Vianca Woldridge
Sacramento
Summary
Experienced with comprehensive medical coding, ensuring accurate and compliant patient data management. Utilizes advanced coding systems and software to streamline processes and enhance data integrity. Track record of maintaining high coding accuracy and supporting healthcare teams with thorough documentation.
Overview
21
21
years of professional experience
Work History
Shift Supervisor
Hope Cooperative Care
09.2025 - Current
- Resolved conflicts among team members in a timely manner, promoting a cohesive and efficient working environment.
- Assisted in training new employees on policies, procedures, and best practices for their respective roles within the organization.
- Developed strong communication channels between day and night shifts, facilitating seamless handovers at the beginning and end of each shift.
- Increased productivity by effectively delegating tasks and monitoring progress throughout the night shift.
- Led team meetings of 25 employees to discuss daily objectives, enhance communication, and foster a collaborative environment.
Managed Care Specialist
UC Davis Health
07.2023 - Current
- Received over 50 inbound inquiries from external providers regarding authorization status and eligibility determinations.
- Deferred referrals to nursing staff based on established health plan criteria and guidelines.
- Utilized MCS Auth Guideline to assess authorization approvals or denials efficiently.
- Accessed health plan websites to review medical policies and benefits, ensuring compliance.
- Processed denial and carveout letters, maintaining accurate records for future references.
Clinical Liaison
Hill Physicians Medical Group
07.2010 - 05.2022
- Collaborated with healthcare providers to streamline patient care processes and improve resource allocation.
- Facilitated communication between patients and providers to ensure clarity in treatment plans and follow-up care.
- Managed patient case files to maintain accurate and up-to-date clinical documentation for regulatory compliance.
- Coordinated care transitions to enhance patient outcomes and minimize readmissions through effective discharge planning.
- Conducted data analysis to identify trends in patient care and informed decision-making for quality improvement initiatives.
Patient Care Coordinator
Hill Physicians Medical Group
07.2010 - 07.2013
- Responsible for obtaining prior authorizations from payers for inpatient and outpatient services
- Understanding of primary code classifications: ICD-10-CM, ICD-10-PCS, CPT and HCPCS
- Analyzing medical records, doctor's notes, and other patient information
- Working with physicians or other providers to clarify diagnoses or procedures for accurate coding while ensuring the security and confidentiality of patient information as mandated by HIPAA.
- Coordinated patient scheduling for multiple providers, optimizing appointment availability and reducing wait times.
Prior Authorizations Rep
Hill Physicians Medical Group
09.2004 - 07.2010
- Monitored a 500 + queue of where electronic authorizations were submitted by provider offices. Verified each authorization contained all the necessary elements e.g., DX, CPT and HCPCS to render a decision on authorization.
- Received and processed prior authorization requests, ensuring compliance with established guidelines and regulations.
- Evaluated patient eligibility for services by reviewing insurance benefits and medical necessity criteria.
- Conducted audits of authorization decisions to ensure adherence to internal policies and state regulations.
- Managed communication with external stakeholders to resolve issues related to claims and authorizations.
Education
Certificate - Certified Professional Coder
AAPC
California09-2025
Certificate - CNA
Kash Career College
Sac12.2012
Skills
- Encoder Pro
- Citrix, QNXT, NFUSE
- MS Suite, EHR, EPIC Resolute
- Healthy Planet, NXTGEN, CERNER, Health Plan Verification, Medical Terminology, Adherence to Federal and State regulations, Over 20 years in Healthcare Industry
- Problem-solving
- Team leadership
Accomplishments
Selected to participate in a competitive 12‑week Leadership Development Program focused on team management, communication, and strategic decision‑making.
Timeline
Shift Supervisor
Hope Cooperative Care
09.2025 - Current
Managed Care Specialist
UC Davis Health
07.2023 - Current
Clinical Liaison
Hill Physicians Medical Group
07.2010 - 05.2022
Patient Care Coordinator
Hill Physicians Medical Group
07.2010 - 07.2013
Prior Authorizations Rep
Hill Physicians Medical Group
09.2004 - 07.2010
Certificate - Certified Professional Coder
AAPC
Certificate - CNA
Kash Career College