Work Preference
Summary
Overview
Work History
Education
Skills
Affiliations
Timeline
Receptionist
Cathy D. Fiermonti
Open To Work
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Cathy D. Fiermonti

Lead Risk Adjustment Coder
Conneaut,OH

Work Preference

Job Search Status

Open to work
Desired start date: 2 weeks notice

Desired Job Title

Lead Risk Adjustment Coder - Value Based ServicesRisk Adjustment Coder - Value Based ServicesMedical Coder II - Team Lead of Medical Coding DepartmentMedical Coder II - System EditsSenior Patient Financial Services/Collections

Work Type

Full TimeContract Work

Location Preference

RemoteHybrid
Location: Conneaut, OHErie, PAAshtabula, OHRemote
Open to relocation: No

Important To Me

Healthcare benefitsWork from home optionPaid time offPaid sick leave401k matchWork-life balanceCompany Culture

Summary

Detail-oriented Risk Adjustment Coder with expertise in healthcare coding and auditing. Skilled in interpreting medical documentation for accurate risk adjustment coding and ensuring regulatory compliance. Proficient in ICD-10-CM guidelines and HCC categories, with a record of enhancing coding processes and data accuracy. Seeking to leverage analytical skills in a data analysis and mining role.

Overview

20
20
years of professional experience

Work History

Lead Risk Adjustment Coder - Value Based Services

Watson Clinic, LLP
Lakeland, FL
04.2019 - 07.2026
  • Educated providers on improving clinical documentation and understanding coding guidelines through prospective reviews before charge release
  • Reviewed provider documentation to accurately capture chronic conditions and provided recommendations for coding and documentation enhancements
  • Ensured compliance with coding rules and regulations for CMS and the OIG, as well as company standards.
  • Perform TCM E/M audits to verify claims are eligible for this type of service and complete the billing of these encounters
  • Assist the VBS Care Coordination team in work that requires the utilization of coding and care measures
  • Coordinated workflow planning, assigned job duties, and recommended improvements for the coding team to enhance operational efficiency
  • Maintained quality control and conducted coder audits while mentoring staff.
  • Assist the data analyst team in development of programs and recommendations for data capture to improve productivity of the team and improve provider communication
  • Report to management trends identified through the review and validation process; Provide related weekly, monthly and year-end reports of review findings

Risk Adjustment Coder - Value Based Services

Watson Clinic, LLP
Lakeland, FL
02.2018 - 04.2019
  • Accurately code diagnostic information in accordance with coding guidelines after review of documentation
  • Review TES work file(s) daily and apply appropriate CAT II codes
  • Stay informed and up to date on coding changes by attending seminars and pursuing additional education
  • Provide education for providers to help improve use of ICD-10 codes and documentation; encourage use of highest level of specificity in code selection
  • Assist management in various special projects and workflow improvements
  • Assist with interviews for risk coding positions; Mentor and train new hires

Medical Coder II - Team Lead of Medical Coding Department

Watson Clinic, LLP
Lakeland, FL
02.2016 - 02.2018
  • Review edits for accuracy of codes and modifiers based on established billing guidelines
  • Communicate coding queries to physicians’ offices or appropriate staff
  • Review TES work file(s) daily; review charges halted from billing due to edits, and make changes if necessary, to release charges to billing system
  • Stay informed and up to date on coding changes by attending seminars and pursuing additional education
  • Assist management with projects, reports and administrative duties
  • Mentor and train new hires
  • Act as liaison between management and staff; report on productivity

Medical Coder II - System Edits

Watson Clinic, LLP
Lakeland, FL
02.2016 - 10.2016
  • Review edits for accuracy of codes and modifiers based on established billing guidelines
  • Communicate coding changes and/or questions to physicians’ offices or appropriate staff
  • Review TES work file(s) daily; review charges halted from billing due to edits, and make changes if necessary, to release charges to billing system
  • Stay informed and up to date on coding changes by attending seminars and pursuing additional education

Senior Patient Financial Services/Collections

Watson Clinic, LLP
Lakeland, FL
08.2010 - 02.2016
  • Patient billing, collections and account management
  • Review of claim denials for billing and coding errors
  • Submission of code review requests with supporting documentation
  • Communication with patients, doctor's offices, insurance companies and various departments within Watson Clinic to resolve billing issues
  • Collection responsibilities to offer opportunity for patients to pay their balance or create a budget plan
  • Assist management with special projects such as settlements and budget plan programs

Certified Medical Assistant for Family Practice

Watson Clinic, LLP
Lakeland, FL
02.2006 - 08.2010
  • Room patients, obtain medical information, update documentation, and measure vital signs, weight, and height to assist physician in patient care
  • Explain treatment procedures, medications, nutrition and physician’s instructions to patients
  • Ordered and prepared routine laboratory tests and conducted sample analyses to assist in patient diagnostics.
  • Scheduled patients for tests or admissions by coordinating with medical facilities and departments
  • Processed prescription refill requests to ensure timely access to medications for patients
  • Office duties such as proper telephone protocol; completion of forms for insurance and doctor referrals; Inventory and ordering of medical, lab or office supplies/equipment; Schedule appointments for patients; Contact insurance companies to verify coverage or appeal insurance decisions for non-covered services

Education

Certificate of Completion - Certified Professional Coder, Certified Risk Adjustment Coder, Certified Professional Medical Auditor, Certified Documentation Expert – Outpatient

American Academy of Professional Coders
Salt Lake City, UT

Diploma - Medical Assistant with Computer Operations

Great Lakes Institute of Technology
Erie, PA

High School - High Honors

Strong Vincent High School
Erie, PA

Skills

  • Risk adjustment coding
  • ICD-10 coding
  • Clinical quality assessment
  • Coding standards development
  • Coding workflow optimization
  • Regulatory compliance
  • Documentation improvement
  • Data analysis collaboration
  • Project management
  • Team leadership
  • Process improvement strategies
  • Problem solving

Affiliations

  • CPC
  • CRC
  • CPMA
  • CDEO

Timeline

Lead Risk Adjustment Coder - Value Based Services

Watson Clinic, LLP
04.2019 - 07.2026

Risk Adjustment Coder - Value Based Services

Watson Clinic, LLP
02.2018 - 04.2019

Medical Coder II - Team Lead of Medical Coding Department

Watson Clinic, LLP
02.2016 - 02.2018

Medical Coder II - System Edits

Watson Clinic, LLP
02.2016 - 10.2016

Senior Patient Financial Services/Collections

Watson Clinic, LLP
08.2010 - 02.2016

Certified Medical Assistant for Family Practice

Watson Clinic, LLP
02.2006 - 08.2010

Certificate of Completion - Certified Professional Coder, Certified Risk Adjustment Coder, Certified Professional Medical Auditor, Certified Documentation Expert – Outpatient

American Academy of Professional Coders

Diploma - Medical Assistant with Computer Operations

Great Lakes Institute of Technology

High School - High Honors

Strong Vincent High School

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Cathy D. FiermontiLead Risk Adjustment Coder