Jessica Wellard
North Chesterfield
Summary
With 18 years of experience in professional fee auditing, billing, and coding, I offer extensive knowledge in revenue cycle billing. Starting with my CPC-A certification, my career has led me to become a highly skilled Medical Auditor with expertise in various professional outpatient specialties.
Overview
18
18
years of professional experience
1
1
Certification
Work History
Medical Auditing Consultation
Ankura Consulting Group, LLC
11.2018 - 01.2025
- Conducted coding audits of providers of evaluation and management (E/M) and procedure code documentation and code selection per the requirements of Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS), and ICD-10
- Audits complied with the requirements for Independent Review Organizations, Office of the Inspector General self-disclosures, litigation, and mergers and acquisitions
- Audits required knowledge of applicable Medicare, relevant state Medicaid, and historical CPT coding standards
- Maintained proficiency in CMS guidelines: Including National Coverage Determinations (NCDs), Local Coverage Determinations (LCDs), CMS internet-only manuals
- Kept abreast of historical billing and coding guidelines to ensure the applicable standards were used for each payer and audit time frame
- Rapidly acquired proficiency in the following Electronic Medical Record (EMR) systems, as required and expected by the clients: Allscripts, Athena Health, Centricity, Cerner, E-Clinical Works, EPIC, Greenway Health, Next Gen, Practice Fusion
- Identified and documented both correct and incorrect coding practices, as well as trends in how practitioners document patient care
- Identified additional trends during audits that were outside the original scope but could benefit clients
- Proactively shared these insights to help clients enhance their understanding, fostering long-term client relationships through education
- Prepared reports for client’s counsel and for direct reporting managers
- Participated in phone calls with counsel and clients to discuss the results of the audit
- Developed and delivered educational presentations for in-house teams, clients, clients counsel(s), and AAPC chapters
- Cultivated professional relationships with long-term clients by addressing coding and compliance inquiries submitted by clients and/or their counsel
- Acquired expertise in various professional fee auditing specialties including, but not limited to: Anesthesia, Behavioral Health, Cardiology, Dental, Ears, Nose and Throat (ENT), Emergency Department Services (Professional and Facility Charges), Evaluation and Management Services (E/M Services), Family Practice, Gastroenterology, Obstetrics and Gynecology, Orthopedics, Payer vs
- Provider Disputes, Pediatrics, Physical Therapy, Occupational Therapy, Speech Therapy, Radiology, Telehealth Services (Pre-CoVid, Mid-CoVid, Post-CoVid Pandemic), Transcranial Magnetic Stimulation (TMS) & Repetitive Transcranial Magnetic Stimulation (rTMS), Urgent Care Services (Professional), Worker’s Compensation Medical Claims
Medical Auditor/Coding Specialist
OrthoVirginia
04.2016 - 11.2018
- Conducted audits and coded services provided by over 13 Orthopedic healthcare professionals including Doctors, Physician’s Assistants, Physical Therapists, and Occupational Therapists to ensure compliance with appropriate guidelines
- Verified that provider documentation substantiated the reported medical CPT codes by each provider
- Ensured accurate documentation of all E/M levels reported by providers met or exceeded the organization’s E/M correct coding standards
- Educated providers on documentation improvement
- Provided education to providers on selecting the appropriate E/M level CPT code when the documentation and initial code selection did not meet the organization’s benchmark standards
- Reported updates and/or changes in CPT and ICD-10 codes to providers as necessary based on the yearly changes implemented by the AMA
- Conducted training sessions for co-workers on coding E/M levels and interpreting operative notes to ensure appropriate selection of CPT codes, for services provided
- Coded surgeries performed and E/M levels with accurate ICD-10 diagnosis codes, ensuring compliance with coding regulations and standards
- Worked closely coworkers to make sure charges and claims were entered into the billing system and submitted to insurance payers in a timely manner (within 24 – 48 hours)
Medical Auditor and Education Specialist
Bon Secours Health System
10.2014 - 04.2016
- Physician site trainer at 6 practices on ICD-10 transition and implementation; physician sub-specialties included OB-GYN, Perinatal, Women’s Oncology, OB-GYN Surgery
- Provided on-going support to 6 practices on ICD-10 transition
- Successfully trained internal candidates for their AAPC certification(s)
- Trained new medical coders on the organizational best practices and processes
- Created and implemented organizational best practices to ensure timely filing and processing of claims
- Served as internal support for physicians, managers, coders and billers to ensure all services were coded correctly
- Accurately assigned ICD-10 diagnosis codes to appropriate CPT charges billed by all providers, including but not limited to, daily E/M charges, pregnancy charges, operative procedures, hospital services and post-operative billing, if applicable
- Assigned E/M codes based on documentation provided by the providers
- Submitted all charges to primary, secondary and tertiary insurance carriers in a timely manner
- Generated reports to ensure all claims passed potential claim edits for accurate claim submissions
- Provided coding education and documentation improvement education to clinical staff and physicians
- Developed reports to ensure that all outstanding charges were accounted for within the practices
- Provided customer service to patients regarding insurance and billing inquiries
Medical Coder II
Richmond OBGYN Associates
03.2007 - 10.2014
- Accurately assigned ICD-9 diagnosis codes and appropriate E/M codes for daily charges
- Accurately assigned ICD-9 diagnosis codes and appropriate E/M codes for hospital services performed by on-call providers
- Accurately assigned ICD-9 diagnosis codes to appropriate pregnancy services performed and operative procedures performed by the providers
- Reconciled medical documentation with charges coded
- Managed reporting systems to ensure all outstanding charges were accounted for within the organization
- Managed reports to ensure all claims passed potential claim edits for accurate claim submission
- Provided coding education and documentation improvement education to clinical staff and physicians
- Assisted with the AR department with patient follow-up for outstanding patient payments
- Provided customer service to patients regarding insurance and billing inquiries
Education
Associate’s - Arts and Liberal Arts
Lord Fairfax Community College
Middletown, Va05.2006
Skills
- Microsoft Word & Excel (Intermediate)
- Microsoft PowerPoint (Intermediate)
Credentials
- CPC
- CRC
- CDC
Certification
CPC, CRC, CDC
Languages
Spanish
Limited Working
Timeline
Medical Auditing Consultation
Ankura Consulting Group, LLC
11.2018 - 01.2025
Medical Auditor/Coding Specialist
OrthoVirginia
04.2016 - 11.2018
Medical Auditor and Education Specialist
Bon Secours Health System
10.2014 - 04.2016
Medical Coder II
Richmond OBGYN Associates
03.2007 - 10.2014
CPC, CRC, CDC
Associate’s - Arts and Liberal Arts
Lord Fairfax Community College
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