Summary
Overview
Work History
Education
Skills
Medical/Coding Software Experience
Timeline
Hi, I’m

Tara N. Roberts, COC, CASCC

Inverness,FL
Tara N. Roberts, COC, CASCC

Summary

I'm a professional with a robust background in outpatient coding, pre- and post- claim edits, medical necessity, NCCI, charge master management, post payment reviews and appeals. I'm a highly collaborative team player focused on delivering precise results, flexible with changing priorities, and consistently dependable. Prioritizes compliance and accuracy, ensuring seamless workflow and optimal outcomes.


Excellent planning and problem-solving abilities.

Proven ability to manage complex billing systems, ensure compliance, and maximize revenue recovery. Valued for team collaboration, adaptability, and achieving measurable results. Skills include claims processing, coding, payer relations, and problem-solving. Reliable and responsive to evolving needs in fast-paced environments.


I'm prepared to bring 31 years of related experience to a dynamic position with room for career growth.



Overview

31
years of professional experience

Work History

IKS Health

Regulatory Edit Specialist
03.2024 - Current

Job overview

  • Review pre and post claim submission coding and charging errors.
  • Serve as support to facility billers and collections for claim denials. +
  • Review and appeal RAC and commercial insurance denials.
  • Train newly hired staff.
  • Review under/overpayment reviews.

AQuity Solutions

Regulatory Edit Specialist
03.2023 - 03.2024

Job overview

  • Review pre and post claim submission coding and charging errors.
  • Serve as support to facility billers and collections for claim denials. +
  • Review and appeal RAC and commercial insurance denials.
  • Train newly hired staff.
  • Review under/overpayment reviews.


AQuity merged with IKS Health,

AxeaSolutions, Inc

Revenue Cycle Advisor
04.2013 - 03.2023

Job overview

  • Review the claims pre and post claim submission for coding and charging errors
  • Serve as support to facility billers and collections on claim denials
  • Review and appeal RAC and commercial insurance denials
  • Train newly hired staff
  • Review under/overpayment reviews


Axea Solutions merged with AQuity Solutions.

Monroe Regional Medical Center

APC Coordinator
06.2012 - 02.2013

Job overview

  • Provided monitoring and daily oversight of all outpatient coding areas (ED, outpatient and surgical)
  • Works with coding manager to provide training and development for new hires and current staff as needed
  • Worked with Director of HIM on all issues regarding 3M Ambulatory management System (ARMS) and to assure timely billing, reimbursement and compliance always

YES HIM

Contract coder/Auditor
09.2011 - 09.2012

Job overview

Contract Auditor for special re-bill project.

Citrus Memorial Health System

Reimbursement Specialist
10.2009 - 06.2012

Job overview

  • Company Overview: now HCA Citrus
  • Maintained the Charge Master to ensure accuracy to meet all CMS guidelines
  • Assist in developing procedures and compliance with all aspects of the revenue cycle
  • Review Outpatient RAC Audits
  • Educate staff to errors found through RAC reviews
  • Review denials for coding, charging and CDM errors
  • Administrator for MedAssets Code Correct, now called FinThrive
  • Now HCA Citrus

Citrus Memorial Health System

Medical Records Clerk
09.2001 - 06.2012

Job overview

  • Company Overview: now HCA Citrus
  • Chart assembly, deficiency and analysis
  • Now HCA Citrus

Citrus Memorial Health System

Transcription Clerk Processor
04.2001 - 06.2012

Job overview

  • Company Overview: now HCA Citrus
  • Process and chart all dictation reports
  • Assign jobs to transcriptionist, assist physicians and staff will all questions and concerns related to dictation
  • Now HCA Citrus

Gatehouse Consulting

Claim edit reviewer
11.2010 - 05.2012

Job overview

  • Review pre and post claim submission coding and charging errors.
  • Serve as support to facility billers and collections for claim denials. +
  • Review and appeal RAC and commercial insurance denials.
  • Train newly hired staff.
  • Review under/overpayment reviews.


