Apr 19, 2024

Audrey H Doss

  • Clinical Documentation Integrity Specialist
  • 5975 Channel Dr. Belews Creek, NC 27009
Part-time General Nursing

Personal Summary

I am a dedicated Registered Nurse with over 20 years of experience in healthcare reimbursement, ICD-10 coding, clinical validation, and DRG review. My expertise lies in analyzing clinical documentation, ensuring accurate coding practices, and maintaining compliance with state and federal regulations. I have a strong background in medical record documentation requirements and coding guidelines, along with exceptional communication skills to collaborate effectively with healthcare professionals. With a proven track record of working independently and in leadership roles, I am proficient in various software applications and have a passion for continuous learning and professional development.

Skills

  • Healthcare Reimbursement
  • ICD-10 Coding
  • Clinical Validation
  • DRG Review
  • Medical Record Documentation
  • Communication Skills
  • Software Proficiency (Microsoft Office, Encoder Programs)

Licenses and certifications

  • HIM Compliance
  • Faye Brown's ICD-9 Training
  • CMS Risk Adjustment Training
  • HCC-MRA Certification
  • HEDIS Training
  • CPHQ Certification
  • CDIP Certification

Awards and achievements

  • Lifetime Member of AAOCMP
  • Recipient of Haiti Disaster Medical Relief Award

Work Experience

RN-Preservice Claim Auditor (DRG)
Dec 2021 - May 2022 Lexicode/Exela (Contract OPTUM)

- Conducted clinical validation and DRG reviews for a new line of business - Analyzed clinical documentation for coding accuracy and reimbursement compliance - Identified and addressed repricing issues leading to policy changes

Education

Associates Degree in Nursing
Dec 2000 - Jan 2003 Forsyth Technical Community College, Winston-Salem NC
Paralegal Program
- Dec 2009 Forsyth Technical Community College, Winston-Salem NC