Erin Fitzgerald
Auditor | Risk Adjustment | Documentation Integrity
- Role
- Quality Assurance Auditor at Norwood
- Location
- Portland, ME, US
- LinkedIn followers
- 500 followers
About Erin Fitzgerald
About Me Certified professional with deep expertise in Risk Adjustment Coding, Hierarchical Condition Category (HCC) capture, and Documentation Compliance, holding the credentials CPC, CRC, and CVBA. I bring a strong track record of ensuring accurate coding and optimized documentation in alignment with CMS guidelines and value-based care models.With hands-on experience at leading healthcare organizations including Optum and Norwood, I’ve contributed to coding accuracy, risk score integrity, and regulatory compliance across Medicare Advantage, ACA, and Medicaid lines of business. Core Competencies:• Certified in professional coding (CPC), risk adjustment (CRC), and value-based arrangements (CVBA)• Deep knowledge of HCC models and clinical documentation improvement (CDI)• Experience in coding audits, gap closure, and provider education• Skilled in EMR/EHR platforms and industry-standard coding tools• Compliance-focused with a commitment to accuracy and integrityI’m passionate about the intersection of coding, compliance, and clinical quality, and I take pride in helping organizations thrive in risk-adjusted and value-based care environments. Open to connecting with fellow professionals in health information management, risk adjustment, CDI, and healthcare compliance.
Experience
Quality Assurance Auditor
Feb 2025 — Present
Key Responsibilities:• Perform quality assurance audits of medical records and coding reviews (HCC, ICD-10) for accuracy and adherence to CMS guidelines.• Ensure compliance with federal and payer-specific Risk Adjustment regulations.• Document audit findings, provide detailed feedback, and contribute to client coding education.• Utilize EMR and coding platforms to audit, track, and report findings using Excel.• Stay updated on evolving CMS regulations, ICD-10 coding changes, and Risk Adjustment Model updates.
Education
AAPC
CPC, Certified Professional Coder
2020 — 2020
AAPC
AI in Medical Coding and Billing
2024 — 2024
Daytona State College
Medical Transcription
2007 — 2008
AAPC
CRC, Certified Risk Adjustment Coder
2021 — 2021
AAPC
CDEI, Certified Documentation Expert Inpatient
2022 — 2022
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