Marta Thomas

• Performs compliance audits on Medicare risk adjustment encounters across various healthcare settings.
• Reconciles encounter lists to ensure accurate risk adjustment coding and submission, while also providing educational feedback to providers and coders on documentation improvement.
• Utilizes multiple coding platforms, including Coder360, SharePoint, Excel, EPIC.
• Validate reported CPT, E/M & ICD-10-CM codes to validate and ensure coding accuracy.
• Coding encounters from a variety of clinic locations and settings including outpatient, inpatient, and discharge summaries.

• Proficiently conducted risk adjustment coding and HCC coding audits, ensuring compliance with CMS regulations.
• Reviewed chart documentation to validate ICD-10-CM diagnosis coding, working closely with compliance teams to improve coding accuracy.
• High volume chart review while maintaining 95% accuracy.

• Observed the health information team apply ICD-10-CM, ICD-10-PCS, CPT, and HCPCS coding to inpatient and outpatient records.
• I contributed to compliance reviews using Protenus Auditing Software and gained firsthand experience with the 21st Century Cures Act and hospital coding regulations.
• Observations of multiple hospital divisions include Revenue cycle division meetings, EMR governance structure, the release of information, record integrity, ambulatory setting, corporate compliance, DRG mismatch, Coding quality, and compliance ROI metrics.

• Completed a practicum focused on ICD-10-CM, ICD-10-PCS, CPT, and HCPCS coding in a simulated acute care setting.
• Reviewed patient charts, assigned codes accurately, and developed understanding of healthcare reimbursement structures.

Management & Leadership Skills

• Managed daily operations remotely and developed productivity activities
• Time management and organizational efficiency in fast-paced environments
• Developed and maintained project timelines to ensure timely delivery
• Monitored project budgets and financial accountability
• Built successful partnerships and coordinated with stakeholders

Medical Coding / Auditing Relevant Skills

• Strong attention to detail and accuracy in reviewing documents and records
• Analytical data interpretation and trend analysis to inform decision-making
• Ensuring compliance with ethical standards and professional guidelines
• Coordinated data collection and resolved inconsistencies or missing information
• Continuous learning and professional development

Communication & Interpersonal Skills

• Effective client/stakeholder communication and relationship management
• Customer service skills for resolving issues and providing guidance
• Collaboration with teams and cross-functional departments