Tracy Peele
Fredericksburg,VA
Summary
Accomplished Certified Professional Coder (CPC) with 27 years in medical billing and revenue cycle management. Expertise in CPT, HCPCS, ICD-10-CM, and radiology coding guidelines. Conducted high-volume coding audits, identified discrepancies, and implemented coding education initiatives. Collaborated with leadership and technology teams to enhance coding accuracy and operational efficiency.
Overview
1
1
Certification
27
27
years of professional experience
Work History
Coding Quality Auditor – Radiology
OptumInsight
Fredericksburg, Virginia
2022.05 - Current
- Perform high-volume coding quality audits, reviewing a minimum of 100 charts daily to evaluate coding accuracy and compliance with established coding guidelines.
- Identified coding errors and provided applicable coding guidelines and supporting references to substantiate audit findings, enhancing overall coding accuracy.
- Analyzed audit results to pinpoint red-zone coding errors and identify opportunities for targeted coder education and training, fostering continuous improvement.
- Identified repetitive coding errors and trends and communicated findings to supervisors for follow-up.
- Review and respond to coder rebuttals, providing clarification and guidance regarding coding decisions.
- Support continuous quality improvement through accurate auditing, constructive feedback, and identification of coding education opportunities.
- Assist supervisors in maintaining and developing an issues list identifying coding concerns requiring AI software review.
- Collaborated with BUDDI AI development team to address coding issues, recommending program corrections and enhancements to improve automated coding accuracy.
- Worked remotely to support coding audits and quality control processes.
Medical Coder / Secondary Radiology Coding Support
OptumInsight
Clinton Township, Michigan
2014.01 - 2022.04
- Performed radiology coding for multiple radiology groups using CPT, modifiers, HCPCS, ICD-10-CM, and PQRS coding guidelines.
- Applied radiology coding knowledge and experience to identify coding issues and support accurate claim submission.
- Reviewed AI-assisted coding using BUDDI platform to ensure accuracy and compliance with coding standards.
- Evaluated coding results, identifying and prioritizing claims needing corrections for timely processing.
- Reviewed and submitted corrected claims to resolve discrepancies and enhance overall claim accuracy.
- Worked remotely to support coding tasks
Medical Coder – Radiology
OptumInsight
Fredericksburg, Virginia
2002.12 - 2013.12
- Conducted radiology coding for multiple groups, ensuring accurate use of CPT, modifiers, HCPCS, ICD-10-CM, and PQRS for optimal billing.
- Reviewed and assigned appropriate codes to ensure accurate billing and compliance with coding guidelines.
- Reviewed coder submissions for accuracy and completeness, facilitating smooth transition of accounts into production.
- Supported coding quality and consistency across radiology accounts, contributing to compliance with industry standards.
- Worked accession logs to ensure 100% monthly charge capture.
Customer Service and Accounts Receivable Representative
OptumInsight
Fredericksburg, Virginia
1999.08 - 2002.12
- Handled patient account calls, resolving medical billing questions and concerns to enhance patient satisfaction.
- Investigated patient account discrepancies and worked toward timely resolution of billing issues.
- Assisted in resolving outstanding accounts receivable, contributing to improved collection rates.
- Worked insurance denials to identify reimbursement issues and support revenue recovery.
- Built a strong foundation in medical billing, insurance processes, and revenue cycle operations to support effective financial management.
Education
High School Diploma -
Courtland High School
Spotsylvania, VA1986-06
Skills
- Radiology Coding and Auditing
- Coding Quality Assurance
- CPT, HCPCS, and ICD-10-CM
- Modifier Selection and Accuracy
- Coding Compliance and Guidelines
- Secondary Radiology Coding
- Audit analysis
- Error Trend Identification
- Claims review
- AI coding review
- AI Coding Solutions
- Automated Coding Tools
- Revenue Cycle Management
- EPIC
- MDIV Billing Platform
- Coding standards
Personal Information
- Title: Radiology Coding Quality Auditor | Certified Professional Coder (CPC)
- Availability: Seeking Remote Opportunities
Certification
- Certified Professional Coder (CPC)
- American Academy of Professional Coders (AAPC)
- April 2010 – Present
Timeline
Coding Quality Auditor – Radiology
OptumInsight
2022.05 - Current
Medical Coder / Secondary Radiology Coding Support
OptumInsight
2014.01 - 2022.04
Medical Coder – Radiology
OptumInsight
2002.12 - 2013.12
Customer Service and Accounts Receivable Representative
OptumInsight
1999.08 - 2002.12
High School Diploma -
Courtland High School