Hauns Martin
Thomasville,NC
Summary
Strong leader and problem-solver dedicated to streamlining operations to decrease costs and promote organizational efficiency. Uses independent decision-making skills and sound judgment to positively impact company success.
Authorized to work in the US for any employer
Overview
16
16
years of professional experience
1
1
Certification
Work History
Director of Coding and Compliance
InnovaCare Partners
09.2021 - Current
- Responsible for ongoing review of third-party payer and government coding/billing guidelines.
- Created an auditing process and facilitated implementation.
- Oversaw audit operations and provided corrective feedback to achieve daily and long-term goals.
- Worked closely with organizational leadership to guide operational strategy of the coding and audit programs.
- Worked with external vendors to help with implementation of audit tool and work to identify tools to help implement AI/NLP technology within current workflows.
- Oversee ongoing medical record audits for each provider to ensure coding and documentation compliance.
- Implement policies, standards, and SOPs based on best practices for coding and documentation.
- Educate staff, including providers, on changes in coding guidelines.
- Developed audit tools, a scoring system, and the coding compliance program to help identify issues and incorporate them as part of the compliance program.
- Perform annual update of new, revised, and deleted CPT and ICD-10 codes.
- Oversee due diligence projects with regard to coding audits performed for potential acquisitions.
- Lead regularly scheduled site meetings, coder’s meetings and executive coding meetings.
- Provide continuing education for offices, staff including development of reference materials.
- Provide coding and compliance updates.
- Perform coding training during new practice integrations.
- Collaborated with Learning and Development to develop a coding education program for the organization.
- Participated in the hiring process of new coding/CDI candidates.
- Lead the Risk Adjustment education program.
- Present audit findings and data reports during executive meetings.
- Provide recommendations regarding program strategy to achieve company goals and initiatives.
Risk Adjustment Coding Manager
Lumeris
03.2021 - 09.2021
- I lead the risk adjustment audit team for Lumeris.
- In this role I worked closely with our team to provide oversight of our auditing vendor, conduct targeted audits for our organization, provided reporting results from our audit findings, and spoke during various operational meetings as a risk adjustment subject matter expert.
- During my time at Lumeris I conducted large webinar-based education sessions to our clients to provide guidance on risk adjustment coding and documentation improvement.
- I traveled to client sites to provide targeted coding and documentation feedback as well as provided a basic risk adjustment overview to a large group of providers.
- I provided feedback to our claims and analytics departments regarding RAPS eligible CPT and HCPCS codes.
- I also assisted the claims department in conducting modifier 22 reviews when necessary to determine the legitimacy of this modifier during various services that were sent through the claims department.
- Participated in hiring and training coding team.
- Performed coding quality reviews and tracked, trended and managed coding quality performance.
- Resourcefully used various coding books, procedure manuals, and on-line encoders.
Network Program Manager/ Medicare Consultant
Optum Insights/ UnitedHealth Group
07.2018 - 03.2021
- I managed the Medical Condition Assessment Incentive Program for UHC in the NC market for over 120 provider groups.
- This network of providers includes small practices to large health systems with multiple contracts including ACO arrangements.
- I provided coding and documentation education within the NC market to support the Medicare Risk Adjustment programs under UnitedHealthcare.
- I obtained the Optum Approved Trainer status with the organization which allowed me to offer CEU’s and CME’s with approved presentations.
- I also audited record documentation for all my assigned provider groups each quarter to validate reported ICD-10 codes.
- This position worked closely with the quality teams that provided support to all the providers in the NC market.
- I have led large live and virtual presentations in the topic area of Medicare Risk Adjustment, Excel workflow, program specific presentations, and the importance of accurate coding and documentation.
- Engaged and worked alongside cross-functional teams to manage strategic initiatives.
- Maintained positive provider group relations by addressing problems head-on and implementing successful corrective actions.
- I provided education and training regarding closing quality gaps through coding.
Senior Medicare Risk Adjustment Educator
Humana
07.2016 - 07.2018
- I worked as a coding and documentation subject matter expert in the MRA department for Humana's North Carolina market.
- In this role I worked to educate providers and provider groups about Medicare Risk Adjustment and the importance of chronic condition capture with accurate coding and record documentation.
- I traveled throughout the state giving various types of presentations to provider groups and providing coder education surrounding the field of Medicare Risk Adjustment.
- I also taught a CPC boot camp to help prepare coders for the CPC certification test administered by the AAPC.
- I utilized PowerPoint, Excel and WebEx extensively in this position.
- In this role I would often meet with staff members of provider groups at all levels of the organization.
Risk Adjustment Team Lead
Silverback/North Texas Specialty Physicians
07.2015 - 07.2016
- I supervised a team of coders in North Carolina for our Medicare Risk Adjustment department.
