Summary
Overview
Work History
Education
Skills
Certification
Timeline
Generic

Tina Colassard

Hampstead

Summary

Detail-oriented Quality Review and Audit Analyst with expertise in compliance analysis, quality improvement, and data assessment. Proven ability to enhance audit processes and drive quality initiatives in healthcare settings.

Overview

17
17
years of professional experience
1
1
Certification

Work History

Quality Review and Audit Analyst

CIGNA HealthCare
Hampstead
12.2024 - Current
  • Evaluated complex medical conditions to ensure compliance with documentation standards.
    Conducted thorough medical records reviews, abstracting diagnosis codes per coding guidelines.
    Performed audits on documentation and data to identify gaps in risk adjustment processes.
    Analyzed compliance risks to support IFP risk adjustment programs and RADV audits.
    Monitored trends in medical coding to suggest improvements in data quality.
    Collaborated with teams to enhance adherence to HHS protocols and best practices.
    Utilized hierarchical condition category expertise to drive continuous quality improvement initiatives.
  • Analyzed financial data to identify trends and discrepancies in reports.
  • Collaborated with cross-functional teams to enhance audit processes and compliance.
  • Conducted risk assessments to evaluate internal controls and operational effectiveness.

Coding Quality Specialist

Centauri Health Solutions
Hampstead
08.2017 - 01.2024
  • Conducted coding quality audits on internal and external coders to ensure accurate assignment of diagnoses based on clinical documentation and coding guidelines.
  • Conducted quality audits to ensure compliance with industry standards.
  • Developed and implemented quality control procedures for healthcare services.
  • Collaborated with cross-functional teams to address quality issues effectively.
  • Coordinated quality assurance processes for healthcare services at Centauri Health Solutions.
  • Reviewed and analyzed client data to ensure compliance with industry standards.
  • Developed training materials for staff on quality control protocols and best practices.

Coding Quality Analyst

Cigna-HealthSpring
Baltimore
06.2009 - 08.2017
  • Audited coded records to verify compliance with ICD9/ICD10 coding guidelines and clinical documentation.
  • Reviewed coding documentation for compliance with quality standards.
  • Analyzed data to identify trends in coding errors.
  • Collaborated with teams to improve coding processes and workflows.

Education

High School Diploma -

James W Robinson Secondary
Fairfax
06-1983

Skills

  • Compliance auditing
  • Quality control
  • Auditing standards
  • Risk assessment
  • Documentation review
  • Data analysis
  • Medical coding

Certification

  • Certified Professional Coder (CPC) AAPC ID#01092591 June 2008
  • Certified Risk Adjustment Coder (CRC) AAPC June 2015
  • ICD10CM Proficiency Assessment AAPC November 2013
  • ICD10CM Certificate of Completion AHIMA May 2014

Timeline

Quality Review and Audit Analyst

CIGNA HealthCare
12.2024 - Current

Coding Quality Specialist

Centauri Health Solutions
08.2017 - 01.2024

Coding Quality Analyst

Cigna-HealthSpring
06.2009 - 08.2017

High School Diploma -

James W Robinson Secondary

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Tina Colassard