Kim Huynh CPC, CPMA, CRC, MBA

Associate Consultant

San Jose, California, United States8 yrs 5 mos experience

Highly Stable

Key Highlights

Over 5 years of experience in medical auditing and coding.
Expert in risk adjustment and CMS data validation.
Proven track record in quality assurance and provider education.

Stackforce AI infers this person is a Healthcare Professional with expertise in Medical Coding and Risk Adjustment.

Contact

Skills

Core Skills

Medical CodingRisk AdjustmentHcc CodingData ValidationProperty ManagementCustomer ServiceClaims DocumentationLogistics ManagementComplianceTutoringIt Support

Other Skills

Business AdministrationCMS Data ValidationCommunicationCost ManagementCreative Problem SolvingCross-functional Team LeadershipCustomer SatisfactionData AnalysisData RetrievalData VisualizationDiagnosis Code VerificationDocument ManagementEmployee RelationsFacilities ManagementFood

About

Meticulously detail-oriented professional medical auditor, educator, coder with more than 5 years of experience in a healthcare facility where in-depth knowledge of medical terminologies and risk adjustment experience would be put into work.

Experience

Centene corporation

Medical Auditor - Educator

Mar 2024 – Present · 2 yrs · California, United States · Remote

. Subject matter experts for proper risk adjustment coding and CMS data validation
. Conduct provider education and training regarding risk adjustment to help to ensure accurate CMS payment and to improve quality of care.
. Perform quality assurance auditing (i.e. ensure appropriateness and accuracy of ICD-9/ICD-10 coding) for WellCare’s Medical Coding Specialists.
. Support and participate in process and quality improvement initiatives using Epic, Allscripts, Athena, Cerner system.

Medical CodingRisk AdjustmentCMS Data ValidationQuality Assurance AuditingProvider EducationProcess Improvement

Agilon health

Senior Risk Adjustment (HCC) Medical Auditor-Coder

Mar 2021 – Mar 2024 · 3 yrs · California, United States · Remote

. Demonstrate analytical and problem-solving ability regarding barriers to receiving and validating accurate HCC information.
. Verify and ensure the accuracy, completeness, specificity and appropriateness of diagnosis codes based on services rendered (MA, ACA, outpatient, and inpatient health care setting).
. Coordinate CMS Data Validation activities, including record selection, tracking and submission.
. Correlate activities, processes and HCC results/ metrics to evaluate outcomes.
. Communicate QA results to medical coding specialists with suggestions for improvement and re-training topics.
. Review medical record information to identify all appropriate coding based on CMS HCC categories.
. Monitor the implementation of Corrective Action Plans as needed, and track implementation as it relates to HCC activities and high risk patients, especially in insuring that those patients have appropriate medical record problem lists and corresponding risk score.

HCC CodingData ValidationDiagnosis Code VerificationQuality AssuranceCommunication

Coding clarified

HCC Coder

Feb 2019 – Feb 2021 · 2 yrs · United States

 Identified, collected, assessed, monitored and documented claims and encountered coding information as it pertained to Clinical Condition Categories.
 Verified and ensured the accuracy, completeness, specificity and appropriateness of diagnosis codes based on services rendered.
 Reviewed medical record information to identify all appropriate coding based on CMS HCC categories.
 Completed appropriate paperwork/documentation/system entry regarding claim/encounter information.
 Queried when documentation in the record was inadequate, ambiguous, or otherwise unclear for medical coding purposes.
 Assisted providers and other professional staff in retrieving and compiling data for research, diagnosis, and teaching purposes.
 Performed coding and abstracting with an accuracy rate higher than 95%.
 Provided support, education, and training related to quality of documentation, level of service and diagnosis coding consistent with established coding guidelines and standards.
 Monitored coding changes to ensure that the most current information was available.
 Demonstrated analytical and problem-solving ability regarding barriers to receiving and validating accurate HCC information.

HCC CodingClaims DocumentationData RetrievalQuality Education

Affordable property management

Property Management Assistant - Part time

May 2018 – Mar 2021 · 2 yrs 10 mos · Union City, California

Conduct all business activities in accordance with policies and procedures, fair housing, ADA, FCRA, and all other Federal and State laws
Organizing, processing, and filing all applicable reports, leases, and other related paperwork
Assisting owners and renters in timely resolution of property issues using the Appfolio system
Maintaining awareness of local market trends by conducting rent matches and marketingresearch

Property ManagementCustomer ServiceMarket ResearchCompliance

D&t foods inc.

Logistics Manager

Aug 2017 – Jan 2018 · 5 mos · Santa Clara, California

 Ensured the quality of all products in the warehouse.
 Managed compliance with both US and international laws and ISO requirements.
 Ensured FDA regulations were followed and developed strategies to release on hold products using Private Labs.
 Tracked quantity of stock levels using Dynamics and FIFO method with frozen and fresh items daily.
 Strategically planned and managed logistics by facilitating the shipping of products in a timely fashion.
 Managed $100K to $500K wire bank transfers weekly.
 Reviewed freight costs, transportation rates, and the price of raw materials to keep costs down.

Logistics ManagementComplianceQuality AssuranceCost Management