Summary
Overview
Work History
Education
Skills
Certification
Timeline
Generic

Latrina Harris RN CPC CDIP

Summary

Experienced with conducting thorough clinical reviews to ensure compliance with healthcare standards. Utilizes critical thinking and effective communication to enhance concurrent and retro review outcomes. Knowledge of regulatory guidelines and team collaboration fosters reliable and proven exceptional accuracy rates.

Overview

10
10
years of professional experience
1
1
Certification

Work History

Clinical Review Nurse

Molina Healthcare
04.2023 - Current
  • Validate claims for the clinical documentation that supports POA of MCC/CC
  • Examine medical records for appropriate medical coding assignment according to coding convention norms and for the correct primary diagnosis.
  • Teach employees to examine medical charts for accuracy, supportive clinical and resource consumption for MCC/CC reporting.
  • Work together with physicians to get their knowledge of the proper medical standards of care for treatment and medical evaluation for diagnosis.
  • Use expert nursing knowledge to review patient records
  • Audit medical records for accurate translation of the patient's condition into the medical codes submitted. Examining specific documentation that is supportive of the ICD-10 coding guidelines.

Registered Nurse/Medical Coder/ CDI Auditor

Corvel Corporation
08.2022 - 01.2024
  • Audit claims for proper coding and supportive documentation
  • Review claims from hospital inpatient bills, physician bills, Michigan auto and workers compensations bills
  • Recode/Audit Hospital bills for accurate DRG according to the medical documentation submitted by use of CDI skills
  • Recode/Audit workers compensation bills according to the state manual and AMA CPT guidelines
  • Audit Auto Claims according to state law, reasonable and medically necessary, CMS guidelines and AMA CPT guidelines

Registered Nurse

Beaumont Hospital Emergency Dept, PCU, Michigan
11.2021 - 11.2023
  • Triage: Initiated patient care, through gathering pertinent information about their health and anticipation of the level of Emergency care needed
  • Fast-track: Treat patients for acute minor illnesses, gather patients’ labs and specimens for diagnosis, with the anticipation of discharge home with medication and or follow-up with primary care.
  • Med/Surg: Treating patients with the anticipation of admission onto hospital floor by collaborating with physician regarding patient healthcare status, medications, prescribed orders clinical findings “eg, labs, radiology”, with anticipation for physician orders
  • Agency/ Registered Nurse American Mobile Nursing

Registered Nurse/ Med Surgical/Telemetry, PCU

Garden City Hospital Prime Healthcare
05.2021 - 08.2022
  • Initiate an on-going systemic assessment of the patient through interviews on admission, observation during stay, and physical examination.
  • Develop a nursing care plan which contains problem identification, nursing diagnosis, nursing orders, approaches, interventions, short/long term goals, and discharge planning.
  • Administer medications per orders. Evaluate effectiveness of PRN medications. Maintenance and care of central line catheters. Trained to administrate critical drip medications; and regulate drip rates as ordered. Administer cardiac and I.V. push drugs.
  • Participant in emergency and life-threatening situations; use of crash cart items/drugs. Member of Rapid Response Team, initiate care during Code Blue and Medical Emergencies.

Medical Review Nurse

United Healthcare/Optum
11.2019 - 03.2020
  • Physician bill Auditing for Medicare/Medicaid, Fraud/Waste/Abuse/Prevention division.
  • Audit charts for accuracy and supportive documentation of CPT codes/ CMS modifications codes and ICD 10 supportive necessity.
  • Maintained a 7day or less turn around and an accuracy of 95% or higher.
  • Agency/ CSI

Medical Bill Review Nurse

Review Works
11.2016 - 08.2019
  • Review medical claims for compliance with CPT code guidelines and proper coding.
  • Analyst claims and supportive documentation to determine relatedness and necessity
  • Complete data entry, review personal injury claims and collaborate with claims adjusters
  • Provided Case Management services for long-term auto injury claims.

Medical Coder, North Atlanta Surgical Associates
03.2016 - 06.2016
  • Coding surgical procedures, utilizing CPT codes for a medical practice of 20 plus Surgeons
  • Chart reviews and Auditing for ICD 10 CM diagnosis code accuracy
  • Entering all patient procedures and diagnoses following ICD-10 and CPT coding guidelines to ensure proper reimbursement
  • Analyzed patient charts to code physician services using ICD 10 and CPT coding
  • Validate insurance and procedure eligibility with insurance companies.
  • Post charges and submission of claims
  • Follow-up on claims management of ARP accounts.

Remote

HCC Risk Adjustment Auditor, CMS/Change.org
01.2016 - 06.2016
  • Auditing charts for accurate ICD-10/9 codes.
  • Capturing documentation of supportive and the accuracy of care provided according to the CMS and project guidelines.
  • Monitoring for physician compliance and identifying non-compliance documentation.
  • PRN/temporary assignment

Education

Bachelor of Nursing -

Capella University
Minneapolis, MN
12.2025

Clinical Documentation Integrity Practitioner - undefined

AHIMA CCHIM
03.2025

Assoc - App Sciences Nursing

Schoolcraft College
Livonia, MI
05.2021

Certificate Professional Coding - undefined

AAPC Davenport Univer
Warren, MI
12.2015

Skills

  • EMR: Epic, Cerner, Allscripts
  • Medical coding expertise: DRG, ICD 10 CM/PCS Inpatient/Outpatient coding, Physician coding, CDI trained/auditor
  • Encoder Pro, 3M encoder/solutions
  • HCC Risk Adjustment (CMS auditor)
  • CPT/ HCPCS level II coding (outpatient coding)
  • Medical Surgical, Telemetry, Progressive Care, Inpatient Rehab, Emergency Department; Triage (Registered Nurse acute care settings)

Certification

  • CDIP, AHIMA - March 2023
  • CPC, AAPC - February 2016
  • Register Nurse - Multi-State 2021

Timeline

Clinical Review Nurse

Molina Healthcare
04.2023 - Current

Registered Nurse/Medical Coder/ CDI Auditor

Corvel Corporation
08.2022 - 01.2024

Registered Nurse

Beaumont Hospital Emergency Dept, PCU, Michigan
11.2021 - 11.2023

Registered Nurse/ Med Surgical/Telemetry, PCU

Garden City Hospital Prime Healthcare
05.2021 - 08.2022

Medical Review Nurse

United Healthcare/Optum
11.2019 - 03.2020

Medical Bill Review Nurse

Review Works
11.2016 - 08.2019

Medical Coder, North Atlanta Surgical Associates
03.2016 - 06.2016

Remote

HCC Risk Adjustment Auditor, CMS/Change.org
01.2016 - 06.2016

Clinical Documentation Integrity Practitioner - undefined

AHIMA CCHIM

Assoc - App Sciences Nursing

Schoolcraft College

Certificate Professional Coding - undefined

AAPC Davenport Univer

Bachelor of Nursing -

Capella University

Similar Profiles

CREATE PROFILE