Jessica Maddux
Navarre,Florida
Summary
Experienced Clinical Analyst II with expertise in CPT and HCPCS coding at Cotiviti, Inc. Proven ability to enhance reimbursement accuracy through effective audits and collaboration with quality assurance teams. Strong communicator skilled in managing tasks and fostering teamwork, ensuring optimal client outcomes in high-pressure environments.
Overview
13
13
years of professional experience
1
1
Certification
Work History
Clinical Analyst II
Cotiviti, Inc.
02.2019 - Current
- Perform daily audits on client data for completeness and accuracy of coding, utilizing both coding and clinical background to ensure appropriateness for reimbursement.
- Utilize Coding Validation specific training to become familiar with claims payment policy and processing – specifically CMS, Medicaid regulations, AAOS, ICD-10, CPT & HCPCS, etc.
- Collaborate with the Quality Assurance team and training team in order to provide quality, timely reimbursement to clients.
- Complete special projects internally to continue collaborative performance.
- Provide direction of daily tasks, client changes and needs to the team as an assistant Team Lead.
- Generate appeal letters noting findings in the medical record to support decisions made.
Recovery Room/Operating Room Registered Nurse
Andrews Institute For Orthopaedics & Sports Medicine
08.2013 - 02.2019
- Received patients in post anesthesia unit and monitored vital signs, signs of complications and implemented appropriate interventions.
- Provided compassionate care to patients while recovering on the unit and maintained a safe and comfortable environment.
- Communicated with patient and family discharge planning for each individuals recovery goals and needs.
- Maintained a sterile environment within the operating room, reducing the risk of infection.
- Utilized sterile techniques and infection-control guidelines to maintain clean and safe environment.
- Coordinated with surgeons and staff to deliver safe patient care during operations.
- Implemented time-out protocols before starting surgeries, verifying correct patient identification and procedural details.
- Prepared equipment and supplies necessary for each surgical procedure, ensuring availability when needed by surgeons.
- Adapted quickly to changing situations in the operating room, utilizing problem-solving skills under pressure.
Emergency Room Staff Nurse
Gulf Breeze Hospital
07.2012 - 08.2013
- Administered medications and treatments as prescribed by physicians.
- Managed time effectively to ensure all assigned tasks were completed in a timely manner, maintaining productivity during high-pressure situations.
- Triage patients in order to provide timely and effective care as needed.
- Performed comprehensive assessments of various levels of medical conditions and chief complaints and reported findings to the providers.
- Communicated with patients and their families in regard to plan of care and discharge planning.
- Assisted providers in procedures at the patient bedside.
- Maintained certifications by attending annual trainings and continued education.
Education
Associate of Science - Nursing
Pensacola State College
Pensacola, Florida05-2012
Skills
Effectively work independently and collaboratively with a team in a remote setting
Ability to manage and prioritize tasks
Strong verbal and and written communication skills
Experience and knowledge of CPT coding and HCPCS coding
Certification
CPC certification
New York Independent Insurance Adjuster licensure
Timeline
Clinical Analyst II
Cotiviti, Inc.
02.2019 - Current
Recovery Room/Operating Room Registered Nurse
Andrews Institute For Orthopaedics & Sports Medicine
08.2013 - 02.2019
Emergency Room Staff Nurse
Gulf Breeze Hospital
07.2012 - 08.2013
Associate of Science - Nursing
Pensacola State College
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