Tanya Bair
Clover
Summary
Dynamic Quality Assurance Manager with a proven track record skilled in Medicare and Medicaid Risk Adjustment Coding. Demonstrates exceptional leadership and organizational abilities, driving teams to exceed production goals while maintaining high-quality standards. Expert in analyzing coding data to identify trends and enhance auditing processes.
Overview
18
18
years of professional experience
1
1
Certification
Work History
Quality Assurance Manager
Optum
03.2024 - Current
- Oversee the daily operations of 5 supervisors and their direct reports (~150 auditors)
- Auditing of internally coded Medicare, ACA, and Medicaid charts as well as third party coded charts for quality assurance
- Analyze coding/auditing data to identify coding concerns and trends
- Ensure production goals and deadlines are met by monitoring chart volumes, making necessary auditing assignments, and allocating staff to different projects
Auditing Manager
Change Healthcare
08.2016 - 03.2024
- Oversaw the day to day operations of a team of remote auditors whose were responsible for auditing coded medical records
- Trained auditors on new client guidelines
- Monitored production (charts per hour) and quality (95% quality goal) on a daily, weekly and monthly basis
- Responsible for ensuring client deadlines were met
Senior Coding Manager
Peak Health Solutions
01.2009 - 01.2015
- Responsible for the day-to-day operations of both the coding and auditing staff
- Coding/auditing included risk adjustment, ER, pro-fee, and inpatient coding
- Met with clients on a weekly and/or monthly basis to ensure coding quality and deliverables were in line with expectations
- Implemented coding Tips of the Day to promote employment engagement
- Trained staff for new projects
- Helped develop internal coding policies and procedures
Coding Auditor
Peak Health Solutions
01.2007 - 01.2009
- Audited charts to verify correct assignments of CPT, ICD and HCPCS codes
- Coding types include ER, and outpatient coding
- Maintained quality accuracy rate while exceeding production goals
- Collaborated with the coding manager to create additional education material for both internal staff and external clients
Education
Certificate of Technical Studies - Health Information Technology
Seminole State College of Florida
Sanford, FL06-2003
Bachelor of Arts - Psychology
University of Central Florida
Orlando, FL05-1999
Skills
- Retrospective/Prospective Risk Adjustment Coding/Auditing
- RADV audits
- Medicare, ACA and Medicaid Risk Adjustment Coding/Auditing
- Effective Leadership Abilities
- Exceptional Organizational Skills
Certification
- Certified Risk Adjustment Coder (CRC)-American Academy of Professional Coders(AAPC).
- Certified Coding Specialist (CCS) - American Health Information Management Association (AHIMA).
- Certified Coding Specialist, Physician Based (CCS-P) - American Health Information Management Association (AHIMA).
Timeline
Quality Assurance Manager
Optum
03.2024 - Current
Auditing Manager
Change Healthcare
08.2016 - 03.2024
Senior Coding Manager
Peak Health Solutions
01.2009 - 01.2015
Coding Auditor
Peak Health Solutions
01.2007 - 01.2009
Certificate of Technical Studies - Health Information Technology
Seminole State College of Florida
Bachelor of Arts - Psychology
University of Central Florida
Similar Profiles
Tracey McAllisterTracey McAllister
Sr UX UI Engineer - Product Manager at OptumSr UX UI Engineer - Product Manager at Optum
MANJUNATH HUNACHIKATTIMANJUNATH HUNACHIKATTI
Associate Medical Coder at OptumAssociate Medical Coder at Optum
MRIDHULA KALLIVALAPPILMRIDHULA KALLIVALAPPIL
Medical Coding Analyst at OptumMedical Coding Analyst at Optum