Paulette Hileman

I have been an LPN for over 39 years, worked in various areas of nursing including geriatrics, rehab and vent support. Worked in Social Services for 2 years in Long Term Care facility. Home Health Authorization Manager for 2 years and currently as an Analyst, Coding Data Quality Auditor for last 14 years at CVS Health. (Formerly known as Health America/Coventry HealthCare/Aetna Insurance). I have been instrumental in developing the HCC department, starting at its' infancy in this company. Involved in all Vendor audits, RADV audits from CMS, internal processes and policies and assisting Managers and Directors when needed. My clinical background is a great asset to this position, and I have performed educational sessions with providers to improve their documentation skills. My goal is to continue to grow and learn in the clinical and financial aspects of my work. I am a member of AAPC and have a current LPN license, CPC and CPC. Continuing Education (CEU's) are up to date Seasoned compliance professional well-versed in policy development, training management and reporting. Well-organized and systematic with excellent communication and planning abilities. Looking for challenging position in fast-paced environment. Qualified HCC Auditor with 14 years of experience in Risk, HCC coding, Compliance, ICD-10 guidelines. Highly skilled in Medicare compliance regulations with training in investigation and auditing requirements. Skilled at keeping detailed records. Fantastic critical thinker with great memory and efficiently organize vast amounts of data. Great at performing internal audits, conducting investigative reporting and transcribing information. Skilled at program based software data entry. Solutions-oriented with commitment to long-term accuracy and efficiency. Enthusiastic leader, eager to contribute to team success through hard work, attention to detail and excellent organizational skills. Clear understanding of Medicare HCC process and training in RADV audits from CMS. Motivated to learn, grow and excel in the Medicare compliance industry. Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals. To seek and maintain full-time position that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills.

• LICENSES, CERTIFICATIONS AND PROFESSIONAL MEMBERSHIPS , Nursing/Licensed Practical Nurse (LPN). Date Issued: 08/1983 Information Technology/Certified Professional Coder (CPC). Date Issued: 03/31/2013 Risk Management/Certified in Risk Adjustment (CRC) Date Issued: 03/30/2015

• CPC - Certified Professional Coder
• CRC - Certified Risk Adjustment Coder