CRYSTAL COOLBAUGH
Tucson,AZ
Summary
Highly proficient and innovative at working in a fast-paced environment demanding strong organizational, leadership, and interpersonal skills. Trustworthy, ethical, and discreet, committed to exceptional customer service, and driven by challenges. Extremely confident and poised in interactions with all individuals. Detail-oriented and resourceful in spearheading, organizing, and completing projects; able to multitask effectively.
Qualified Certified Professional Coder with solid foundation in medical coding and risk adjustment. Proficient in accurately interpreting medical records to ensure proper coding, with track record of enhancing coding accuracy and compliance. Demonstrated expertise in utilizing coding software and ensuring adherence to coding guidelines.
Professional with deep expertise in medical coding and risk adjustment. Proven track record in analyzing and interpreting complex medical records to ensure accurate coding and compliance with regulatory standards. Strong team collaborator focused on achieving measurable results and adapting to evolving requirements. Skilled in ICD-10, CPT, and HCC coding, with keen eye for detail and commitment to maintaining high standards of accuracy and efficiency.
Overview
12
12
years of professional experience
1
1
Certification
Work History
HCC Risk Adjustment Coder
The Judge Group- Contracted for UnitedHealthcare
Tucson, AZ
06.2025 - Current
- Conducted comprehensive risk adjustment coding for diverse patient populations, ensuring compliance with regulatory standards.
- Collaborated with clinical teams to enhance documentation practices and improve coding accuracy across diagnoses.
- Analyzed and resolved discrepancies in medical records, facilitating accurate risk score calculations for reimbursement purposes.
- Provided training and mentorship to junior coders, fostering a culture of continuous improvement and professional development.
Medical Billing & Coding Specialist
Retina Associates
10.2021 - 04.2025
- Review and interpret medical records and charts to assign appropriate CPT, ICD-10, and HCPCS codes
- Ensure accuracy and compliance with federal regulations and insurance requirements
- Prepare and submit claims to insurance companies, Medicare, or Medicaid
- Follow up on unpaid or denied claims and initiate appeals as needed
- Enter and update patient data and billing information in practice management systems
- Communicate with healthcare providers to clarify diagnoses or obtain additional documentation
- Maintain patient confidentiality in accordance with HIPAA guidelines
- Monitor and resolve billing discrepancies or coding errors
- Generate patient invoices and process payments
- Ensure documentation supports the coded services
- Stay current on coding updates, insurance changes, and billing regulations
- Provide coding support and education to clinical staff as needed
Store Manager
Taco Bell
06.2014 - 10.2021
- Oversee daily operations to ensure smooth and efficient store performance
- Manage and lead team members, including hiring, training, scheduling, and evaluating staff
- Monitor inventory levels and order supplies to maintain adequate stock
- Ensure food quality, safety, and cleanliness standards are consistently met
- Handle customer complaints and resolve issues promptly and professionally
- Monitor sales and labor costs to meet or exceed financial targets
- Implement and enforce company policies, procedures, and brand standards
- Prepare and analyze reports on sales, labor, and operational performance
- Coordinate with regional or district managers to align store goals with company objectives
- Plan and execute marketing or promotional initiatives to increase sales
- Train and motivate employees to deliver excellent customer service
- Manage cash handling procedures and ensure accurate financial reporting
Education
Medical Billing & Coding -
Carrington College
04-2022
Skills
- ICD-10 (5 Years)
- CPT (5 Years)
- HCPCS (5 Years)
- Microsoft Word
- Microsoft Excel
- Microsoft Outlook
- Medical Records Software
- NextTech
- Google Suite
- Self-motivation and discipline
- ICD-10 proficiency
- Leadership qualities
- HIPAA compliance
Accomplishments
- Achieved 95% accuracy through effectively and accurately coding to ensure minimal errors, denials and delayed payments of claims.
Affiliations
AAPC Membership
Tucson Cactus Coders
Certification
- National Healthcare Association - Certified Billing & Coding Specialist - March 2022
- American Academy of Professional Coders - Certified Professional Coder - April 2023
Languages
English
Native or Bilingual
Spanish
Full Professional
Timeline
HCC Risk Adjustment Coder
The Judge Group- Contracted for UnitedHealthcare
06.2025 - Current
Medical Billing & Coding Specialist
Retina Associates
10.2021 - 04.2025
Store Manager
Taco Bell
06.2014 - 10.2021
Medical Billing & Coding -
Carrington College