Imani Montgomery,RHIT,CPC
Valdosta,GA
Summary
Results-driven outpatient auditor with a strong foundation in coding and billing. Proven ability to conduct thorough audits, ensure compliance with CMS standards, and provide actionable feedback to enhance coding accuracy. Committed to fostering continuous improvement in healthcare documentation.
Overview
2026
2026
years of professional experience
2026
2026
years of post-secondary education
1
1
Certification
Work History
Clinical Placement Student Nurse
HCA West Marion
Ocala, Florida
- Performed physical exams and collected vital signs for assigned patients.
- Maintained safe and comfortable environment for each patient.
- Observed and communicated changes in patient's condition to registered nurse on duty.
- Supported personal hygiene needs of patients and monitored fluid input and output for permanent records.
- Cared directly for patients by assisting with daily living activities and mobility needs.
- Interacted with patients in a professional manner while providing compassionate care.
- Maintained confidentiality of patient records according to HIPAA guidelines.
Outpatient Auditor
Memorial Hermann
Houston, Texas
08.2025 - Current
- Conduct detailed outpatient coding audits for Emergency Department (ER), Same Day Surgery (BDO), and Recurring Accounts, ensuring compliance with CPT, HCPCS, ICD-10-CM, and CMS outpatient billing and compliance standards.• Utilize Epic and 3M to review provider documentation, verify accurate code assignment, charge capture, and modifier usage.• Provide recommendations and feedback to coders on retro (post-bill) and concurrent (pre-bill) accounts to improve coding accuracy and prevent recurring errors.• Complete and provide QA reports for retro account coders, summarizing audit findings, identifying documentation deficiencies, and recommending corrective actions.
Outpatient Medical Coder/Auditor
AdventHealth
Orlando, FL
07.2024 - 08.2025
- Review medical records across various outpatient specialties to ensure the correct diagnosis and procedure codes are assigned.
- Coding patient information using ICD-10, CPT, and HCPCS codes, according to established guidelines.
- Reviewing physician documentation, and performing audits to determine accuracy.
- Reviews and audits medical charts coded by peers, and provides feedback, improvement, and correction recommendations.
- Utilizes effective research, extensive study, and active questioning skills to maintain a working knowledge of medical terminology, diseases, and medical procedures, and to identify, correct, and report coding problems.
- Understands the relationship between ICD-10-CM coding and HCC (hierarchical condition categories) coding.
- Maintains high level of accuracy when coding complex cases utilizing multiple diagnosis codes.
- Ensures all documentation is compliant with CMS regulations and guidelines.
- Prepares detailed reports outlining trends in denied claims due to incorrect or incomplete code assignments.
- Collaborates with physicians, nurses, and other healthcare professionals regarding coding issues or questions.
- Maintain RX Effect and Practice Assist portals by verifying that HCCs have been addressed for the current year.
- Maintains current working knowledge of CPT and ICD-10 coding principles, government regulations, protocols, and third-party billing requirements.
- Participates in coding team meetings to discuss challenges and best practices.
Risk Adjustment Auditor
Norwood/ Humana
Atlanta, GA
11.2023 - 03.2025
- Reviewed medical records for accurate risk adjustment coding compliance.
- Analyzed coding guidelines to ensure adherence to regulatory standards.
- Analyzed provider documentation to ensure accurate coding of diagnoses and procedures according to CMS Medicare Risk Adjustment Coding Guidelines.
- Maintained a high level of productivity while adhering to established standards of quality control.
Outpatient Medical Coder/Risk Adjustment Coder
Enjoincdi
Rosharon, TX
08.2023 - 07.2024
- Reviewed medical records for accuracy and completeness to ensure compliance with coding standards.
- Coded patient information using ICD-10, CPT, HCPCS codes according to established guidelines.
- Verified accuracy of diagnosis codes by reviewing clinical documentation in the medical record.
- Reviewed medical records to ensure accuracy and completeness of clinical documentation.
- Analyzed data from multiple sources including laboratory, radiology and pathology reports.
- Identified discrepancies in documentation with providers and resolved inconsistencies in a timely manner.
- Provided education to healthcare professionals on proper utilization of ICD-10 codes and other relevant coding guidelines.
