Anita Pittman
Certified Professional Coder
Bogalusa,LA
Summary
Dynamic Clinical Quality Improvement Specialist with expertise in ICD-10-CM coding and provider education at VillageMD. Proven track record in enhancing claim resolution strategies and conducting quality audits, ensuring compliance with CMS guidelines. Adept at leveraging healthcare software to drive operational excellence and improve clinical documentation standards.
Overview
11
11
years of professional experience
1
1
Certification
Work History
Clinical Quality Improvement Specialist/CPC
VillageMD
Houston, TX
12.2022 - Current
- Evaluated current operations by gathering information from various sources, including records and surveys.
- Communicates managed care and value-based care model requirements and expectations with staff and providers in order to achieve goals.
- Conducted internal provider audits and educated providers on trends to minimize claim denials.
- Handles risk adjustment coding , ICD 10 CM, ICD 10 PCS, CPT coding : orthopedics, urgent care, surgical cents, internal and family medicine, cardiology, pediatrics, and emergency department billing.
- Maintained awareness of payor-specific and government regulations.
- Collaborate with healthcare professionals, including physicians and nurses to clarify and gather supplementary information as required.
Senior Customer Support Representative/Billing Specialist
Maximus Federal
Fairfax, VA
02.2014 - 07.2022
- Resolved escalated customer inquiries through high-level service interactions.
- Facilitated customer service by answering inbound calls, chats, and emails.
- Conducted weekly quality audits to ensure team performance standards.
- Analyzed documentation to identify and resolve billing disputes.
- Escalated unresolved billing issues to commercial, private, Medicare, and Medicaid insurance companies .
- Escalated benefit discrepancies to Health Insurance Casework Specialists .
Education
Associate of Science - Health Information Technology
Devry
Chicago, IL06-2020
Some College (No Degree) - Certified Professional Coder
AAPC
Salt Lake City, UTSkills
- ICD-10-CM and PCS coding
- HCPCS and CPT coding
- Clinical documentation improvement
- Provider education and training
- Quality assurance and audits
- Claim resolution strategies
- Healthcare software proficiency (Athena, Epic, Cerner, E-clinical, Modernized Medicine)
- Microsoft Office applications
- Managed care coordination
- Value-based care coding
- HCC and pro-fee coding
Certification
- Certified Professional Coder- AAPC (Active)
Languages
English
Professional
References
References available upon request.
Timeline
Clinical Quality Improvement Specialist/CPC
VillageMD
12.2022 - Current
Senior Customer Support Representative/Billing Specialist
Maximus Federal
02.2014 - 07.2022
Associate of Science - Health Information Technology
Devry
Some College (No Degree) - Certified Professional Coder
AAPC
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