Emily Nolen, CCA
Murfreesboro,TN
Summary
Dynamic Coding Quality Analyst with extensive experience at Optum, recognized for enhancing coding accuracy and reducing claim denials. Proficient in ICD-10 and medical terminology, I leverage analytical skills to drive quality improvements and ensure compliance with industry standards,
Overview
14
14
years of professional experience
1
1
Certification
Work History
Coding Quality Analyst
Optum
Brentwood, TN
04.2024 - Current
- Maintained confidentiality, handling sensitive information discreetly throughout all stages of the audit process.
- Followed established auditing processes to meet internal and regulatory requirements.
- Increased internal control effectiveness through diligent evaluation of processes and providing recommendations for improvement.
- Performed observations and evaluated supporting documents to supplement audit findings.
- Participated in ongoing professional development opportunities to stay current with industry trends and advancements in coding methodologies.
- Advanced overall project success through consistent adherence to company-wide standards, guidelines, and best practices.
- Developed comprehensive reports highlighting areas of concern in coding quality, enabling management to make informed decisions about resource allocation and training needs.
- Enhanced overall code quality for the department by implementing best practices and maintaining up-to-date knowledge of industry standards.
- Reviewed and analyzed trends to advise and develop recommendations to achieve or modify program goals.
- Contributed to increased project efficiency through meticulous attention to detail when reviewing code submissions.
- Maintained accuracy, completeness, and security for medical records and health information.
- Verified accuracy of patient information in medical records.
- Researched and resolved medical record discrepancies.
Sr Medical Coder
Optum
Brentwood, TN
08.2019 - 04.2024
- Reduced claim denials by identifying and addressing common errors in the coding process.
- Ensured compliance with industry regulations by staying updated on current coding practices and guidelines.
- Contributed to quality improvement initiatives by identifying areas for potential enhancement within the medical coding department.
- Streamlined the coding process for efficiency, resulting in a higher volume of claims processed daily.
- Participated in relevant professional development opportunities to stay abreast of changes in medical coding standards.
- Maintained ICD-10 proficiency, leading to more accurate code assignments and fewer claim rejections.
- Resourcefully used various coding books, procedure manuals, and on-line encoders.
- Reviewed, analyzed, and managed coding of diagnostic and treatment procedures contained in outpatient medical records.
- Reviewed patient charts to better understand health histories, diagnoses, and treatments.
- Applied official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services to assign diagnostic codes.
- Reviewed outpatient records and interpreted documentation to identify diagnoses and procedures.
- Verified signatures and checked medical charts for accuracy and completion.
- Maintained accuracy, completeness, and security for medical records and health information.
- Verified accuracy of patient information in medical records.
contract HCC medical coder
Judge Group ( Optum contract)
Brentwood, TN
05.2017 - 08.2019
- Thoroughly researched newly identified diagnoses and/or medical procedures to expand skills and knowledge.
- Maintained updated knowledge of coding requirements, through continuing education and certification renewal.
- Assigned appropriate medical codes with a 95 percent accuracy rate.
- Maintained strict patient and physician confidentiality.
- Resourcefully used various coding books, procedure manuals and on-line encoders.
- Actively maintained current working knowledge of CPT and ICD-9 coding principles, government regulation, protocols and third party requirements regarding billing.
- Conscientiously reviewed medical record information to identify appropriate coding based on CMS HCC categories.
Contract remote medical coder
Aerotek ( Allegis Care)
Brentwood, TN
11.2015 - 02.2016
- Meticulously identified and rectified inconsistencies, deficiencies and discrepancies in medical documentation.
- Maintained updated knowledge of coding requirements, through continuing education and certification renewal.
- Assigned appropriate medical codes with a 95 percent accuracy rate.
- Researched CPT and ICD-10 coding discrepancies for compliance and reimbursement accuracy.
- Maintained strict patient and physician confidentiality.
- Resourcefully used various coding books, procedure manuals and on-line encoders.
- Actively maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third party requirements regarding billing.
Remote HCC coder, contract
Aerotek ( Cigna)
Brentwood, TN
06.2015 - 10.2015
- Maintained updated knowledge of coding requirements, through continuing education and certification renewal.
- Assigned appropriate medical codes with a [95] percent accuracy rate.
- Reviewed, analyzed and managed coding of diagnostic and treatment procedures contained in outpatient medical records.
- Maintained strict patient and physician confidentiality.
- Resourcefully used various coding books, procedure manuals and on-line encoders.
- Actively maintained current working knowledge of CPT and ICD-9 coding principles, government regulation, protocols and third party requirements regarding billing.
Medical coder, remote
Complex Care Solutions
Nashville, TN
04.2014 - 04.2015
- I coded medical charts for providers in office and in home settings, assigning correct codes maintaining at least 95 percent accuracy and at least 32 assessments per day.
- Thoroughly researched newly identified diagnoses and/or medical procedures to expand skills and knowledge.
- Maintained updated knowledge of coding requirements, through continuing education and certification renewal.
- Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy.
- Maintained strict patient and physician confidentiality.
- Resourcefully used various coding books, procedure manuals and on-line encoders.
- Actively maintained current working knowledge of CPT and ICD-9 coding principles, government regulation, protocols and third party requirements regarding billing.
- Interacted with providers and other medical professionals regarding billing and documentation policies, procedures and regulations.
Medical coder, contract
United Healthcare
Brentwood, TN
11.2013 - 02.2014
- Correctly coded and billed medical claims for various hospital and nursing facilities.
- Coded inpatient charts at a rate of 4 per hour or 32 per day.
- Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy.
- Maintained strict patient and physician confidentiality.
- Resourcefully used various coding books, procedure manuals and on-line encoders.
- Actively maintained current working knowledge of CPT and ICD-9 coding principles, government regulation, protocols and third party requirements regarding billing.
- Conscientiously reviewed medical record information to identify appropriate coding based on CMS HCC categories.
Documentation specialist
Simplex Healthcare
Franklin, TN
11.2010 - 08.2013
- Meticulously identified and rectified inconsistencies, deficiencies and discrepancies in medical documentation. I helped get physician order requests from Dr's offices for diabetic supplies. I called Dr's offices and patients. If we received the documentation incomplete then I followed up with them to make sure it was corrected and sent back. I made 120 calls per day.
- Maintained strict patient and physician confidentiality.
Education
Certified medical coder - medical coding
Stratford Career Institute
2009
Business - Business
Pensacola Jr College
1997
Skills
- Medical terminology expert
- ICD-10 (International Classification of Disease Systems)
- Hospital outpatient records
- HCPCS Coding Guidelines
- Familiar with commercial and private insurance carriers
- Understands insurance benefits
Certification
- Certified Professional Coder (CPC)
Timeline
Coding Quality Analyst
Optum
04.2024 - Current
Sr Medical Coder
Optum
08.2019 - 04.2024
contract HCC medical coder
Judge Group ( Optum contract)
05.2017 - 08.2019
Contract remote medical coder
Aerotek ( Allegis Care)
11.2015 - 02.2016
Remote HCC coder, contract
Aerotek ( Cigna)
06.2015 - 10.2015
Medical coder, remote
Complex Care Solutions
04.2014 - 04.2015
Medical coder, contract
United Healthcare
11.2013 - 02.2014
Documentation specialist
Simplex Healthcare
11.2010 - 08.2013
Certified medical coder - medical coding
Stratford Career Institute
Business - Business
Pensacola Jr College