Donna Suer, CPC
Coeur d'Alene,ID
Summary
Certified professional coder with remote RADV IVA, HHS-HCC, CMS-HCC, ACA-HCC, as well as Second Level Review (open suspect), Code Validation, IOA/PAF coding experience. Remote medical language specialist for over 20 years. Advanced knowledge of medical charts, language and codes. Organizational skills required to stay focused, manage time appropriately, and maintain high productivity. Goal-oriented individual with a pleasant personality and a tenacity that knows no restrictions. Willing to meet or exceed company goals.
Overview
11
11
years of professional experience
1
1
Certification
Work History
Risk Adjustment Coder
Norwood
10.2023 - 01.2024
- Maintained accuracy, completeness, and security for medical records and health information.
- Verified accuracy of patient information in medical records.
- Applied official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services to assign diagnostic codes.
- Resourcefully used various coding books, procedure manuals, and on-line encoders.
- Easily worked various projects and able to comprehend and follow different project guidelines.
- Verified signatures and checked medical charts for accuracy and completion.
- Verified absence or presence of targeted HCC conditions.
- Maintained above 95% accuracy.
- Maintained above required minimum production.
Coder 2, Risk Adjustment Production Coder
Cotiviti Healthcare
04.2022 - 10.2023
- Applied official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services to assign diagnostic codes as well as Cotiviti and client specific coding guidelines.
- Resourcefully used various coding books and on-line encoders.
- Reviewed patient charts to better understand health histories, diagnoses, and treatments.
- Verified signatures and checked medical charts for accuracy and completion.
- Verified accuracy of patient information in medical records.
- Ability to manage and meet deadlines, adapt to changing priorities, flexible and open to new ideas.
- Review medical records for accurate, compliant, and complete diagnosis code abstraction for Medicare, Commercial and Medicaid risk adjustment from various chart types (physician, facility, and non-facility).
HCC Coder
Judge Group
09.2020 - 04.2022
- Reviewed outpatient records and interpreted documentation to identify diagnoses and procedures for UHG/Optum.
- Verified signatures and checked medical charts for accuracy and completion.
- Applied official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services to assign diagnostic codes.
- Resourcefully used various coding books, procedure manuals and on-line encoders.
- Accurately selected code of highest proper specificity including combination codes.
- Easily switched between various projects and applied coding skills accurately based on different guidelines.
- Maintained CPH and accuracy requirements for each individual project.
Medical Coding Specialist
TrustHCS
07.2020 - 09.2020
- Guarded against fraud and abuse by verifying all coded data accurately reflected services provided.
- Resourcefully used various coding books, procedure manuals and on-line encoders.
- Reviewed 4 medical records per hour to select appropriate HCC codes.
- Applied official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services to assign diagnostic codes.
- Verified signatures and checked medical charts for accuracy and completion.
- Performed first pass HCC coding, flagging incorrect coding, entering correct codes and submitting completed chart.
- Accurately selected code of highest proper specificity including combination codes.
- Verified data integrity and accuracy.
HCC Medical Coder
Cotiviti
08.2019 - 02.2020
- Performed first pass HCC coding and filtered audits, flagging incorrect coding, entering correct codes and submitting completed chart
- Verified data integrity and accuracy
- Reviewed and analyzed coding of diagnostic and treatment procedures contained in outpatient and inpatient medical records
- Accurately selected code of highest proper specificity including combination codes
- Guarded against fraud and abuse by verifying all coded data accurately reflected appropriate chronic and acute condition(s)
- Resourcefully used various coding books, procedure manuals and on-line encoders
- Applied official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services to assign diagnostic codes for chronic conditions
- Verified signatures and checked medical charts for accuracy and completion
Remote Coding Review Consultant
Inovalon
01.2019 - 08.2019
- Verified data integrity and accuracy for Medicare HCC and Medicaid Clinical Risk Group (CRG)
- Reviewed, analyzed and managed coding of diagnostic assessments contained in outpatient and inpatient medical records
- Resourcefully used various coding books, procedure manuals and on-line encoders
- Applied official coding conventions and rules from the American Medical Association and the Centers for Medicare and Medicaid Services to assign diagnostic codes
- Verified signatures and checked medical charts for accuracy and completion
- Accurately selected the proper descriptive code when more than one anatomical location was indicated
- Reviewed patient charts to better understand health histories, diagnoses and treatments
RADV IVA/HCC First Pass Auditor
IonHealthcare, LLC
07.2018 - 04.2019
- First pass audit for high volume client charts.
- Maintain above 95% accuracy.
- Recognize and submit substantiated HCC MA-C, MA-D and HHS value based diagnostic codes previously not submitted for complete data compilation.
- Verify data integrity and accuracy.
- Fail unsubstantiated HCC MA-C, MA-D and HHS value codes and/or charts.
HCC Risk Adjustment Coder
CIOX Health
10.2017 - 07.2018
- Resourcefully use various coding books and online encoder.
- Maintained strict patient and physician confidentiality.
- Reviewed, analyzed and coded retrospective, complete code capture, history and status contained in outpatient and inpatient medical records.
- Conscientiously reviewed medical record information to identify appropriate coding based on CMS HCC categories.
- Performed qualitative analysis of records to ensure coding accuracy and correlation of recorded data.
- Actively maintained current working knowledge of ICD-10 coding principles and guidelines.
- Maintained updated knowledge of coding requirements.
- Verified data integrity and accuracy.
Medical Transcriptionist/Medical Language Specialist
MedScribe Information Systems
02.2013 - 10.2017
- Solid knowledge of medical terminology, anatomy, pharmacology.
- Thoroughly researched newly identified diagnoses and/or medical procedures to expand skills and knowledge.
- Meticulously identified and rectified inconsistencies, deficiencies and discrepancies in medical documentation.
- Performed qualitative analysis of records to ensure accuracy and correlation of recorded data.
- Maintained strict patient and physician confidentiality.
- Expertly transcribed medical reports for a variety of physicians, hospitals and clinics.
Skills
- Medical language and terminology expert
- Remote employee experience
- HCC Risk Adjustment
- HHS-HCC experience
- ACA-HCC experience
- Capitated Risk Adjustment CMS-HCC
- Capitated Risk Adjustment Medicaid CRG
- Code validation skills
- Complete code capture
- Detail oriented
- Resourceful and reliable worker
- Strong organizational and time management skills
- High productivity and accuracy
- ICD-10 Proficiency
- Diagnostic Coding Accuracy
- Risk Adjustment Principles
- Continuous Learning Attitude
- Certified Professional Coder
Certification
Certified Professional Coder (CPC) #01533457
Timeline
Risk Adjustment Coder
Norwood
10.2023 - 01.2024
Coder 2, Risk Adjustment Production Coder
Cotiviti Healthcare
04.2022 - 10.2023
HCC Coder
Judge Group
09.2020 - 04.2022
Medical Coding Specialist
TrustHCS
07.2020 - 09.2020
HCC Medical Coder
Cotiviti
08.2019 - 02.2020
Remote Coding Review Consultant
Inovalon
01.2019 - 08.2019
RADV IVA/HCC First Pass Auditor
IonHealthcare, LLC
07.2018 - 04.2019
HCC Risk Adjustment Coder
CIOX Health
10.2017 - 07.2018
Medical Transcriptionist/Medical Language Specialist
MedScribe Information Systems
02.2013 - 10.2017
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