- Acquire, clean and analyze EMR data; conduct data profiling, quality assessment and EDA to support RCM and clinical operations.
- Apply ICD‑10‑CM/PCS, ICD‑11, CPT, and HCPCS‑II across inpatient, ambulatory, and professional fee services.
- Perform HCC coding for MA/ACA/commercial payers per CMS guidance; emphasize RAF accuracy and documentation specificity.
- Oversee full‑cycle A/R: coding, claim submission, denial follow‑up and payment reconciliation across multiple clients.
- Analyze billing trends and denial patterns; build data‑driven reports and dashboards to guide appeals and process improvements.
- Collaborate with providers to streamline documentation and billing workflows; deliver staff training and payer communications.
- Technical stack: Python, SQL, R, JavaScript and Excel; automation via Google Sheets API & Apps Script; financial tracking in QuickBooks.
- Develop interactive dashboards and web assets (HTML/JS); create visualizations with Pandas, ggplot and Matplotlib.
- Platforms: Epic, M3, Athenahealth, Medisoft, Kareo.
Professional Summary
Certified Coding Specialist (CCS, AHIMA #271762) and Medical Billing & Coding Specialist with 10+ years across surgical, inpatient, ambulatory, and professional fee settings. Expert in ICD‑10‑CM/PCS, CPT, HCPCS‑II and APC methodologies; experienced in full‑cycle RCM (Epic, Athenahealth, Kareo, Medisoft) from coding through denials and reconciliation. Perform risk‑adjustment/HCC coding for Medicare Advantage, ACA, and commercial plans per CMS guidance. Technical stack: SQL, Python, R, and Excel with automation via Google Sheets API & Apps Script; visualizations with Pandas, Matplotlib, and ggplot. Biochemistry B.S. with advanced biostatistics/bioinformatics; strong support for Nuclear Medicine and imaging workflows. Johns Hopkins University certificate sequences: Data Science, Biostatistics in Public Health, and Health Informatics.
Selected Highlights
- CCS (AHIMA #271762) — accurate, compliant coding across hospital & ambulatory settings.
- Johns Hopkins University — certificate sequences in Data Science, Biostatistics in Public Health, and Health Informatics.
- HCC coding for Medicare Advantage, ACA, and commercial plans with RAF accuracy per CMS (and payer) standards.
- Full‑cycle RCM: coding → claims → denials → payment reconciliation across multiple clients.
- Platforms: Epic, M3, Athenahealth, Kareo, Medisoft; financial tracking with QuickBooks.
- Analytics & automation: SQL, Python, R, Excel · Pandas/Matplotlib/ggplot · Google Sheets API & Apps Script.
- Clinical domains: surgical, inpatient, ambulatory, professional fee; support for Nuclear Medicine & imaging.
- Languages: English · Spanish · Italian.
Risk Adjustment & Compliance
- HCC coding for MA/ACA/commercial plans; focus on RAF accuracy and documentation specificity.
- ICD‑10‑CM/PCS, CPT, and HCPCS‑II mapping across inpatient/outpatient; familiarity with APC/DRG impacts.
- Audit readiness: align coding with payer policies; support appeal strategies with data-backed rationale.
- Privacy & security: HIPAA-aware workflows and minimum‑necessary data handling.
Experience
Medical Assistant (Coder)
· Wellness and Skin Care Clinic, Greenville, SC
Dec 2005 — 2014
- Applied ICD‑9/ICD‑10‑PCS, CPT, and HCPCS‑II codes while ensuring regulatory compliance.
- Maintained patient records and supported medical billing and payer communications.
- Resolved billing questions with insurers and patients; supported accurate documentation workflows.
- Utilized EHR/billing software to maintain complete, accurate records.
- Reviewed diagnosis coding for completeness and accuracy across assigned care centers.
Projects & Dashboards
Interactive analytics and documentation samples:
- Portfolio · R Shiny visualizations and certificates
- Python/R notebooks and Excel automation (Pandas · ggplot · Matplotlib · Google Sheets API & Apps Script).
Education
B.S., Biochemistry · Clemson University
Aug 2014 — Dec 2017
Bioinformatics‑oriented program. Areas: Genomics, Proteomics, Biostatistics, Python for Data Science.
A.S., Science · Greenville Technical College
Aug 2010 — May 2014
Medical Assistant · Greenville Technical College
Aug 2002 — May 2005
Certifications & Specializations
Featured Credentials — Johns Hopkins University (3 certificate sequences): Data Science · Biostatistics in Public Health · Health Informatics
CCS (AHIMA #271762)
Medical Assistant (GTC)
JHU: Data Science
JHU: Data Science using R
JHU: Biostatistics in Public Health
JHU: Health Informatics
JHU: Medical Office Manager
Full list of coursework & certificates
- Advanced Reproducibility in Cancer Informatics
- Statistics using R — Certificate
- R Programming — Certificate
- Exploratory Data Analysis (R & Python) — Certificate
- Getting and Cleaning Data — Certificate
- Reproducible Research — Certificate
- Regression Models — Certificate
- Machine Learning — Certificate
- Developing Data Products — Certificate
- Data Science Capstone — Certificate
- Summary Statistics in Public Health — Certificate
- Hypothesis Testing in Public Health — Certificate
- Simple & Multiple Regression in Public Health — Certificate
- The Data Science of Health Informatics
- Outcomes & Interventions in Health Informatics
- Leading Change
- Social & Technical Context of Health Informatics
- Ambulatory Healthcare Management series
- Foundations of Distributed Database Systems
- Distributed Query Optimization & Security
- Reliability, Cloud Computing & Machine Learning
- Patient Safety
- Medical Office Manager
Licenses & Research Certifications
Conflicts of Interest
· CITI Program
Issued Aug 2025 · Expires Aug 2029 · Credential ID 71456214
Data Analytics
Medical Coding
Data or Specimens Only Research
· CITI Program
Issued Aug 2025 · Expires Aug 2028 · Credential ID 71456213
Data Science
Medical Coding