RALENA WILBON
Waddell,AZ
Summary
Detail-oriented coding expert with extensive knowledge of medical coding standards and procedures, delivering precise code assignments that enhance billing and reimbursement processes. Recognized for exceptional teamwork and adaptability in dynamic environments, fostering collaboration and efficiency. Strong analytical capabilities and effective communication skills facilitate seamless interactions with healthcare professionals and stakeholders. Committed to maintaining the highest standards of accuracy and compliance in all coding practices.
Overview
12
12
years of professional experience
1
1
Certification
Work History
Medical Billing and Coding Instructor
Arizona College
Glendale, AZ
01.2026 - Current
- Developed and maintained structured medical billing and coding curriculum, lesson plans, and assessments for 100+ students annually, supporting successful course completion and certification preparation.
- Delivered engaging virtual and classroom lectures to cohorts of 10-15 students per session, simplifying complex coding concepts and improving student comprehension.
- Designed and implemented engaging instructional strategies aimed at improving student retention.
- Evaluated student progress through assessments, providing constructive feedback for improvement.
- Mentored and supported 100+ aspiring medical coders and billers, fostering academic success, career readiness, and professional development through ongoing coaching and guidance.
Profee Coder/Auditor
Favored Medical Billing
Remote
04.2021 - Current
- Applied AMA and CMS coding conventions to assign accurate diagnostic codes for Dermatology, Podiatry, Trauma, and Orthopedic claims, contributing to a 15% reduction in coding-related denials.
- Assigned appropriate E/M codes based on the level of service, maintaining a 96%+ accuracy rate across CPT, ICD-10-CM, and HCPCS guidelines.
- Ensured coding accuracy and documentation compliance for all E/M levels, helping improve provider documentation completeness by approximately 20%.
- Audited behavioral health, dermatology, podiatry, trauma, and orthopedic coding cases to identify documentation gaps, validate CPT/ICD-10 accuracy, ensure compliance with payer guidelines, and provide actionable feedback to improve coding quality and revenue integrity.
- Accurately code multi-specialty surgical cases for dermatology, trauma, orthopedics, and podiatry with a 96% coding accuracy rate, using CPT, ICD-10-CM, and HCPCS guidelines to support correct reimbursement and reduce denials.
- Review and interpret complex operative reports, ensure documentation compliance, and collaborate with providers to maintain coding accuracy and streamline the surgical billing workflow.
Profee Coder
Nuvance Health
Remote
03.2023 - 06.2024
- Attained perfect 100% accuracy on quarterly coding audits through precise execution of ICD-10 CM and CPT coding for primary care offices, palliative care, vascular labs and EKG's.
- Processed 75-100 claims per day with consistent accuracy, contributing to a 20% reduction in billing lag and improved reimbursement turnaround.
- Exceeded organizational expectations for customer service and teamwork, reflected in a 95%+ satisfaction rating from internal stakeholders and providers.
Profee Coder
Regency Specialties
Surprise, AZ
05.2020 - 03.2023
- Accurately code specialty surgical cases for trauma, using CPT, ICD-10-CM, and HCPCS guidelines to support correct reimbursement and reduce denials.
- Consistently went extra mile in supporting coworkers, offering extensive assistance and guidance with their medical coding inquiries.
- Utilized understanding of 2020-2024 coding guidelines, ICD-10 and CPT codes to meticulously rectify denied claims, leading to significant increase in successful reimbursement rates.
- Review and interpret complex operative reports, ensure documentation compliance, and collaborate with providers to maintain coding accuracy and streamline the surgical billing workflow.
- Quarterly auditing of Dermatology and Trauma charts to ensure coding compliance and insurance guidelines were met.
- Charge entry and validation for professional Dermatology, Reconstructive and Trauma services.
Profee Coder/Auditor
Arizona Asthma And Allergy
Remote
10.2019 - 06.2021
- Applied AMA and CMS coding conventions to assign accurate diagnostic codes across diverse clinical encounters, contributing to a 15% reduction in coding-related errors.
- Assigned appropriate E/M codes based on services rendered, maintaining a 96%+ accuracy rate in alignment with CPT, ICD-10-CM, and HCPCS guidelines.
- Ensured documentation compliance for all E/M levels, helping reduce payer denials by approximately 20% through improved clarity and coding precision.
- Hired for special project to audit charts for United Healthcare red flag audit.
