ANISSA BELLARD
Humble,TX
Summary
Enterprising Risk Adjustment Manager demonstrating high level of ownership, and initiative. Successful in fast-paced deadline-driven environments. Diligent trainer, and mentor with exceptional management abilities and results-driven approach. Strategic thinker, and tactical decision-maker with passion for serving customers and exceeding expectations. Creative problem solver skilled at de-escalating situations, and driving positive change.
Overview
17
17
years of professional experience
Work History
Manager, Risk Adjustment
Centene Corporation
04.2021 - Current
- Develop and implement action plans, across all departments affecting assigned products and plans, to address issues identified by business units, including detailed work plans, issue logs, and progress reports.
- Review performance data to monitor and measure productivity, goal progress and activity levels.
- Cross-train 31 existing employees to maximize team agility and performance.
- Identify and partner with various departments to implement assigned products business requirements.
- Evaluate and manage risk adjustment strategy across all functional areas that impact assigned products.
- Identify and support health plan initiatives related to assigned products.
- Prepare dashboards for senior management and identify improvement opportunities.
- Onboard new employees with training and new hire documentation.
- Adjust job assignments and schedules to keep pace with business needs, factoring in processes, employee knowledge and customer demands.
Supervisor of Coding Audit/Provider
WellCare/Centene Corporation
02.2016 - 04.2021
- Collects, summarizes, and tracks provider performance data to identify, and strategize opportunities for provider improvement.
- Supports quality improvement HEDIS, and program studies as needed, requesting records from providers, maintaining databases, and researching to identify member, provider encounter history.
- Hired, managed, developed, and trained staff, established, and monitored goals, conducted performance reviews, and administered salaries for staff.
- Completed bi-weekly payroll for 11 employees.
Team Lead/Quality Improvement
Universal American (A WellCare Company)
08.2015 - 02.2016
- Delegated daily tasks to team members to optimize group productivity by 90%.
- Monitored team progress and enforced deadlines.
- Fostered positive employee relationships through communication, training, and development coaching.
- Documented production levels, and materials used to keep management informed.
- Collaborated with management team to implement new work procedures, and policies.
- Created and distributed monthly, quarterly, and annual reports to management regarding customer performance.
Auditing Coder Specialist
Humana
07.2013 - 08.2015
- Maintained current working knowledge of CPT, and ICD-10 coding principles, government regulation, protocols and third-party billing requirements.
- Read through patient health data, histories, physician diagnoses, and treatments to gain understanding for coding purposes.
- Added modifiers as appropriate, coded narrative diagnoses, and verified diagnoses.
- Communicated with healthcare personnel, including practitioners to promote accuracy.
- Assigned additional diagnosis codes based on clinical findings (laboratory, radiology and, pathology reports as well as clinical studies) in support of existing diagnoses.
- Used coordination and planning skills to achieve results according to schedule.
Coding Specialist II
Texas Children's Hospital
09.2007 - 07.2013
- Reviewed over 60 inpatient records per day, and interpreted documentation to identify diagnoses, and procedures.
- Assigned additional diagnosis codes based on specific clinical findings (laboratory, radiology and, pathology reports as well as clinical studies) in support of existing diagnoses.
- Verified proper coding, sequencing of diagnoses and accuracy of CPT Code procedures.
- Interpreted medical terminology and pharmacological information to translate information into coding system.
- Interacted with physicians and other healthcare staff to ask questions regarding patient services.
Coding Specialist
Baylor College Of Medicine
09.2007 - 06.2009
- Verified, and abstracted all medical data to assign appropriate codes for hospital inpatient records.
- Sought clarification from physicians, and other hospital personnel for answers to needed coding interpretations prior to abstracting records.
- Verified final claim submissions by comparing account charges with documentation.
- Recorded, stored and reported medical coding information to create statistics of healthcare encounters.
- Submitted, and accurately processed insurance claims with related medical code verification and assessments.
- Maintained high accuracy rate on daily production of completed reviews.
- Verified signatures and checked medical charts for accuracy and completion.
Education
Bachelor of Science - Business Administration And Management
Southern New Hampshire University
Hooksett, NH06.2027
Certified Professional Coder (CPC) - Medical Insurance Coding
Med Advance Institute
Houston, TX01.2007
High School Diploma -
Klein Forest High School
Houston, TX06.1992
Skills
- Work Planning and Prioritization
- Hiring and Training
- Employee Development
- Team Building
- Quality Improvement Planning
- Performance Tracking and Evaluation
- Complex Problem Solving
- Sound Quality Management Techniques
- Verbal and Written Communication
- Risk Management Processes
- Creative Thinking
- Advising on Strategies
Timeline
Manager, Risk Adjustment
Centene Corporation
04.2021 - Current
Supervisor of Coding Audit/Provider
WellCare/Centene Corporation
02.2016 - 04.2021
Team Lead/Quality Improvement
Universal American (A WellCare Company)
08.2015 - 02.2016
Auditing Coder Specialist
Humana
07.2013 - 08.2015
Coding Specialist II
Texas Children's Hospital
09.2007 - 07.2013
Coding Specialist
Baylor College Of Medicine
09.2007 - 06.2009
Bachelor of Science - Business Administration And Management
Southern New Hampshire University
Certified Professional Coder (CPC) - Medical Insurance Coding
Med Advance Institute
High School Diploma -
Klein Forest High School