Sara Milam
Titusville,FL
Summary
A high performing and dynamic provider educator, HCC Coder/auditor with vast experience in Risk Adjustment and Valued Base Care. Possesses expertise in leading coders, providers and medical staff achieve overall better health outcomes. Possesses expertise documentation standards and guidelines, review medical records for physician documentation integrity and improvement, educate and give feedback for providers and coders to achieve correct documentation, reporting the highest specificity of a patient's diagnosis and reporting the most accurate and complete patient assessment and achieving the correct RAF scores. Leading providers and provider practices to overall better workflows, leading to the best patient outcomes.
Overview
19
19
years of professional experience
1
1
Certification
Work History
Clinical Documentation Integrity Coding Auditor
Honest Medical Group
Nashville , TN
01.2022 - Current
- Successfully perform coding quality reviews to validate correct coding of both internal coders and JV partners.
- Implemented Quality Review and education program to ensure coders are meeting industry standards.
- Developed coders' private session to provide feedback on audit results and provide 1:1 education session to support coders, allowing them to reach the industry standard of 95%.
- Provide feedback to company leadership on audit results and improvements within the internal coding team.
- Developed and supported coders with production standards.
- Developed training programs and conducted education sessions to promote proper documentation practices.
- Organized monthly roundtables and quarterly lunch and learns to provide coders with support and an open floor for coding questions.
- Analyzed medical records and identified document deficiencies
- Served as coding consultant and educator to primary care providers and internal coding team
- Collaborated with healthcare providers to improve documentation quality and coding specificity
Risk Adjustment Auditor/Quality CHA Auditor
Health First Health Plans
Rockledge , FL
09.2018 - 07.2022
- Responsible for audit and feedback to Health First Medical Group about yearly CHA visits and medical records for Health First and Advent Health independent providers.
- Further duties included resourcefully using various coding books, procedure manuals, and online encoders.
- Analyzed data from multiple sources including laboratory, radiology and pathology reports.
- Identified discrepancies in documentation with providers and resolved inconsistencies in a timely manner.
- Developed and implemented policies and procedures related to clinical documentation improvement initiatives.
- Maintained current knowledge of ICD-10 coding requirements, CPT and HCPCS coding systems, DRG assignment criteria and CMS regulations.
- Compiled data from various sources such as EMRs, physician notes and other documents into a single source document.
- Performed periodic audits of medical coders both internal and vendors to verify accuracy of coded diagnoses and procedures.
Patient Care Specialist Team Lead
Health First Medical Group
Rockledge , FL
03.2016 - 09.2018
- Maintained accurate patient records in the Electronic Health Records system.
- Collaborated with physicians and other healthcare professionals regarding patient care plans.
- Assisted in scheduling appointments for diagnostic testing or specialist referrals.
- Conducted performance appraisals for team members, providing feedback and identifying areas of improvement.
- Trained new staff in relevant processes and procedures.
- Resolved escalated customer complaints or queries promptly and efficiently.
- Ensured compliance with company policies and procedures throughout the team.
- Monitored team performance against targets, taking corrective action where necessary.
Supervisor Medicare Risk Adjustment Department
Royal Oak Medical Center
Titusville , FL
01.2006 - 03.2006
- Reviewed and analyzing UHC and WellCare Medicare patients.
- Developed in the improvement of UHC and WellCare Medicare Advantage panels by developing an effective training program, regarding correct coding and documentation guidelines.
- Developed and implemented operational policies and procedures to ensure efficiency and accuracy of workflows.
- Provided guidance and direction to subordinates regarding job duties and responsibilities.
- Created new strategies for improving customer service standards within the organization.
- Monitored employee productivity to provide constructive feedback and coaching.
Education
Medical Assisting
Brevard Community College
Palm Bay, FL12-1998
Skills
- Clinical Documentation
- Auditing
- Compliance
- Valued Based Care
- HCC Coding
- ICD-10
- Analytical Skills
- Problem Solving
- Attention to Detail
- Process evaluations
Certification
- Certified Professional Coder (AAPC)
- Certified Risk Adjustment Coder (AAPC)
- Completed CDEO course (AACP) sitting for exam 11/2024
- ACDIS Outpatient CDI Apprenticeship (ACDIS) Eligible to sit for exam 4/2025
References
References available upon request.
Timeline
Clinical Documentation Integrity Coding Auditor
Honest Medical Group
01.2022 - Current
Risk Adjustment Auditor/Quality CHA Auditor
Health First Health Plans
09.2018 - 07.2022
Patient Care Specialist Team Lead
Health First Medical Group
03.2016 - 09.2018
Supervisor Medicare Risk Adjustment Department
Royal Oak Medical Center
01.2006 - 03.2006
- Certified Professional Coder (AAPC)
- Certified Risk Adjustment Coder (AAPC)
- Completed CDEO course (AACP) sitting for exam 11/2024
- ACDIS Outpatient CDI Apprenticeship (ACDIS) Eligible to sit for exam 4/2025
Medical Assisting
Brevard Community College
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