Summary
Overview
Work History
Education
Skills
Certification
Timeline
Generic

Sheila Cobb CPC CRC

Gordon,GA

Summary

Hands-on professional offering a keen understanding of data confidentiality and HIPAA regulations. Highly trained Medical Coder knowledgeable in AMA and the CMS coding rules.

Overview

18
18
years of professional experience
1
1
Certification

Work History

Associate I- Certified Medical Coder

Advantasure/UST Healthproof
05.2022 - 09.2024
  • Maintained compliance with all applicable federal laws and regulations related to coding and documentation guidelines for Commercial and Medicare Risk Adjustment Payment System.
  • Performed medical record review to capture all relevant diagnosis codes included in CMS and HHS Hierarchical Condition Categories (HCC) conditions for Commercial and Medicare Risk Adjustment Payment System.
  • Focused on retrospectie coding to close HCC gaps and add HCC codes not reported.
  • Esure diagnosis are supported by the documentation and ensure adherence with ICD 10-CM Gudelines for Coding and Reporting
  • Maintained target goal of 95% for quality adn accuracy

Risk Adjustment Coder

Cotiviti
03.2022 - 05.2023
  • Reviewed medical records to identify and code diagnoses in accordance with ICD-10 guidelines.
  • Documented risk adjustment codes into electronic health record systems, ensuring accuracy of data entry.
  • Analyzed provider documentation to ensure accurate coding of diagnoses and procedures according to CMS Medicare Risk Adjustment Coding Guidelines.
  • Participated in team meetings with other coders and supervisors to discuss case studies or review difficult cases.

Risk Adjustment Coder

Change Healthcare
12.2020 - 06.2022
  • Assigned appropriate ICD 10-cm codes mapping to risk adjustment models as applicable.
  • Assigned Change Healthcare Flagged Event codes when documentation in the record is inadequate, ambiguous, or otherwise unclear for medical coding purposes.
  • Maintain quality and production standard required by company.
  • Always remained current on diagnosis coding guidelines and risk adjustment reimbursement reporting requirements.

Jail Officer

Wilkinson County Sheriff's Office
03.2007 - 03.2022
  • Ensured compliance with established security protocols and procedures.
  • Maintained order within the jail facility by monitoring inmate activities.
  • Supervised inmate movement within the jail, including transporting inmates to court hearings.
  • Conducted searches of inmates, cells, and visitors for contraband items such as weapons or drugs.
  • Inspected all incoming mail for contraband materials.
  • Monitored surveillance cameras and took action when necessary.
  • Communicated effectively with inmates, coworkers, and other law enforcement personnel.
  • Prepared written reports on activity within the jail facility.

Education

Insurance Billing And Medical Coding Specialist

Herzing University
Dearborn, MI
08-2015

Skills

  • Type 50 WPM
  • Microsoft Office Software
  • ICD 10-CM HCPCS, and CPT
  • NLP Processor
  • Healthcare claim coding
  • Anatomy and physiology understanding
  • Critical thinking abilities
  • HIPAA Compliance
  • Ethical standards
  • Medical Terminology
  • Patient Registration

Certification

  • Certified Professional Coder (CPC)
  • Certified Risk Adjustment Coder (CRC)
  • Member of American Academy of Professional Coders (AAPC)

Timeline

Associate I- Certified Medical Coder

Advantasure/UST Healthproof
05.2022 - 09.2024

Risk Adjustment Coder

Cotiviti
03.2022 - 05.2023

Risk Adjustment Coder

Change Healthcare
12.2020 - 06.2022

Jail Officer

Wilkinson County Sheriff's Office
03.2007 - 03.2022

Insurance Billing And Medical Coding Specialist

Herzing University

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Sheila Cobb CPC CRC