As the Provider Audit Program Manager, I lead the development and management of compliance audits to prevent and detect medical coding risk specifically related to provider documentation and coding for our organization. I maintain current knowledge of compliance requirements and monitor risks as well as mitigate and develop strategies to ensure compliance. This includes tracking trends and reporting key findings to identify risk areas with key stakeholders and external entities as well as create and execute provider coding & documentation education on 1:1 or rounds basis. As part of my role, I regularly communicate throughout the organization on a wide-range of topics from provider audits to working cross-functionally with different teams on implementing new medical services. In addition, I manage the Provider Audit team including but not limited to monitoring day to day activities and performance as well as training, mentoring and handling of issues or questions.

Monitor claims processing and payor revenue collections for five Health System Partnership districts through strong knowledge of the intricacies of insurance claim denials, payment tracking, and generating reports to identify district specific problems. I have completed schooling and acquired certification in medical coding to assist in ensuring accuracy in provider coding for stronger and more efficient healthcare revenue stream from payors and coding compliance.

Managed all medical and office supply ordering, expiration deadlines, monthly usage tracking, and acted as liaison between my office, providers, and Inventory Central Support. Trained in Envi Materials Management Information System and Microsoft Excel to reconcile and book keep inventory count and receipts

Helped coordinate the healthcare of 60+ patients per day including prior authorizations for medications and diagnostic testing, specialists referrals, medical records, customer service resolutions, and insurance billing. Acted as a liaison between my district and corporate billing department and acquired special medical billing training. Appointed Classroom Training Admin to lead classroom presentations and oversee areas of development for new hires for our company.