Summary
Overview
Work History
Education
Skills
Provider Educator
Timeline
Generic

Tonya McAuliffe-Giunta

Ventura,CA

Summary

I work in the healthcare information management department at Ventura County Medical Center and also assist with resident education at AFMC.

I have more than 25 years of experience in the healthcare industry, specializing in medical coding for inpatient, outpatient, and risk adjustment for Medicare. My expertise includes extensive knowledge of coding compliance, with a particular focus on auditing documentation to ensure medical necessity.

I am actively promoting education through professional affiliations. I am currently the President of the AAPC Oxnard Chapter and an active member of AHIMA and CCO.

Overview

6
6
years of professional experience

Work History

Certified Professional Coder

Ventura County Medical Center
11.2020 - Current
  • provide physician and/or other clinical staff with appropriate billing and diagnosis codes to ensure we are meeting all coding guidelines and supporting documentation is validated according to coding guidelines.
  • Applied official coding conventions and rules from the American Medical Association and Centers for Medicare and Medicaid Services to assign diagnostic codes.
  • Monitored changes in coding regulations to provide recommendations for compliance.
  • Performed on-site coding audits to determine accuracy and compliance with coding guidelines.
  • Resourcefully used various coding books, procedure manuals, and online encoders.
  • Reviewed outpatient records and interpreted documentation to identify diagnoses and procedures.
  • Interacted with physicians and other healthcare staff to ask questions regarding patient services.

Audit Manager

Seaview IPA
01.2018 - 11.2020
  • Coordinated, managed, and implemented auditing projects and prepared for evaluation.
  • Trained and mentored department staff on policies and procedures to establish a strong foundation for client development and service activities.
  • Facilitated internal audits and prepared detailed reports on findings.
  • Recommended changes to management regarding financial operations.
  • Developed high-level knowledge of client business goals, policies, and procedures to establish a foundation for targeted problem solutions.

Education

Certified Professional Coder - Allied Healthcare

American Academy of Professional Coders
2233 S Presidents Dr. Suite F · Salt Lake City, UT

Certified Coding Specialist - Allied Healthcare

American Health Information Management Association
Chicago, IL

Certified Professional Medical Auditor (CPMA) - Medical Documentation Auditing

American Academy of Professional Coders
2233 S Presidents Dr. Suite F · Salt Lake City, UT

Certified Risk Adjustment Coder - Hierarchical Condition Categories Auditing

American Academy of Professional Coders
2233 S Presidents Dr. Suite F · Salt Lake City, UT

Skills

  • Documentation Oversight
  • Inpatient Coding
  • Medical Billing Code Accuracy
  • Compliance Requirements
  • Coding Error Resolution
  • Medical Release of Information ROI
  • Charting and Clinical Documentation
  • ICD-10 Requirements
  • Coding Appeals
  • Procedural Codes

Provider Educator

I conduct educational sessions for healthcare providers, pertaining to inpatient, outpatient, and risk adjustment coding. Additionally, I collaborate closely with providers to identify opportunities for enhancing medical documentation and adopting best practices in the field. The objective is to promote a comprehensive understanding of optimal coding and documentation practices among providers, thereby ensuring contractual agreements are adhered to and compliant with all federal and state guidelines. 

Timeline

Certified Professional Coder

Ventura County Medical Center
11.2020 - Current

Audit Manager

Seaview IPA
01.2018 - 11.2020

Certified Professional Coder - Allied Healthcare

American Academy of Professional Coders

Certified Coding Specialist - Allied Healthcare

American Health Information Management Association

Certified Professional Medical Auditor (CPMA) - Medical Documentation Auditing

American Academy of Professional Coders

Certified Risk Adjustment Coder - Hierarchical Condition Categories Auditing

American Academy of Professional Coders
Tonya McAuliffe-Giunta