- I helped implement projects for our team, collect the results, and report the data to our corporate headquarters in Texas.
- I monitored coder productivity and reported results to leadership.
- Coached team members in techniques necessary to complete job tasks.
- Evaluated employee skills and knowledge regularly, training, and mentoring individuals with lagging skills.
- Worked with team to identify areas of improvement and devised solutions based on findings.
- I prepared and presented PowerPoint presentations to provider groups for risk adjustment education.
- Responsible for training new coders as they are added to our team.
- I audited medical records to ensure correct coding for the risk adjustment department.
Office Manager
Low Country Eye Associates
08.2013 - 07.2015
- I managed the day to day operations of the office.
- Overseeing staff, running payroll, ordering supplies, paying bills, overseeing the doctors credentialing with insurance providers, hospitals and surgical centers, working on all the aspects of billing, coding and accounts receivable.
- This practice was previously an ophthalmic partnership specializing in general ophthalmology, cataract surgery and oculoplastic surgery that has split and is owned solely by the oculoplastic surgeon.
- I helped our physician with surgical and in office coding.
- I kept up with all national billing and coding guidelines, rules and regulations for our office and ensured our compliance in these areas.
- Maintained computer and physical filing systems.
- Oversaw office inventory activities by ordering and requisitions and stocking and shipment receiving.
- Managed compliance to keep organization operating within legal and regulatory guidelines.
- Improved safety procedures to promote employee well-being and safety and protect company from potential liability.
- Maintained professional demeanor by staying calm when addressing unhappy or angry customers.
- I also helped educate our provider on all coding guidelines as it pertained to our area of practice.
Coding Analyst
MRA Southeast Region, Humana Inc
04.2012 - 08.2013
- I worked as an MRA coding analyst for the southeast region within Humana.
- This position was remote home based that performed medical record reviews through Humana's medical records portal.
- Prior to this I worked in the Daytona Beach FL office, actively traveling to retrieve records for the Special Audit Team and then helped audit the records that were retrieved.
- This team worked on special projects for Humana corporate offices to help investigate possible fraud, waste, and abuse.
- I helped work on a special project where I traveled to Puerto Rico for three weeks to help retrieve records for the special project team.
- All of the coding positions within Humana required travel to physician offices as well as for corporate and regional meetings.
- Our team also helped provide audit support and education as necessary for chart validation.
Billing Coordinator
Low Country Eye Associates, LLC
08.2007 - 04.2012
- I oversaw all aspects of insurance billing for the office.
- I worked on all insurance related issues with denials, A/R, correct coding, chart auditing, etc.
- I oversaw the cataract surgery schedule by coordinating with all patients and providing the necessary paper work needed by all surgery centers.
- I worked with two surgeons - one was a cataract surgeon, the other was an oculoplastic and facial surgeon.
- I helped with code assignment on all surgeries and office visits prior to claim submission.
Education
Bachelor of Biblical Studies -
Andersonville Theological Seminary
Camilla, GA2005
General Education
Lee University
Cleveland, TN2000
Skills
- Coding, Documentation, Audit, Risk Adjustment Professional
- Expertise in insurance billing standards for most carriers including Medicare, Medicaid, BCBS, Cigna, Aetna, UHC, Tricare, Humana, etc
- 3M training
- Optum EncodePro experience
- People Management
- HCC coding and auditing experience
- Completed ICD-10-CM code set training through the AAPC
- Organizational Development
- Verbal and Written Communication
- Regulatory and Legal Compliance
- Strategic Planning
Certification
Certified Professional Coder, CPC (AAPC)
Certified Risk Coder, CRC (AAPC)
Certified Professional Coding Instructor, CPC-I (AAPC)
Affiliations
American Academy of Professional Coders (AAPC)
Timeline
Director of Coding and Compliance
InnovaCare Partners
09.2021 - Current
Risk Adjustment Coding Manager
Lumeris
03.2021 - 09.2021
Network Program Manager/ Medicare Consultant
Optum Insights/ UnitedHealth Group
07.2018 - 03.2021
Senior Medicare Risk Adjustment Educator
Humana
07.2016 - 07.2018
Risk Adjustment Team Lead
Silverback/North Texas Specialty Physicians
07.2015 - 07.2016
Office Manager
Low Country Eye Associates
08.2013 - 07.2015
Coding Analyst
MRA Southeast Region, Humana Inc
04.2012 - 08.2013
Billing Coordinator
Low Country Eye Associates, LLC
08.2007 - 04.2012
Bachelor of Biblical Studies -
Andersonville Theological Seminary
General Education
Lee University