Summary
Overview
Work History
Education
Skills
Professional Affiliations And Certifications
Timeline
Generic

Kathy Melton RHIT, CPC, CPCO, CDEO , CRC

Essex

Summary

Experienced professional in risk adjustment management with a strong background in compliance with industry regulations and company policies. Successfully established a medical coding department, creating policies and procedures that drove results across multiple markets. Conducted comprehensive research and data analysis to support strategic planning, while mentoring team members to enhance job performance. Proficient in CPT, ICD-9/10-CM/PCS, HCPCs, and Medicare compliance, ensuring adherence to coding guidelines and risk adjustment policies.

Overview

2026
2026
years of professional experience

Work History

Manager Of Risk Adjustment

UMass Memorial Hospital
Worcester
01.2023 - Current
  • Ensured compliance with industry regulations and company policies.
  • Conducted regular meetings with staff to discuss progress and identify areas of improvement.
  • Coached, mentored and trained team members in order to improve their job performance.
  • Created all provider education materials.

Head of Medical Coding Operations

Honest Medical Group
Nashville
10.2021 - 12.2023
  • Utilized various software and tools to streamline processes and optimize performance.
  • Conducted comprehensive research and data analysis to support strategic planning and informed decision-making.
  • Worked successfully with diverse group of coworkers to accomplish goals and address issues related to our products and services.
  • Created medical coding department.
  • Established policies and Procedures
  • Driven results with highly successful programs in 16 Markets.
  • Hired 20 Medical Coders

Senior Medical Coding Manager

Landmark Health
01.2017 - 10.2021
  • Code medical records for the complete and correct assignment of CPT, ICD, and HCPCS codes
  • Educate providers regarding coding guidelines, documentation processes, and coding and billing procedures to ensure compliance and support correct documentation
  • Develop and implement Correct Documentation Improvement program using data collection and identification of issue trends to focus education efforts

Quality Manager

EMSI
06.2016 - 12.2016
  • Managed code team quality output, reviewing production and verifying code selection
  • Provided education to maintain coder compliance with coding guidelines and correct coding initiatives

Manager

United Healthcare
07.2008 - 06.2016
  • Directed daily production and quality for a team of 43 coding employees, supporting optimal quality and top production
  • Audited coded Medicare Risk Adjustment charts to verify correct coding

Head Of Medical Coding Operations

Honest Medical Group
Nash

Education

RHIT

Rasmussen University
Eden Prairie, MN

Skills

  • CPT
  • ICD-9/10-CM/PCS
  • HCPCs
  • Medical Terminology
  • Anatomy
  • Physiology
  • Coding Guidelines
  • HIPAA Policies
  • HCC Coding
  • Risk Adjustment Policies
  • Medicare Risk Adjustment
  • Medicare Compliance

Professional Affiliations And Certifications

  • American Academy of Professional Coders (AAPC), Member in good standing, Certified Professional Coder, CPC, Certified Risk Adjustment Coder, CRC, Certified Documentation Expert Outpatient, CDEO
  • American Health Information Management Association, Member in good standing, Registered Health Information Technician, Approved ICD-10 Trainer

Timeline

Manager Of Risk Adjustment

UMass Memorial Hospital
01.2023 - Current

Head of Medical Coding Operations

Honest Medical Group
10.2021 - 12.2023

Senior Medical Coding Manager

Landmark Health
01.2017 - 10.2021

Quality Manager

EMSI
06.2016 - 12.2016

Manager

United Healthcare
07.2008 - 06.2016

Head Of Medical Coding Operations

Honest Medical Group

RHIT

Rasmussen University
Kathy Melton RHIT, CPC, CPCO, CDEO , CRC