Citrus Memorial Health System

Medicare Records Coder II
07.2009 - 10.2009

Job overview

  • Company Overview: now HCA Citrus
  • Appropriately select and assigned diagnosis and procedure codes to patient records for the purpose of billing and statistical tracking
  • Participated in departmental and organizational performance improvement activities
  • Maintained relevant and up to date knowledge of Coding and CMS guidelines
  • Maintained department productivity standards
  • Now HCA Citrus

Citrus Memorial Health System

MR Coding Compliance Coordinator
07.2003 - 07.2009

Job overview

  • Company Overview: now HCA Citrus
  • Review physician diagnosis, documentation, medical necessity, NCCI compliance edits
  • Effectively communicated, coordinated and facilitated timely and accurate responses to all coding compliance inquiries
  • Assisted in internal quality reviews of coded data as well as assist in training coding staff
  • Worked collaboratively with external departments to ensure the understanding of CMS guidelines
  • Now HCA Citrus

Citrus Memorial Health System

Medicare Records OP Coder
08.2002 - 07.2003

Job overview

  • Company Overview: now HCA Citrus
  • Coded ICD-9-CM diagnosis and applicable HCPCS/CPT procedure documented on outpatient encounters
  • Performed duties according to established policies and procedures, protocols and professional standards
  • Now HCA Citrus

Education

CFCC Community College
Ocala

CFCC Community College from Health Information Management
01.2005

University Overview

Education

Central Florida College

The Language of Medicine – Basic Medical Terminology

December 2002

Freshman Comp Math

December 2003

Basic Anatomy and Physiology

December 2003

Concepts of Disease

December 2005

American Health Information Management Association

Using HCPCS/CPT

Using ICD-9-CM

Emergency Room Coding In Hospitals

Injections and Infusions using CPT codes

Reimbursement Overview

Digestive System Ambulatory CPT Coding

Cardiology Procedure Coding

February 2008-September 2009

American Academy of Professional Coders

AAPC CPC-H/COC Certification July 2009

AAPC CASCC Certification 2023

Skills

  • Ability to think and work independently
  • Prioritizing and organizing work
  • Ability to handle multiple tasks
  • Superior decision-making
  • Conflict resolution
  • Critical thinking skills
  • Ability to interact effectively
  • Excellent detail
  • Analytical skills
  • Problem-solving skills
  • Ability to quickly adjust to changing workflows
  • ICD-10-CM and CPT Coding
  • Coding/Claim edits for Medical Necessity and NCCI Edits
  • Denials management and resolution
  • Proficient in [software]

Medical/Coding Software Experience

Medical/Coding Software Experience

3M

TruCode

McKesson Star

Med Assets, Code Correct, FinThrive

Epremis

McKesson Paragon

Meditech

Cerner

Epic

Health Quest

Omega

Availity

eSerives

Timeline

Regulatory Edit Specialist
IKS Health
03.2024 - Current
Regulatory Edit Specialist
AQuity Solutions
03.2023 - 03.2024
Revenue Cycle Advisor
AxeaSolutions, Inc
04.2013 - 03.2023
APC Coordinator
Monroe Regional Medical Center
06.2012 - 02.2013
Contract coder/Auditor
YES HIM
09.2011 - 09.2012
Claim edit reviewer
Gatehouse Consulting
11.2010 - 05.2012
Reimbursement Specialist
Citrus Memorial Health System
10.2009 - 06.2012
Medicare Records Coder II
Citrus Memorial Health System
07.2009 - 10.2009
MR Coding Compliance Coordinator
Citrus Memorial Health System
07.2003 - 07.2009
Medicare Records OP Coder
Citrus Memorial Health System
08.2002 - 07.2003
Medical Records Clerk
Citrus Memorial Health System
09.2001 - 06.2012
Transcription Clerk Processor
Citrus Memorial Health System
04.2001 - 06.2012
CFCC Community College
CFCC Community College from Health Information Management
Tara N. Roberts, COC, CASCC