Kelli Parson
Bowling Green,KY
Summary
Collaborative leader with dedication to partnering with coworkers to promote engaged, empowering work culture. Documented strengths in building and maintaining relationships with diverse range of stakeholders in dynamic, fast-paced settings.
Overview
14
14
years of professional experience
1
1
Certification
Work History
Manager, Medicare Risk Adjustment and Quality
Elevance Health
04.2022 - Current
- Lead a team responsible for managing and optimizing Medicare risk adjustment processes and strategies.
- Oversee the development and implementation of risk adjustment initiatives to ensure complete and accurate documentation of patients' medical records.
- Prepare and present reports on risk adjustment outcomes, trends and performance metrics to senior management.
- Collaborate with IT team to enhance data capture, reporting and analytics capabilities for risk adjustment and quality measurements.
- Drive quality improvement initiatives by identifying gaps in care, collaborating on interventions, and measuring outcomes.
- Provide mentorship and guidance to team members, fostering their professional growth and development.
- Participate in strategic planning discussions to align risk adjustment and quality improvement goals with organizational objective.
Manager, Medicare Risk Adjustment and Coding
Anthem
11.2018 - 04.2022
- Lead and oversee a team of coding professionals and specialists focused on risk adjustment coding accuracy.
- Monitor regulatory changes and updates related to coding and risk adjustment, an ensure timely adjustments to coding practices.
- Manage the development and implementation of coding polices, procedures, and guidelines.
- Participate in planning discussions to align risk adjustment and coding goals with the organization's objectives.
- Develop and maintain relationships with external vendors.
- Collaborate with IT teams to optimize coding software and tools, ensuring efficient coding processes.
- Implement training programs and educational initiatives to enhance coding proficiency and understanding of risk adjustment concepts.
- Manage coding audits and reviews to assess coding accuracy, identify trends and provide feedback to coding teams.
- Stay updated on relevant coding guidelines, regulations and industry trends.
Coding Auditor, Sr
Anthem
03.2016 - 11.2018
- Perform thorough and accurate reviews of medical claims and coding to ensure compliance with regulatory guidelines and company policies.
- Utilize in-depth knowledge of medical coding systems (such as ICD-9, ICD-10, CPT and HCPCS)to identify discrepancies and inaccuracies in coding.
- Collaborate with coding team to provide feedback and education on coding practices, documentation requirements, and coding guidelines.
- Conduct audits and reviews to assess the quality and accuracy of coding practices, documentation requirements and coding guidelines.
- Analyze coding-related data and metrics to identify patterns and opportunities for enhanced coding accuracy and efficiency.
- Participate in meetings with cross-functional teams to address coding-related issues and contribute process improvements.
- Prepare detailed reports summarizing audit findings, trends, and recommendations for corrective actions.
Independent Consultant
DocuComp LLC
08.2009 - 03.2016
- Review medical records, documentation, and coding to ensure accuracy and appropriateness of DRG assignment.
- Validate that the assigned DRG accurately reflects the patient's clinical condition and treatment.
- Identify discrepancies and inconsistencies in coding and documentation that may impact DRG assignment.
- Collaborate with coding and clinical teams to resolve coding-related queries and discrepancies.
- Analyze coding-related data and metrics to identify patterns, trends and opportunities for improvement.
- Provide feedback and education to coding teams to enhance coding accuracy and compliance.
- Communicate audit findings and recommendations to relevant stakeholders, including physicians and coding managers.
Education
Bachelor of Science - Health Information Management
Western Kentucky University
Bowling Green, KY12.2022
Associate of Science - Health Information Technology
Western Kentucky University
Bowling Green, KY05.2002
Skills
- Coding Knowledge
- Quality Improvement
- HCC Knowledge
- Healthcare Regulations
- Clinical Knowledge
- Leadership
- Communication
- Project Management
- Continuous Learning
- Adaptability
- Team Collaboration
Certification
RHIT- Registered Health Information Technician
CRC - Certified Risk Adjustment Coder
Timeline
Manager, Medicare Risk Adjustment and Quality
Elevance Health
04.2022 - Current
Manager, Medicare Risk Adjustment and Coding
Anthem
11.2018 - 04.2022
Coding Auditor, Sr
Anthem
03.2016 - 11.2018
Independent Consultant
DocuComp LLC
08.2009 - 03.2016
Bachelor of Science - Health Information Management
Western Kentucky University
Associate of Science - Health Information Technology
Western Kentucky University
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