Anita W.
Coding and Billing Specialist @Imagine Pediatrics
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WORK HISTORY
Coding and Billing Specialist @Imagine Pediatrics
Houston, TX, US
Coded and abstracted high‑volume pediatric and telehealth encounters with 95%+ accuracy across ICD‑10‑CM, CPT, HCPCS, and modifier assignment.• Conducted concurrent and retrospective documentation reviews, maintaining 98% compliance alignment with payer and medical‑necessity standards.• Resolved automation variances and exception queues with a 90% first‑pass correction rate, reducing downstream rework.• Served as a resource for billers, improving denial correction and resubmission outcomes by 30% through clearer documentation guidance.• Performed internal QA reviews and built tracking tools that identified accuracy gaps and improved coding consistency by 15%.• Strengthened audit readiness by validating documentation and reconciling charges with a 97% alignment rate to payer and compliance requirements.
EDUCATION
EVEREST COLLEGE-WOODBRIDGE
MEDICAL INSURANCE BILLING AND CODING
Germanna Community College
Associate's degree, Accounting
ABOUT ANITA W.
With 12 years of experience in healthcare billing, coding, and compliance, I’ve built a career focused on strengthening documentation accuracy, reducing risk, and supporting clean, compliant reimbursement across outpatient, pediatric, oncology, and multi‑state telehealth environments. My background spans front‑end patient access through back‑end revenue cycle operations, giving me a full‑picture understanding of how clinical, operational, and financial workflows connect.I specialize in interpreting payer policies, resolving complex edits (NCCI, MUE, payer‑specific), analyzing documentation for accuracy, and supporting audit readiness. I’m known for my ability to break down complex regulatory requirements into clear, actionable guidance that helps providers, coders, and operational teams work more confidently and efficiently.Throughout my career, I’ve contributed to improved clean claim rates, reduced recurring denials, and strengthened compliance posture by identifying root causes, improving workflows, and creating practical tools and resources. Earning my CPCO certification further deepened my commitment to compliance, integrity, and continuous improvement.Key strengths:• Revenue cycle operations & compliance support• NCCI/MUE logic, modifier accuracy, payer policy interpretation• Documentation quality, audit readiness, and risk mitigation• Denial prevention & root‑cause analysis• Provider and coder education• Epic, Athenahealth, Salesforce, Availity, Waystar, Change HealthcareI’m passionate about helping organizations protect revenue, improve accuracy, and create workflows that make the revenue cycle clearer and more manageable for everyone involved.
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