Risk Adjustment Coder
Advantsure/Blue Cross Blue Shield of Michigan
Detroit, Michigan
05.2022 - 10.2023
- Reviewed medical records for accurate risk adjustment coding compliance.
- Analyzed coding guidelines to ensure adherence to regulatory standards.
- Analyzed provider documentation to ensure accurate coding of diagnoses and procedures according to CMS Medicare Risk Adjustment Coding Guidelines.
- Maintained a high level of productivity while adhering to established standards of quality control.
Inpatient/Outpatient Medical Coder
Optum
Atlanta, GA
08.2022 - 07.2023
- Utilized effective research, extensive study and active questioning skills to maintain working knowledge of medical terminology, diseases and medical procedures.
- Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements.
- E/M leveling, Same day surgeries, ER visits, Inpatient, edits.
- Coded for the Facility and Hospital outpatient.
- Read through patient health data, histories, physician diagnoses and treatments to gain understanding for coding purposes.
- Maintained high accuracy rate on daily production of completed reviews.
- Verified proper coding, sequencing of diagnoses and accuracy of PCS procedures.
- Added modifiers as appropriate, coded narrative diagnoses and verified diagnoses.
- Assigned patients to diagnosis-related groups using appropriate computer software.
Risk Adjustment Coder
ChenMed
Miami Gardens, FL
03.2022 - 01.2023
- Read through patient health data, histories, physician diagnoses and treatments to gain understanding for coding purposes.
- Maintained updated knowledge of coding requirements, which included continuing education and certification renewal.
- Reviewed account information to confirm patient and insurance information is accurate and complete.
- Maintained high accuracy rate on daily production of completed reviews.
- Compiled and coded patient data using standard classification systems.
- Assigned patients to diagnosis-related groups using appropriate computer software.
- Juggled multiple projects and tasks to ensure high quality and timely delivery.
HCC Coder
Insight Global/United Health Care
Atlanta, GA
06.2021 - 01.2022
- Completed Medicare, Commerical and ACA Projects.
- Read through patient health data, histories, physician diagnoses and treatments to gain understanding for coding purposes.
- Maintained updated knowledge of coding requirements, which included continuing education and certification renewal.
- Reviewed account information to confirm patient and insurance information is accurate and complete.
- Maintained high accuracy rate on daily production of completed reviews.
- Compiled and coded patient data using standard classification systems.
- Assigned patients to diagnosis-related groups using appropriate computer software.
- Juggled multiple projects and tasks to ensure high quality and timely delivery.
Inpatient/Outpatient Medical Coder
Caritas Medical Center
Stockbridge, GA
09.2019 - 04.2020
- Submitted clean claims to insurance companies electronically to secure payments.
- Risk Adjustment Coding
- Translated patient information into alphanumeric and numeric medical codes
- Maintained strict confidentiality with adherence to HIPAA guidelines and regulations.
- Investigated rejected and denied claims, correcting applicable coding.
- Utilized Level 1 HCPCS and Level 2 HCPCS systems to complete coding tasks.
- Evaluated patient's financial status to establish budget payment plans.
- Pulled patient records and transferred information to appropriate parties.
- Streamlined day-to-day office processes to meet long-term goals.
- Provided respectful assistance to all parties, including patients, staff members and insurance company representatives.
- Entered patient insurance, demographic and health information into software and confirmed records.
Healthcare Advisor, Accounts Receivable
UnitedHealth Group, Optum
Atlanta, GA
04.2019 - 09.2019
- Sole point of contact for all claim appeals as well as submission of electronic and paper claims , Answer EOB questions Check Benefits Billing.
Receptionist/Biller and Coder, Accounts Receivable
Hanger Clinic
Atlanta, GA
08.2017 - 04.2019
- Checked in and checked out 30-60 patients daily and assisted 4 doctors Verified insurance and eligibility and obtained prior authorizations Maintained patient records, scanned documents, filed and edited patient charts Answered multiple phone lines and scheduled appointments Collected and posted payments Resubmitted denied claims to proper payer after correcting CPT and/or ICD-10 CM codes Coded charts for Physicians in an Internal Medicine Practice, also coded charts for Hospital Visits and Nursing Home visits Facilitated NextGen and Epic Sole point of contact for all claim appeals as well as submission of electronic and paper claims , Billing.
