Nicole Navarro

CPC, CRC, CPMA, CRC-I

I'm an AAPC-certified medical coder, auditor, and coding instructor. Since 2016, I have been coding for most major specialties including orthopedics, internal medicine, family medicine, all types of therapy, and risk adjustment. I've coded extensively in commercial, state- and federally- sponsored plans, and workers compensation. 

I've participated in the implementation of Epic EMR across more than ten healthcare centers across the United States. I am currently coding team lead for these centers, providing expert coding interventions and guidance regarding system optimization.  

Experience

January 2021-present

Houston, TX

Assist in day-to-day management of team of 5 certified coders. Create and distribute assignments based on key priorities (timeliness and outstanding amount). Monitor productivity through use of reports and dashboards within the EHR. Provide coaching to all line staff to increase efficiency and effectiveness in using EHR, encoder software, and Microsoft applications to resolve claim rejections and denials.

• Increased productivity of each team member an average of 50% through one-on-one coaching and through the creation of written job aids

• Performed audits of coders to maintain an accuracy rate of 90+% in resolving rejections and denials. Provided personalized training to each coder to reach benchmarks

• Guided team to resolution of an average of $400-500K rejections and denials per week, contributing to an overall AR management of about $6M.

May 2015-November 2020

Generated and disseminated invoices based on contracted or statutory allowed amounts. Performed all follow-up on sent invoices to ensure prompt payment. Reviewed medical records for accuracy and completion by QA team. Called payers within 72 hours of bill submission to ensure receipt. Drafted and submitted requests for reconsideration for underpaid or denied claims.

• Developed relationships with insurance adjusters and other key payer contacts to ensure prompt payments

• Developed counter-affidavit line of business in conjunction with management to open a revenue stream of a minimum of $15K per month.

• Conducted research regarding the National Correct Coding Initiative.

• Created a database for the identification and storage of information regarding appropriate reimbursement. • Provided guidance to staff on completing reviews and drafting affidavits.

Status Risk Adjustment Training

Tutoring......for rate and scheduling, please contact nnavarrocrc@gmail.com

CRC course.... for rate and scheduling, please contact nnavarrocrc@gmail.com

Status Risk Adjustment Training