Summary
Overview
Work History
Education
Skills
Certification
Languages
Timeline
Generic
Eunice Sanchez Garcia

Eunice Sanchez Garcia

La Marque

Summary

Manager and Content Specialist in the Risk Adjustment medical field with 16 years of coding experience. Specialized in retrospective, prospective, and concurrent audits, OIG audits, RADV, H-RADV, and IVA, using the MA, HHS, and CDPS models. Experience in management and coding education.

Overview

17
17
years of professional experience
3
3
Certification

Work History

Client Project Manager and RA Content Specialist

Datavant
07.2022 - Current
  • Directed the development and maintenance of coding guidelines for MRA and CRA, ensuring alignment with current industry standards. Oversaw the review of client coding guidelines and facilitated client calls to enhance collaboration. Led coding audits and managed rebuttals to address client concerns effectively. Authored FAQ documents for approval, contributing to improved coding accuracy. Collaborated with the training team to ensure coders received prompt feedback for continuous improvement.
  • Directed content development for news posts and timed tests focused on coding and risk adjustment, enhancing coder knowledge and quality standards. Oversaw strategic planning processes, including content distribution and scheduling. Led ongoing research initiatives to ensure alignment with current industry news, regulations, and deadlines.
  • Directed client audit team in reviewing audits and rebuttals, achieving high accuracy rates. Oversaw feedback processes to enhance client and vendor coding education. Continued to evaluate audits to uphold quality assurance.

Quality Assurance Manager

IonHealthcare
01.2014 - 06.2022
  • Managed a team of quality assurance coders to ensure client requirements and deadlines were met. Oversaw multiple projects simultaneously, distributing work efficiently to maintain workflow balance. The team handled a variety of audits, including retrospective and concurrent audits, Client Privilege audits, OIG audits, E&M audits, RADV, and IVA.
  • Responsibilities included managing and conducting training, developing educational materials to uphold the highest quality standards for all clients, and actively participating in client calls to provide feedback and ensure expectations were met. Additionally, assisted with coding as needed to support the team and maintain accuracy.

Education

Computer and General Studies

J. Sargeant Reynolds Community College
Richmond, VA
01.2001

Sociology, Psychology, Speech

Santa Monica College
Santa Monica, CA
01.2000

Skills

  • Team leadership
  • Collaborative teamwork
  • Reliable and trustworthy
  • Driven individual
  • Quick to adjust
  • Adept in Microsoft Office applications

Certification

  • 2019 Passed the CRC-I Instructor Exam
  • 2015 Passed the CRC Exam
  • 2008 Passed the CPC Exam

Languages

Spanish

Timeline

Client Project Manager and RA Content Specialist

Datavant
07.2022 - Current

Quality Assurance Manager

IonHealthcare
01.2014 - 06.2022

Sociology, Psychology, Speech

Santa Monica College

Computer and General Studies

J. Sargeant Reynolds Community College
Eunice Sanchez Garcia