- Reconciled accounts receivable and prepared income summary reports and cash reports.
- Prepared appropriate documentation for income summaries, cash reports and accounts receivable reconciliation.
- Generated monthly statements for accounts receivable operations.
- Entered, posted and scanned accounts receivable documents into NextGen software program.
- Kept accounts receivable tracking database current with relevant client information, collection and billing progress and program changes.
- Used NextGen to enter and post accounts receivable documents.
- Sorted and distributed business correspondence to correct department or staff member, reducing dropped communications and enabling faster responses to key requests.
- Initiated and recorded accounts receivables to update accounting database and facilitate receipt of customer payments.
- Posted customer payments by recording cash, checks and credit card transactions.
Inpatient/Outpatient Medical Coder
Med-South Associates
Riverdale, GA
10.2012 - 08.2017
- Checked in and checked out 30-40 patients daily and assisted 2 doctors Verified insurance and eligibility and obtained prior authorizations Billing , Maintained patient records, scanned documents, filed and edited patient charts Answered multiple phone lines and scheduled appointments Collected and posted payments Resubmitted denied claims to proper payer after correcting CPT and/or ICD-10 CM codes Coded charts for Physicians in an Internal Medicine Practice, also coded charts for Hospital Visits and Nursing Home visits Facilitated 5010 Conversion on Cerner EMR Software Sole point of contact for all claim appeals as well as submission of electronic and paper claims.
- Risk Adjustment Coding
- Logged all requests for medical records into spreadsheets.
- Entered patient insurance, demographic and health information into software and confirmed records.
Education
Associate of Science - Nursing
Rasmussen University
Ocala, FL 07.2025 - 12.2025
Associate of Science - Health Information Technology
Rasmussen University
Saint Cloud, MNHigh School Diploma -
Woodland High School
Stockbridge, GASkills
- Front Office, Coding, and Billing Experience(Physician, Hospital- Profee and Facility coding, Home Health, DME, Hospice, Mental Health, HCC and Risk Adjusment)
- Revenue Cycle Management
- Hospital Inpatient and Outpatient Records
- Inpatient Coding/Diagnostic Coding/HCPCS Coding
- Clinical Documentation Improvement
- Medical Record Review
- HIPAA Compliance
- Insurances Knowledge (Medicare, Medicaid, HMO, PPO, Commercial and Worker’s Comp)
- Claims Processing & Adjudication
- Claim Denial Follow Up & Submission
- EMR Knowledge: Cerner, Epic, Eclincal Works, GreenWay, and Next-Gen
- Computer Proficient in Microsoft Office Suites
- Coding Error Resolution
- Medical Terminology
- Time Management
- Problem-Solving
- Training and Mentoring
Certification
AAPC-Certified Professional Coder (CPC)
AHIMA- Registered Health Information Technician ( RHIT)
Timeline
Outpatient Auditor
Memorial Hermann
08.2025 - Current
Associate of Science - Nursing
Rasmussen University
07.2025 - 12.2025
Outpatient Medical Coder/Auditor
AdventHealth
07.2024 - 08.2025
Risk Adjustment Auditor
Norwood/ Humana
11.2023 - 03.2025
Outpatient Medical Coder/Risk Adjustment Coder
Enjoincdi
08.2023 - 07.2024
Inpatient/Outpatient Medical Coder
Optum
08.2022 - 07.2023
Risk Adjustment Coder
Advantsure/Blue Cross Blue Shield of Michigan
05.2022 - 10.2023
Risk Adjustment Coder
ChenMed
03.2022 - 01.2023
HCC Coder
Insight Global/United Health Care
06.2021 - 01.2022
Inpatient/Outpatient Medical Coder
Caritas Medical Center
09.2019 - 04.2020
Healthcare Advisor, Accounts Receivable
UnitedHealth Group, Optum
04.2019 - 09.2019
Receptionist/Biller and Coder, Accounts Receivable
Hanger Clinic
08.2017 - 04.2019
Inpatient/Outpatient Medical Coder
Med-South Associates
10.2012 - 08.2017
Clinical Placement Student Nurse
HCA West Marion
Associate of Science - Health Information Technology
Rasmussen University
High School Diploma -
Woodland High School