Melissa Wilson
Elgin
Summary
An efficient professional with 14 years of experience in Medical Coding , HCC Coding, and Auditing boasts high productivity and the capability to complete tasks swiftly while maintaining a 95% accuracy. Skilled in medical coding, electronic health records management, and data analysis. Excel in organizational, communication, and problem-solving skills, ensuring seamless workflow and compliance with healthcare regulations. Highly skilled in auditing medical records, ensuring compliance with industry standards, and regulatory requirements. Possess strong knowledge of coding systems and electronic health record (EHR) technology, combined with keen analytical skills to identify discrepancies and areas for improvement. I am an adaptable professional with a quick learning ability and a talent for adjusting to new environments. Skilled in rapidly acquiring new knowledge and applying it effectively. Driven by a passion for continuous learning and successfully navigating change, I have ten years of experience working remotely, and I have my own quiet office in my home.
Overview
14
14
years of professional experience
1
1
Certification
Work History
Quality Review Audit Analyst
Cigna / Evernorth
Chicago
03.2022 - 03.2025
- Prepared audit reports and communicated findings to management.
- Presented audit results to management teams, delivering information in non-technical terms for easy understanding.
- Conducted testing of software and systems to ensure quality and reliability.
- Provided support and guidance to colleagues to maintain a collaborative work environment.
- Contributed innovative ideas and solutions to enhance team performance
- Maintained detailed records on all activities conducted during the audit process.
- Researched and implemented best practices to improve audit results.
- Identified and assessed areas of significant business risk and internal control weaknesses.
Senior Medical Coder
Alegis Care / Cigna
Chicago
04.2014 - 03.2025
- Analyzed physician documentation to ensure the accuracy of codes assigned in accordance with accepted coding guidelines. Collaborated closely with team members to achieve project objectives and meet deadlines.
- Interpreted medical reports to apply appropriate ICD-10, CPT-4, and HCPCS codes.
- Provided coding guidance and assistance to physicians, nurses and other staff members.
- Assigned additional diagnosis codes based on specific clinical findings (laboratory, radiology, and pathology reports, as well as clinical studies) in support of existing diagnoses. Participated in coding team meetings to discuss challenges and best practices.
- Coordinated with billing department to clarify billing issues related to coding.
- Trained new coders on proper use of ICD-10 codes and CPT codes.
- Maintained 95% accuracy rate on all monthly audits
- Updated coding skills and knowledge through continuous education and training.
- Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements.
- Maintained current knowledge of industry changes related to ICD-10 and CPT codes by attending seminars and webinars.
Medical Coder
Home Physicians / Alegis Care
Chicago
12.2010 - 04.2014
- I worked extensively with the senior coder, as I was just fresh out of school, and I came on as an apprentice and was hired in the first two weeks.
- I learned the EMR, NextGen, and reviewed the nine-page annual health assessments that were completed by our providers for Medicare Advantage patients in their homes.
- I faxed all paper charts to the different health plans, added all the charts' information into the EMR to be compliant with EHR requirements, and assisted in boxing up and having all paper charts boxed and stored.
- Verified proper coding, sequencing of diagnoses, and accuracy of procedures.
- I met all providers in person and worked on building working relationships with each one, and with clear communication, queries were welcomed and easily responded to.
- Entered patient insurance, demographic and health information into software and confirmed records.
Education
CPMA - Medical Auditor
AAPC
Salt Lake City, UT01-2026
CRC - Risk Adjustment Certification
AAPC
Salt Lake City, UT04-2016
CPC # 01179169 - Medical Coding Certification
AAPC
Salt Lake City, UT04-2011
Certificate Medical Sciences - Medical Technology
Wright College
Chicago, IL12-2010
Certificate of Medical Studies - Anatomy, Medical Terminology, Pathophysiology
Northwestern Business College
Chicago, IL05-2006
Some College (No Degree) - General Studies
Truman College
Chicago, IL09-2003
GED -
Amundsen
Chicago, IL05-1998
Skills
- Clinical Coding Expertise
- Risk adjustment
- Data analysis
- Regulatory Standards Knowledge
- Ethics and integrity
- Attention to detail
- Effective team collaboration
- Quality assurance
- Experience with EPIC, NextGen, and Rounding Well platforms
- Experience with IMO coding software
- Microsoft Office
- Excel
- HIPAA compliance
- Continuing education CEU's with AAPC and
Certification
- CPC
- CRC
- CPMA in school
Languages
English
Professional
Accomplishments
- Employee of the Year at Alegis Care in 2016
- Promoted to Quality Review Audit Analyst 2022
- 3.% raise last 4 years and Bonus 2025
Affiliations
- I have a heart for Child Protection and Volunteer at DCFS and provide Family support
- I have two children that I sponsor in Uganda through Compassion International
- I enjoy supporting the little ones in my family by attending Sporting events ,Camping , and School events
- I have 4 grown children and I now enjoy spending time the grandkids
References
References available upon request.
Timeline
Quality Review Audit Analyst
Cigna / Evernorth
03.2022 - 03.2025
Senior Medical Coder
Alegis Care / Cigna
04.2014 - 03.2025
Medical Coder
Home Physicians / Alegis Care
12.2010 - 04.2014
CPMA - Medical Auditor
AAPC
CRC - Risk Adjustment Certification
AAPC
CPC # 01179169 - Medical Coding Certification
AAPC
Certificate Medical Sciences - Medical Technology
Wright College
Certificate of Medical Studies - Anatomy, Medical Terminology, Pathophysiology
Northwestern Business College
Some College (No Degree) - General Studies
Truman College
GED -
Amundsen
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