Summary
Overview
Work History
Education
Skills
Certification
Licenses And Memberships
Timeline
Generic

Sandra Young CPC CRC CPC-I

Ormond Beach,FL

Summary

Motivated and self-starting professional with a collaborative approach to teamwork. Proven track record of taking initiative and driving results in fast-paced environments. Strong work ethic and ability to adapt quickly to new challenges. Seeking opportunities to leverage skills and contribute to a dynamic team.

Overview

15
15
years of professional experience
1
1
Certification

Work History

MRA IPA Coder

Conviva Care Solutions
Remote Daytona Beach Fl , FL
10.2023 - 01.2024
  • Reviewed clinical data from medical records to assign ICD, CPT, and HCPCS codes.
  • Applied coding rules established by American Medical Association and Centers for Medicare and Medicaid Services for assignment of procedural codes.
  • Conducted code reviews to ensure adherence to coding standards and best practices.

MRA Education Manager

Conviva Care Solutions
10.2018 - 10.2023
  • Maintain and develop educational materials for all providers and coders within the organization.
  • Supervise a remote team of educators in multiple states within Humana's PCO Organization who conduct both in person and virtual education sessions.
  • Collaborate with MRA leadership for educational opportunities, review data to compile education sessions.
  • Conduct Provider and Coding team educations as assigned.

MRA Educator

Conviva
06.2017 - 10.2018
  • Conducted MRA education for multiple Conviva markets for both wholly owned and independent centers in all markets.
  • Compiled education materials and strategy for education on Risk Adjustment and disease specific conditions.

MRA Coding Supervisor

Conviva
06.2015 - 06.2017
  • Lead for coding team in the Daytona IPA market- conducting MRA reviews.

MRA Coder

Humana MSO Transcend
01.2015 - 06.2015
  • Conducts on site and remote MRA reviews for providers, provides coding and documentation education to providers and staff.

UHC Remote HCC Coder

Optum Insight
09.2014 - 01.2015
  • Conducting MRA reviews for inpatient and outpatient vendors.

Process Manager Provider Data validation

Humana Insurance Company
12.2008 - 09.2014
  • Team conducts periodic chart reviews for HCC verification and education to physicians and staff.
  • Supervise team of 12 coders in the daily operations.
  • Member of Humana's Medical Record Review Subcommittee.
  • Proficient in HCC coding and physician education efforts.

Education

HS Diploma -

McArthur High School
Hollywood, Fl

Practical Nursing Diploma -

Sheridan Voc /Tech
Hollywood, Fl

Professional Coding -

Doctors Management Corp
Gainesville, Fl

Skills

  • Experienced and skilled in CPT and ICD-10 Coding
  • Ability to use Microsoft Word, Excel, 3M software, Encoder Pro, Scio, Trinity and ECW EMR systems
  • Self-starter, highly motivated professional with a team player attitude
  • Educational material development
  • Provider training
  • Clinical documentation

Certification

  • Practical Nursing-LPN, Inactive
  • Professional Coding Certification, CPC
  • Professional Coding Certification, CRC
  • Professional Coding Certification, CPC-I
  • AHIMA Approved ICD-10 Trainer

Licenses And Memberships

  • LPN, Florida, Inactive
  • Certified Professional Coder, CPC, Current
  • Certified Risk Coder, CRC, Current
  • Certified Coding Instructor, CPC-I, Current
  • AHIMA approved ICD-10 Trainer
  • Proficiency Coding Certification, Otolaryngology, 2003-2004
  • Member American Academy of Professional Coders, Current

Timeline

MRA IPA Coder

Conviva Care Solutions
10.2023 - 01.2024

MRA Education Manager

Conviva Care Solutions
10.2018 - 10.2023

MRA Educator

Conviva
06.2017 - 10.2018

MRA Coding Supervisor

Conviva
06.2015 - 06.2017

MRA Coder

Humana MSO Transcend
01.2015 - 06.2015

UHC Remote HCC Coder

Optum Insight
09.2014 - 01.2015

Process Manager Provider Data validation

Humana Insurance Company
12.2008 - 09.2014

HS Diploma -

McArthur High School

Practical Nursing Diploma -

Sheridan Voc /Tech

Professional Coding -

Doctors Management Corp
Sandra Young CPC CRC CPC-I
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