April Catlett Probus
Shelbyville,KY
Summary
Dynamic Risk Adjustment Coder at HUMANA with extensive expertise in ICD-10-CM and HCC coding. Demonstrated success in optimizing reimbursement through thorough clinical documentation review, achieving accuracy rates exceeding industry standards. Adaptable to changing healthcare policies, with a strong commitment to continuous learning and improvement in coding practices.
Overview
23
23
years of professional experience
1
1
Certification
Work History
Risk Adjustment Coder
HUMANA
04.2023 - Current
- Conducted through reviews of inpatient and outpatient medical records, assigning accurate ICD-10-CM diagnosis codes in compliance with CMS-HCC risk adjustment guidelines, to optimize reimbursement and reflect patient complexity.
- Analyze clinical documentation for Hierarchical Condition Category (HCC) coding opportunities, capturing chronic conditions, and ensuring precise risk adjustment factor (RAF) scoring for Medicare Advantage Plans.
- Utilized coding software to assign appropriate codes for diagnoses and procedures.
- Reviewed and updated coding guidelines based on changes in healthcare policies.
- Maintained high accuracy rate on daily production of completed reviews.
Owner/ Contractor
502 Redesign, LLC
01.2019 - 01.2023
- 100% of all operations, billing, filing, taxes, quotes, consulting, contracted labor, painters, and construction.
- Managed design projects from concept through completion for diverse clients.
- Collaborated with clients to understand their vision and requirements effectively.
Realtor
Home | Land of Kentucky
03.2016 - 01.2019
- Guided clients through buying and selling residential properties in Kentucky.
- Conducted market analysis to determine property values and trends.
- Built strong relationships with clients to understand their needs and preferences.
- Managed all documentation related to real estate transactions efficiently.
Office Manager
RE/MAX Performance Realty
Shelbyville, KY
01.2007 - 03.2016
- Managed accounts receivable, billing, budgeting, and data entry while maintaining compliance with state regulations.
- Managed daily office operations and ensured efficient workflow among staff.
- Oversaw office supplies inventory and maintained optimal stock levels.
Claims Adjuster-Contractor
Frontier Adjuster
Louisville, KY
06.2006 - 12.2006
- Promoted due to obtaining Kentucky Adjusters license, Investigate, evaluate, estimate, and settle bodily injury claims, property damage claims, and general casualty claims.
- Coordinate with law enforcement, attorneys, and physicians to obtain all detailed information and report back insurance companies and corporations’ legal department for settlement of claims.
- Assisted consumers with complaints and continued contact with consumers until their claim was resolved.
Claims Assistant
Frontier Adjusters
Louisville, KY
01.2003 - 06.2006
- Assisted clients with inquiries regarding claim status and procedures.
- Coordinated communication between adjusters, clients, and insurance companies.
- Processed claims paperwork for accuracy and completeness.
- Maintained case files and oversaw transmissions between offices.
Education
CPC Certified -
AAPC
12.2022
Eastern KY University
Richmond, KY01.1991
Graduated -
Shelby County High School
01.1988
Skills
- ICD-10-CM coding
- HCC coding
- Coding software
- medical documentation
- Self-motivation and discipline
- attention to detail
- HIPAA compliance
- Clinical documentation review
- Continuous learning attitude
References
Available upon request
Certification
- CPC certification with AAPC
Timeline
Risk Adjustment Coder
HUMANA
04.2023 - Current
Owner/ Contractor
502 Redesign, LLC
01.2019 - 01.2023
Realtor
Home | Land of Kentucky
03.2016 - 01.2019
Office Manager
RE/MAX Performance Realty
01.2007 - 03.2016
Claims Adjuster-Contractor
Frontier Adjuster
06.2006 - 12.2006
Claims Assistant
Frontier Adjusters
01.2003 - 06.2006
CPC Certified -
AAPC
Eastern KY University
Graduated -
Shelby County High School