Janois Middleton
McKinney,TX
Summary
Highly-motivated employee with desire to take on new challenges. Strong work ethic, adaptability, and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills.
Overview
21
21
years of professional experience
1
1
Certification
Work History
Lead coder
Optum
Irving, Texas
04.2007 - Current
- Participated in meetings with external auditors concerning coding audit results.
- Resolved discrepancies between coded data and source documents according to established protocols.
- Acted as liaison between clinical providers and administrative personnel when resolving questions or disputes related to code assignments.
- Conducted periodic audits of coded data for quality assurance purposes.
- Monitored trends in coding procedures and industry standards, revising policies accordingly when needed.
- Analyzed complex coding issues and provided recommendations for resolution.
- Identified areas where process improvements could be made in order to increase efficiency or accuracy of coding operations.
- Created reports on coding activity for management review.
- Collaborated closely with other departments to ensure accurate data capture from patient records into electronic health record system.
- Supervised the daily activities of a team of coders, ensuring accuracy and timely completion of tasks.
- Provided coding training and mentorship to new hires.
- Performed regular reviews of staff performance, providing feedback as necessary to ensure goals were met.
- Assigned additional diagnosis codes based on specific clinical findings (laboratory, radiology and, pathology reports as well as clinical studies) in support of existing diagnoses.
- Quickly responded to staff and client inquiries regarding CPT codes.
- Coordinated with billing department to clarify billing issues related to coding.
- Supported external audits by providing coded data and documentation as requested.
- Resolved coding discrepancies and denials to maximize reimbursement.
- Participated in coding team meetings to discuss challenges and best practices.
- Verified proper coding, sequencing of diagnoses, and accuracy of procedures.
Coder/Code/Cmdr/Internal Auditor
Medical Edge
Dallas, Texas
05.2006 - 04.2026
- Conducted code reviews to ensure adherence to coding standards and best practices.
- Reviewed account information to confirm patient and insurance information is accurate and complete.
- Collaborated with billing team to confirm no additional diagnosis codes available for LCD and NCD coverage.
Coding Specialist
Associated Physicians
Madison, Wisconsin
09.2005 - 03.2006
- Processed incoming information from physicians' offices such as lab results or diagnostic imaging studies.
- Conducted quality assurance audits to ensure accurate medical coding practices were followed.
- Collaborated with medical staff to clarify diagnoses or treatments when necessary.
- Prepared documents for insurance companies, including appeals letters, prior authorization requests.
- Reviewed patient records to ensure accuracy of documentation and assigned appropriate codes for diagnosis, treatment, and procedures.
Education
Bachelor of Science - Business With emphasis in Health Care Management
Capella University
Minneapolis, MN09-2020
Skills
- Medical coding
- Coding audits
- CPT coding
- Health information management
- Quality assurance
- Conflict resolution
- Effective communication
- Training and mentorship
- Performance optimization
- Proficiency in BFE
- Proficiency in Pathway LIS
- Team leadership
Accomplishments
- Six Sigma Green Belt Training
Certification
- COC & CPC Certified
Timeline
Lead coder
Optum
04.2007 - Current
Coder/Code/Cmdr/Internal Auditor
Medical Edge
05.2006 - 04.2026
Coding Specialist
Associated Physicians
09.2005 - 03.2006
Bachelor of Science - Business With emphasis in Health Care Management
Capella University
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