- Developed a structured audit tool to educate providers on E/M documentation requirements, improving provider documentation accuracy by 25%.
- Successfully assisted providers in achieving full removal from the UnitedHealthcare red-flag audit list, reducing oversight risk and strengthening payer compliance.
Home Health Coder
Select Data Home Care
Remote
12.2019 - 07.2020
- Collaborates with clinical supervisor and field staff to ensure comprehensive and accurate coding of 485's.
- Diligently inspects medical records to verify accuracy and completeness, meeting criteria stipulated by insurance companies.
- Consistently achieved coding of minimum of 300 charts per month or daily number of admissions, ensuring accurate and efficient medical coding.
- Meticulously followed coding updates, ensuring prompt access to most recent information.
- Attained 95% accuracy on monthly coding audits through precise execution of ICD-10 CM and CPT coding.
Medical Billing and Coder Instructor
UEI Enterprises
Phoenix, AZ
04.2019 - 11.2019
- Enhanced student comprehension by incorporating real-life examples and case studies in lessons.
- Collaborated with colleagues to develop an updated curriculum for Medical Billing, Insurance, and Coding courses.
- Evaluated student progress regularly through assignments, quizzes, and exams to ensure optimal learning outcomes.
- Increased class participation by fostering a positive and inclusive learning environment for diverse learners.
- Mentored students during office hours, providing guidance on coursework and career development in the healthcare industry.
- Implemented interactive teaching methods such as group projects and role-plays to improve student engagement with course material.
- Developed comprehensive lesson plans that incorporated hands-on activities to reinforce key concepts in Medical Billing, Insurance, and Coding.
Home Health Coder
Team Select Home Care
Phoenix, AZ
08.2015 - 01.2020
- Collaborates with clinical supervisor and field staff to ensure comprehensive and accurate coding of 485's.
- Diligently inspects medical records to verify accuracy and completeness, meeting criteria stipulated by insurance companies.
- Consistently achieved coding of minimum of 300 charts per month or daily number of admissions, ensuring accurate and efficient medical coding.
- Vigilantly tracked coding updates to ensure immediate access to latest information.
- Attained 96% accuracy on monthly coding audits through precise execution of ICD-10 CM and CPT coding.
Medical Billing and Coding Instructor
Carrington College
Phoenix
07.2014 - 02.2016
- Increased student motivation and engagement by 30%, measured through improved attendance and participation, by developing dynamic lesson plans tailored to multiple learning styles.
- Enhanced student comprehension by incorporating real-life examples and case studies in lessons.
- Collaborated with colleagues to develop an updated curriculum for Medical Billing, Insurance, and Coding courses.
- Organized guest speaker events featuring experienced professionals from the industry to provide valuable insights into real-world applications of course content.
- Developed comprehensive lesson plans that incorporated hands-on activities to reinforce key concepts in Medical Billing, Insurance, and Coding.
- Increased class participation by 35% by cultivating a positive, inclusive learning environment that encouraged interaction from diverse learners.
Education
Diploma - Medical Billing And Coding
Brookline
Phoenix, AZ11.2010
Bachelor's - Business Management
University of Phoenix
Phoenix, Az07.2005
Skills
- Healthcare Documentation Review
- Revenue Cycle Management
- Auditing and Quality Assurance
- Claim Denial Management
- Strategic Thinking and Planning
- Data Analysis and Interpretation
- Cross Functional Collaboration
- Insurance Verification
Certification
- CRC - Certified Risk Adjustment Coder
- CPC - Certified Professional Coder
- CPC-I - AAPC Approved Instructor
- HCS-D Certified Home Health Coder
Timeline
Medical Billing and Coding Instructor
Arizona College
01.2026 - Current
Profee Coder
Nuvance Health
03.2023 - 06.2024
Profee Coder/Auditor
Favored Medical Billing
04.2021 - Current
Profee Coder
Regency Specialties
05.2020 - 03.2023
Home Health Coder
Select Data Home Care
12.2019 - 07.2020
Profee Coder/Auditor
Arizona Asthma And Allergy
10.2019 - 06.2021
Medical Billing and Coder Instructor
UEI Enterprises
04.2019 - 11.2019
Home Health Coder
Team Select Home Care
08.2015 - 01.2020
Medical Billing and Coding Instructor
Carrington College
07.2014 - 02.2016
Diploma - Medical Billing And Coding
Brookline
Bachelor's - Business Management
University of Phoenix