Cathy Fiermonti
Conneaut,USA
Summary
Lead Risk Adjustment Coder with expertise in optimizing coding accuracy and operational efficiency. Enhanced coding standards through mentorship and educational initiatives for healthcare providers. Achieved significant improvements in documentation quality and compliance with quality measures, contributing to better patient outcomes. Specialized in value-based coding, efficient workflow management, and effective communication with multidisciplinary teams.
Overview
16
16
years of professional experience
Work History
Lead Risk Adjustment Coder - Value Based Services
Watson Clinic, LLP
Lakeland, FL
04.2019 - 07.2026
- Directed quality control processes and mentored a team of risk adjustment coders to enhance coding standards and minimize errors.
- Delivered value-based solutions focused on coding accuracy, documentation quality, and compliance with quality measures.
- Coordinated with data analysts to align program goals, boosting productivity and improving code capture.
- Summarized audit insights for leadership, highlighting emerging issues and control gaps.
- Assisted management with special projects, reducing delays and boosting efficiency.
- Executed pre-visit, concurrent, and post-visit documentation analysis to ensure accurate diagnosis capture.
- Spearheaded educational initiatives for over 50 primary care providers to improve clinical documentation.
- Presented insights from audits and reviews, driving awareness of compliance gaps.
- Streamlined project execution, enhancing operational efficiency.
Risk Adjustment Coder - Value Based Services
Watson Clinic, LLP
Lakeland, FL
02.2018 - 04.2019
- Performed precise diagnostic coding in line with established guidelines after thorough documentation reviews.
- Participated in continuous education to remain updated on coding changes.
- Reviewed work files daily, utilizing Category II codes to enhance quality care metrics.
- Advised providers on coding standards and reimbursement regulations, ensuring accurate documentation and claim processing.
- Achieved coding accuracy through meticulous documentation assessment.
- Contributed to improved care metrics via Category II code application.
- Supported providers with comprehensive coding guidance.
Medical Coding Department Team Lead
Watson Clinic, LLP
Lakeland, FL
02.2016 - 02.2018
- Oversaw workflow and job assignments for a 30+ member coding team, enhancing throughput and minimizing coding backlogs for expedited, accurate claim submissions.
- Mentored team members and newcomers, promoting skill development and knowledge sharing.
- Aligned management priorities with staff, delivering consistent productivity performance updates.
- Managed coding inquiries communication with physicians' offices and relevant personnel.
- Partnered with management to prepare project reports and optimize administrative workflows.
- Increased team throughput by reallocating tasks efficiently.
- Reduced coding backlogs through proactive mentoring and training initiatives.
- Enhanced communication channels between coding and medical teams.
- Streamlined administrative processes, improving overall efficiency.
Medical Coder II - System Edits
Watson Clinic, LLP
Lakeland, FL
02.2016 - 10.2016
- Reviewed system edits for accuracy of codes and modifiers per billing guidelines.
- Collaborated with healthcare providers to resolve documentation discrepancies.
- Ensured compliance with industry standards for coding accuracy.
- Streamlined coding processes to enhance efficiency and reduce errors.
- Enhanced coding accuracy by implementing systematic review protocols.
- Improved collaboration with healthcare teams, resulting in quicker documentation resolution.
- Maintained up-to-date knowledge of coding principles, government regulations, and third-party billing requirements.
Senior Patient Financial Services/Collections
Watson Clinic, LLP
Lakeland, FL
08.2010 - 02.2016
- Oversaw comprehensive patient billing and collections, ensuring timely payments and minimizing bad debt.
- Collaborated with patients, healthcare staff, and insurance entities to resolve billing issues.
- Enhanced collection rates through strategic billing practices and implemented patient-friendly payment solutions to boost satisfaction.
- Analyzed and appealed complex billing denials, recovering lost revenue and decreasing repeat denials by refining processes.
- Improved collection rates by adopting effective billing strategies.
- Resolved billing issues by engaging with patients and insurance providers.
- Decreased claim denials by correcting coding errors.
- Increased patient satisfaction through user-friendly payment options.
Education
Certified Documentation Expert Outpatient -
American Academy of Professional Coders
Salt Lake City, UT10-2019
Certified Risk Adjustment Coder -
American Academy of Professional Coders
Salt Lake City, UT05-2018
Certified Professional Medical Auditor -
American Academy of Professional Coders
Salt Lake City, UT03-2018
Certified Professional Coder -
American Academy of Professional Coders
Salt Lake City, UT12-2015
Medical Assistant/Secretary with Computer Operations -
J.H. Thompson Academies
Erie, PA12-1997
High School Diploma with High Honors -
Strong Vincent High School
Erie, PASkills
- Interdepartmental Communication
- Team Mentoring & Collaboration
- Data Analysis
- Compliance Auditing
- Operational Efficiency
- Value-Based Coding
- Risk Adjustment Methodologies
- Provider Communication & Education
- CMS-HCC Models
- CDI Education
- Quality Improvement
- RAF Score Optimization
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 Coding Department Team Lead
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 Documentation Expert Outpatient -
American Academy of Professional Coders
Certified Risk Adjustment Coder -
American Academy of Professional Coders
Certified Professional Medical Auditor -
American Academy of Professional Coders
Certified Professional Coder -
American Academy of Professional Coders
Medical Assistant/Secretary with Computer Operations -
J.H. Thompson Academies
High School Diploma with High Honors -
Strong Vincent High School