Sonali Bhor - CPC
Suwanee,GA
Summary
Certified Professional Coder with practical experience in HCC Risk Adjustment coding within Optum’s Medicare Advantage environment. Skilled in ICD-10-CM diagnosis. Current President at AAPC Cumming Local Chapter - 2026 and served as Education Officer for the AAPC Cumming Chapter in 2025.
Overview
2026
2026
years of professional experience
1
1
Certification
Work History
HCC Risk Adjustment Coder
Optum / United Health Group
04.2024 - 02.2026
- Performed ICD-10-CM diagnosis coding for Medicare Advantage charts as part of Optum’s risk adjustment workflow. Captured HCC conditions in alignment with CMS-HCC guidelines and Optum coding standards.
- Validated MEAT criteria to ensure chronic conditions were fully supported in provider documentation.
- Reviewed provider notes for accuracy, completeness, and proper linkage of chronic conditions.
- Verified that chronic conditions were active, monitored, evaluated, or treated to support accurate RAF scoring.
- Followed Optum’s internal coding policies, productivity expectations, and compliance requirements.
- Used Optum internal tools to retrieve charts, review documentation, and submit coded encounters.
- Worked with QA reviewers, applied audit feedback, and maintained accuracy benchmarks.
Intern
CCO.us
01.2025 - 05.2025
- Edit coding education materials for accuracy and clarity.
- Research ICD-10-CM, CPT, and compliance topics to support curriculum development.
- Create CEU quizzes, answer keys, and rationales for instructor presentations.
- Support student engagement through discussion prompts and Q&A.
Medical Coding Apprenticeship
AAPC Practicode
- Completed 600+ real-world cases across cardiology, orthopedics, general surgery, and primary care.
- Demonstrated proficiency in ICD-10-CM, CPT, HCPCS, documentation guidelines, and compliance.
Skills
- ICD-10-CM diagnosis
- HCC Risk Adjustment coding
- Teamwork and collaboration
Certification
- Certified Professional Coder (CPC) – AAPC
- Preparing for Certified Risk Adjustment Coder (CRC)
- Pune University - Bachelors degree in Commerce (B.Com)
Timeline
Intern
CCO.us
01.2025 - 05.2025
HCC Risk Adjustment Coder
Optum / United Health Group
04.2024 - 02.2026
Medical Coding Apprenticeship
AAPC Practicode
Additional Roles
- Functional Tester - uTest 2016 - 2024
- Stay at Home parent - 2012 - 2016
- Preschool Teacher – VIBGYOR Schools (2011)
- Software Tester – Patni Computers (2008–2010)
- QA Tester – Tech Mahindra (2005–2007)
- Stay-at-Home Parent (2012–2016)
References
Reference available on request