Ontario, California, United States
Detail-oriented Medical Coding Auditor with expertise in auditing and validating ICD-10-CM, CPT, and HCPCS coding to ensure accuracy, compliance, and optimal reimbursement. Experienced in reviewing clinical documentation, identifying coding discrepancies, and maintaining compliance with CMS, Medicare, Medicaid, commercial payer, and HIPAA guidelines. Skilled in coding quality assurance, claims validation, revenue cycle management, denial prevention, and clinical documentation review. Known for strong analytical skills, attention to detail, and the ability to manage high-volume workloads while consistently meeting productivity and quality standards. I am committed to continuous professional development and enjoy collaborating with healthcare providers and coding teams to improve documentation quality, coding accuracy, and organizational performance.
-Perform detailed audits of inpatient medical records to ensure accuracy, completeness, and compliance with ICD-10-CM/PCS and official coding guidelines. -Review clinical documentation to validate principal and secondary diagnoses, procedures, and severity of illness. -Identify documentation gaps and generate physician queries to improve clarity and support accurate code assignment. -Utilize Epic and Meditech EHR systems to analyze physician notes, operative reports, discharge summaries, and diagnostic results. -Support quality initiatives by improving documentation that impacts DRGs, risk adjustment, and quality performance metrics. -Collaborate with providers, CDI teams, and coding leadership to ensure alignment with regulatory and reimbursement standards.
Family Practice
Pediatric Care
Emergency Department