Kaila Flowers
Houston
Summary
CPC/CRC/COC certified medical auditor with 7+ years of experience applying and evaluating various code sets for physician and facility services. Skilled at identifying discrepancies and ensuring high accuracy in patient documentation. Reliable and adaptable professional with expertise in data analysis and regulatory compliance.
Overview
14
14
years of professional experience
Work History
Medical Auditor
Optum
09.2021 - Current
- Supports revenue cycle management through diligent monitoring of claims submissions, denials, and appeals
- Conducts comprehensive chart reviews to validate coding accuracy and ensure compliance with regulations
- Improves coding process efficiency by assisting with the development and implementation of standardized procedures
- Participates effectively in clinical documentation improvement initiatives and department training sessions to promote quality across all projects
Medical Coding Specialist
PMB Medical Billing And Coding
05.2018 - 08.2021
- Performed billing and coding procedures for ambulance, emergency room, inpatient, outpatient and risk adjustment services per AMA and CMS standards
- Maintained an average of 4 IP charts per hour, 6 OP charts per hour and 15 ER charts per hour with 95% accuracy
- Provided specialty coding assistance for E/M, surgery, anesthesia, radiology and cardiology departments
- Queried physicians and other healthcare staff to review documentation and ensure chart accuracy
Administrative Assistant
Costco Logistics
09.2014 - 04.2018
- Coordinated bookkeeping activities, transactions, invoicing and budgeting for the world's sixth largest retailer
- Kept financial records accurate, current and compliant by monitoring records and addressing variances, leading to the first zero-error financial audit in the southern division in ten years
- Regularly processed payroll for 300 employees
- Developed and updated spreadsheets and databases to track, analyze and report on performance and sales data involving up to $1.3 million in daily transactions per location
- Created detailed expense reports and requests for capital expenditures
- Interacted with vendors, contractors and professional services personnel to receive orders, direct activities and communicate instructions
Assistant Manager
Petco
06.2011 - 08.2014
- Instrumental in raising performance in areas of sales, management and operations which guided the location to becoming the top performer in the divisional branch for 2013
- Increased customer retention and satisfaction by closely monitoring team member performance and assessing problematic practices, leading the location from the top 34% rated location to the top 10% nationally
- Maintained team efficiency by strategically delegating daily activities, monitoring output and rewarding positive contributions
- Improved operational planning and business frameworks to enhance resource utilization and reduce waste
- Controlled costs and optimized spending via restructuring of budgets for labor, capital assets, inventory purchasing, and technology upgrades
- Achieved or exceeded financial goals on a regular basis by controlling expenses, optimizing schedules and regulating inventory usage
Education
Bachelor of Science - Health Information Management
Western Governors University
Salt Lake City, UT05-2025
COC Certification - Outpatient Hospital/Physician Coding
AAPC
01-2019
CRC Certification - Risk Adjustment/HCC Coding
AAPC
01-2019
CPC Certification - Outpatient/Inpatient Coding
AAPC
EnR Coding & Project Xtern01-2018
Skills
- Thoroughly versed in federal, state and payer specific regulations and policies, including HIPAA compliance
- Strong command of ICD-10, CPT, HCPCS, and modifiers
- Vast experience with Medicare, Medicaid and commercial payers
- Extensive knowledge of medical terminology, anatomy, physiology and pathology
Timeline
Medical Auditor
Optum
09.2021 - Current
Medical Coding Specialist
PMB Medical Billing And Coding
05.2018 - 08.2021
Administrative Assistant
Costco Logistics
09.2014 - 04.2018
Assistant Manager
Petco
06.2011 - 08.2014
Bachelor of Science - Health Information Management
Western Governors University
COC Certification - Outpatient Hospital/Physician Coding
AAPC
CRC Certification - Risk Adjustment/HCC Coding
AAPC
CPC Certification - Outpatient/Inpatient Coding
AAPC
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