I have over 27 years of extensive experience in the insurance industry, medical claim coding, consulting and medical claim auditing. In my current position as Senior Auditor & Analytics Coordination, my primary responsibility is to provide coding and logic for BMI’s proprietary editing system. This requires ongoing research into payment policy sources, including, but not limited to, CMS, AMA, and specialty academies to provide BMI with the necessary information to establish edit policies that are date sensitive.Prior responsibilities included Director of Analytics, Procedure Analyst, Group Claim Consultant, Operations Consultant, Business Analyst, Claim Manager, Trainer and Senior Auditor Manager for several Third Party Administrators and Audit Firms. I specialize in medical claim coding and processing, the performance of claim audits and operational reviews for employers. I have accreditation with HIAA, LOMA (with a specialization in life and health insurance claims.) Before joining BMI, I served as Director of Analytics for ClaimReturn, LLC and Senior Audit Manager, at Healthcare Data Management (acquired by Thompson Reuters; now known as Truven Health), where my responsibilities included providing all coding (CPT/HCPCS, ICD-9, etc.) for editing logic, the performance of pre-implementation audits, targeted/focused and random medical/eligibility, excess loss audits for self funded employers, subsequent planning for recovery efforts and the identification and implementation of system and process improvement opportunities for clients and Third Party Administrators (TPAs) alike; resulting in minimization of future errors.