DEBRA L. WASHINGTON
Harvey,Illinois
Summary
Dynamic, highly motivated management professional with a proven track record of maintaining efficiency of daily operations while providing insightful vision for optimization seeking to utilize skills, expertise and passionate commitment to excellence in a challenging leadership position within a progressive organization.
Overview
19
19
years of professional experience
1
1
Certification
Work History
Coding Compliance Supervisor
HCSC - Blue Cross Blue Shield of Illinois
Chicago, IL
07.2023 - Current
- Led comprehensive compliance audits to identify gaps in coding practices and implement corrective measures.
- Directed the development of training programs that improved team proficiency in regulatory standards and procedures.
- Coordinated cross-departmental initiatives to enhance communication regarding compliance updates and policy changes.
- Managed ongoing monitoring of coding accuracy, ensuring alignment with federal regulations and payer guidelines.
Coding Compliance Specialist II
HCSC - Blue Cross Blue Shield of Illinois
Chicago, IL
12.2018 - 07.2023
- Preforms retrospective and prospective HCC Provider Educations to select providers that have HCC’s Risk Gaps. Education to provider regarding documentation in order to close the risk gaps for BCBS members.
- **Executed comprehensive compliance assessments on coding submissions, ensuring adherence to HIPAA regulations.**
- **Facilitated regular training sessions for staff on emerging coding guidelines and compliance mandates.**
- **Developed corrective action plans following compliance discrepancies, collaborating with stakeholders for effective resolution.**
- **Monitored ongoing regulatory changes affecting coding practices, updating team protocols as necessary to maintain compliance.**
- **Collaborated with clinical teams to streamline documentation processes, enhancing accuracy in coding submissions.**
- **Conducted periodic reviews of provider documentation to ensure alignment with payer requirements and internal policies.**
- Supported team by pitching in to complete special projects.
Coding & Compliance Supervisor
Franciscan Alliance
Hammond, Indiana
01.2011 - 01.2018
- Responsible for supervising all front end operations for the Coding Department including Coding, client billing, onboarding and retention as well as the development of a highly qualified Team to service various clients with multiple locations and providers. Manage human resource activities including recruiting, hiring, training and payroll of all new and existing staff. Oversee work flow development and personnel assignments per specialties as well as client billing requirements. Travel to various client locations to liaise with onsite management and personnel regarding new policies and changes to service. Ensure compliance with CPT, ICD-10 and Payer Guidelines.
- Oversee the onboarding process for all new providers including credentialing, outlining workflows for all encounters received and providing insight as necessary.
- Develop training programs to improve daily coding and billing operations for junior staff members; conduct internal coding audits to assess compliance with quality and performance standards.
- Analyze client billing to ensure compliance with regulatory and requirements.
- Responsible for identifying compliance issues, completing time/attendance for coders and performing annual evaluations for coders.
- Closely collaborate with senior management regarding all issues within the coding department as well as offering suggestions for resolution and improvement.
- Conduct monthly meeting with operations in order to review any issues resulting from the introduction of new providers/specialties, EPIC workflow issues, documentation issues and timely reception of encounters.
- Assist with developing department handbook as well as new policies and procedures regarding client audits, work flow and problem resolution.
Instructor - Medical Insurance, Billing & Coding Program
Teaching Kaplan College
Hammond, Indiana
01.2009 - 01.2014
- Developed and taught medical insurance, billing and coding curriculum and modules to undergraduate students utilizing various methodologies and university technologies. Responsible for the creation, distribution and review of course syllabus for each specialty. Utilized a variety of instructional strategies in order to engage students, including cooperative and experiential learning. Presented prepared materials and supervise organized activities.
- Evaluated student performance promptly and accurately based on departmental policies.
- Coordinated with the college bookstore in order to ensure availability of class and lesson material.
- Maintained detailed records of student attendance, involvement and progress.
- Taught assigned class material in accordance with learning objectives that were developed by the department.
- Communicated with students outside of class to provide supplementary instruction when necessary.
- Surveyed students to obtain information about wants and needs in certain courses.
Coding Compliance Auditor
St. Margaret Hospital
Dyer, Indiana
01.2007 - 01.2011
- Responsible for providing detailed education for providers and clinic support staff as related to charges both received and billed. Performed evaluation and management auditing for physicians. Conducted internal audits (including pre-billing and postbilling) per providers as well as specialties. Reviewed and provided education to providers following completing of audits and reports. Led and directed assessments and on-boarding procedures for new providers.
- Reviewed daily reports and swiftly reconciled discrepancies.
- Identified and rectified claim payments, reductions, rejections and denials; managed corrective action procedures and submitted appeal letters for reconsideration.
- Communicated with medical personnel, providers and patients to clarify discrepancies or secure additional data for medical billing, coding and auditing procedures.
- Established lines of communication for reconciliation.
Education
Bachelor of Science - Health Services Management
University of Maryland
College Park, Maryland12-2025
Skills
- Healthcare billing administration
- Health services administration
- Regulatory compliance auditing
- Procedure implementation
- Government & Commercial Payers
- Project Management
- Relationship Management
- Budgeting & Payroll
- Human Resources
- Staff Development & Training
- Presentations & Public Speaking
- JCAHO Requirements
- Database & Document Management
- Communication & Networking
- Process Improvement
- Proficient in the use of Microsoft Office
- Proficient in various EMR Systems, EPIC
Certification
- Certified Professional Coder (CPC) - Academy of Professional Coders
- Certified Professional Compliance Officer (CPCO) - Academy of Professional Coders
- Certified Risk Adjustment Coder (CRC)
Timeline
Coding Compliance Supervisor
HCSC - Blue Cross Blue Shield of Illinois
07.2023 - Current
Coding Compliance Specialist II
HCSC - Blue Cross Blue Shield of Illinois
12.2018 - 07.2023
Coding & Compliance Supervisor
Franciscan Alliance
01.2011 - 01.2018
Instructor - Medical Insurance, Billing & Coding Program
Teaching Kaplan College
01.2009 - 01.2014
Coding Compliance Auditor
St. Margaret Hospital
01.2007 - 01.2011
Bachelor of Science - Health Services Management
University of Maryland