Shanda Lerner

• Conducted detailed audits of outpatient and pro fee medical records, ensuring accuracy and compliance with coding guidelines.
• Collaborated with providers, coders, and compliance teams to clarify documentation and coding issues, enhancing overall coding accuracy.
• Identifying coding errors, trends, discrepancies and providing feedback and education to providers, clinical and coding staff to promote continuous improvement.
• Participated in internal compliance audits and assisted in developing and implementing quality assurance programs to strengthen compliance efforts.
• Supporting training initiatives by delivering targeted education sessions and coding updates to staff and providers.

• Performed detailed audits of 200+ outpatient and professional fee medical records monthly, ensuring 98% accuracy and compliance with coding guidelines
• Collaborated with 15+ providers, coders, and compliance teams to resolve documentation and coding discrepancies, reducing claim denials by 25%
• Identified coding error trends and provided targeted feedback to 20+ clinical and coding staff members, improving overall coding accuracy by 15%
• Participated in quarterly internal compliance audits and assisted in developing quality assurance programs that reduced audit findings by 30%
• Delivered targeted education sessions on coding updates to 50+ staff members and providers, ensuring compliance with current regulations

• Analyzed medical coding for alignment with industry regulations, enhancing compliance standards.
• Collaborated with healthcare providers to clarify documentation and coding processes, improving accuracy.
• Reviewed patient records for accurate code assignments, ensuring adherence to coding standards.

• Enrolled 100+ participants monthly into Personal Preference Program, exceeding enrollment targets by 15%
• Managed budget allocation for 200+ client accounts, ensuring 100% compliance with program guidelines
• Generated weekly trend reports identifying enrollment patterns and processed follow-up documentation with 98% accuracy
• Reviewed and processed 500+ enrollment documents monthly, achieving 95% approval rate for submitted applications

• Processed enrollment applications for 500+ clients seeking support services monthly, ensuring timely access to necessary resources.
• Guided clients through eligibility requirements and documentation submission to facilitate successful enrollment.
• Coordinated communication between clients and service providers, enhancing the enrollment experience and ensuring clarity in the process.

• Communicated with internal personnel, payers, providers, and patients regarding accounts receivable management for 500+ accounts monthly
• Conducted quarterly meetings with 10+ providers to review audit results and established quality improvement goals, increasing collection rates by 20%

• Processed medical claims using advanced billing software, ensuring accuracy and compliance with regulations.
• Verified patient insurance information, confirming coverage and eligibility to facilitate timely billing.
• Communicate with healthcare providers to resolve billing discrepancies promptly.

• Completed six-week course to obtain certification in Epic for medical billing within Epic EHR system.
• Identified trends in carrier payments and denials, documenting resolutions to enhance claim processing.
• Ensured submission of clean claims and accurate payment postings, contributing to revenue optimization.
• Facilitated professional communication with providers and payers, enabling timely and accurate claim filing.