Lasbat A. P. Adeniji-Nelson Adeniji-Nelson, MBA, CPC, CPMA, CRC

● Researching and analyzing the medical records ● Validating and reporting the findings ● Audit Medical records to ensure compliance with the organization's coding procedures and standards according to the CMS Coding Guidelines and Official ICD 10 Coding guidelines ● Reviews insurance payments and denials and recommends coding corrections ● Providing training to Physicians and appropriate staff support on correct coding guidelines ● Reviewing scheduled member medical records for open HCC/CDPS gaps and other coding opportunities ● Building dashboards in Tableau ● Data Cleaning and Visualization ● Utilized Allscripts, Athenahealth, Epic, and Practice Fusion for medical record review and analysis

● Perform compliance audits for designated Providers with established audit protocol ● Provide education to the Providers to ensure proper completion of EHR and proper assignment of ICD-10, HCPCs, and CPT codes ● Participates in Provider’s meetings, which may include Provider education through written communications ● Assist in providing coding training to new Physicians ● Maintain accurate productivity logs and provide this information to Management in a timely fashion ● Work with cutting-edge technology, including Epic and Cerner EMR systems, complex abstracting programs, and Optum Encoder ● Maintain strict Patient and Provider confidentiality in compliance with all Federal, State, and Hospital laws and guidelines for release of information

• Reviewed submitted medical records to identify diagnosis • Coded all diagnoses and services accurately and completely, from the medical record following ICD-9, CPT, and HCPCs.

● Utilized Soft Ally and Epic to ensure accurate and efficient charge capture, reducing errors and denials. Prepared and attached required claims documentation, including referrals and treatment plans, to support accurate billing and reimbursement ● Collected and recorded required insurance information ● Processed EOBs and denials ● Communicated with the Patient on payment status ● Pursuing third-party Payers for complete Payments ● Utilized Word, Excel, and Outlook as appropriate to aid in the completion of daily tasks ● Assigned additional diagnosis codes based on specific clinical findings in support of existing diagnoses ● Acted as a liaison between the business department, billers, and third-party payers in resolving billing and reimbursement accuracy ● Utilized Soft Ally and Epic for Claims Management (Epic’s Claim Builder and Scrubber) and Payment Posting and Reconciliation (Payment Poster and Remittance Manager functions) ● Prepared and attached all required claims documentation including referrals, treatment plans, or other required correspondence to reduce the incidence of denials ● Streamlined charge capture processes by assigning additional diagnosis codes based on clinical findings, supporting existing diagnoses, and enhancing revenue cycle management

• Identifying, collecting, and documenting coding information for Emergency, Inpatient, and Outpatient for different kinds of specialties. • Exhibiting knowledge of ICD-9-CM and CPT coding guidelines, A&P and medical terminology. • Reviewing medical records to identify all suitable coding based on CMS HCC categories. • Computer proficiency in a Windows environment, including MS Word and Excel • Able to achieve and maintain an accuracy standard of 90% or better.

Improved formulas and processes to increase efficiency. Wrote technical papers and reports. Wet Chemistry. Conducted both qualitative and quantitative analysis. Evaluated and inspected incoming raw material. Maintained up-to-date records of product technical data sheet and certificate of analysis.

Customer Service Data entry