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

Kimberley Guerin

Elkton

Summary

Experienced with clinical documentation and risk adjustment methodologies, ensuring accurate and compliant medical records. Utilizes critical thinking and attention to detail to enhance patient care and support healthcare teams. Track record of collaboration and adaptability in dynamic environments.

Overview

12
12
years of professional experience

Work History

Certified Risk Adjustment Specialist

Rendr
08.2023 - Current
  • Oversight and auditing of offshore vendor coders, monitoring coding practices and query creation. Presentation of findings during weekly virtual meetings
  • Give feedback, develop workflow, and execute prospective risk adjustment project for team. Ongoing presentation of risk adjustment opportunities in order to fill gaps in reporting.
  • Update and maintain offshore vendor rosters, verifying coding credentials regularly
  • Identify clinical documentation inefficiencies and report them to management for issue tracking

CDI Reviewer, Level 1 Coder

Advantasure
02.2020 - 08.2023
  • Reviewed, analyzed, and responded to provider alerts for documentation deficiencies, creating compliant queries for providers when further documentation deficiencies exist
  • Reviewed provider documentation to abstract and confirm all diagnosis codes mapping to HCC categories, according to Risk Adjustment policies, internal contract terms, and coding guidelines, for proper diagnostic code assignment
  • Maintained quality accuracy rate while meeting and exceeding production goals, supporting peers in the same goal

Second-level Audit Specialist, Coding Specialist

Ciox Health
09.2015 - 02.2020
  • Audited medical records for the complete and correct assignment of all applicable ICD-10-CM codes, facilitating quality assurance of internal coders and first-level auditors
  • Provided shadowing and mentoring services to new and struggling coders
  • Reviewed provider documentation for correct assignment of ICD-10-CM codes, recommending education topics to management

Medical Transcriptionist

CommandHealth
04.2013 - 08.2015
  • Transcribed provider dictation of patient encounters, ensuring complete and correct capture of all provider notations, and obtaining knowledge of specialty terminology as necessary to provide optimal quality
  • Met client needs and project deadlines to guarantee all work was completed in a timely fashion

Education

Health Information Management Program -

Eastern Gateway Community College
12.2023

Skills

  • CPT
  • ICD-10-CM
  • HCPCS
  • Provider Education
  • Allscripts EMR
  • HIPAA Policies
  • Coding Guidelines
  • NCCI Edits
  • Medicare Parts A, B, C, D
  • EPIC EMR
  • EClinicalWorks EMR
  • Compliance
  • Athena EMR
  • Microsoft Office Suite

Professional Affiliations And Certifications

  • American Academy of Professional Coders (AAPC), Member in good standing
  • Certified Professional Coder (CPC)
  • Certified Documentation Expert Inpatient (CDEI)
  • Certified Documentation Expert Outpatient (CDEO)
  • Certified Professional Medical Auditor (CPMA)
  • Certified Risk Adjustment Coder (CRC)
  • American Health Information Management Association (AHIMA), Member in good standing
  • Registered Health Information Technician (RHIT)

Timeline

Certified Risk Adjustment Specialist

Rendr
08.2023 - Current

CDI Reviewer, Level 1 Coder

Advantasure
02.2020 - 08.2023

Second-level Audit Specialist, Coding Specialist

Ciox Health
09.2015 - 02.2020

Medical Transcriptionist

CommandHealth
04.2013 - 08.2015

Health Information Management Program -

Eastern Gateway Community College

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