for management review.
- Reconciled accounts receivable ledger to verify payments and resolve variances.
- Identified, researched, and resolved billing variances to maintain system accuracy and currency.
- Safeguarded documents of accounts receivable and payments to enable tracking history and maintain accurate records.
- Monitored accounts to verify compliance with payment terms and schedules.
- Followed up overdue payments and payment plans from clients to establish good cash flow.
- Negotiated payment arrangements with customers to establish timely receipt of payments.
Education
No Degree - Medical Billing And Coding
Kee's Business College
Newport News, VA08.2004
No Degree - Nursing
Tidewater Community College
Suffolk, VA05.1992
High School Diploma -
Churchland High School
Portsmouth, VA06.1991
Skills
- Microsoft Excel, PowerPoint, etc
- Information Classification
- Diagnostic Codes
- Treatment Documentation
- Health Record Index Maintenance
- Guidelines Understanding
- Patient Data Abstracts
- Patient Data Coding
- Standard Classification Systems
- Code Validation
- Medication Review
- Insurance Billing
- Coding Error Resolution
Timeline
Risk Adjustment Coder
Change Healthcare/OptumInsight
08.2022 - Current
Risk Adjustment Coder
MedKoder, LLC
05.2016 - 06.2021
Risk Adjustment Coder
PopHealthCare
01.2016 - 06.2022
Operations Manager
Advantmed
05.2013 - 01.2016
Coding Manager
MedSystems, LLC
2011.03 - 2013.10
Risk Adjustment Coder
OptumInsight
10.2010 - 05.2016
Accounts Receivable Specialist
Riverside Physician Group
2008.01 - 2011.03
No Degree - Medical Billing And Coding
Kee's Business College
No Degree - Nursing
Tidewater Community College
High School Diploma -
Churchland High School
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