1. SHARON D. BUSH
1102 Pelham Wood Road, Parkville, MD21234 | H: (667) 206-4556 | sdbush26@aol.com
Professional Summary
Certified by the American Academy of Professional Coders highly efficient medical Coder with ten years’ experience
in outpatient and HCC coding. Certified in ICD-9 and ICD-10. Excellent multi-tasker and demonstrated team player
with a positive attitude. Seeks a position of increased responsibility and authority.
Certifications
CPC
Skill Highlights
Certified coding instructor Maintains strict confidentiality
CPT and HCPCS coding Knowledge of HMO's, Medicare/Medicaid
Quality assessment of coded data Extensive HCC and Risk Adjustment and HEDIS
ICD-10 coding knowledge
Electronic Medical Record (EMR) software
Professional Experience
Coding Quality Auditor Mar 2013 to Current
Cigna/HealthSpring － Baltimore, MD
Demonstrate analytical and problem-solving ability by addressing barriers to receiving and validating accurate
HCC information.
Review ICD 9/10 codes for clinical appropriateness and consistency Perform random audits for coding and
technical compliance.
Communicate QA results to management and medical coding staff, work with leadership to identify areas of
improvement related to individuals who fall below quality standards.
Coordinate with Coding leadership to focus training efforts around common errors or potential areas of process
improvement.
Assign additional diagnosis codes based on specific clinical findings (laboratory, radiology and, pathology
reports as well as clinical studies) in support of existing diagnoses.
Research, investigate evaluate and identify opportunities for improvement Monitors compliance with
documentation standards and keeps current with changes in coding guidelines, compliance, reimbursements, and
other regulatory updates.
Actively involved in mentoring and training all function of services related to HCC medical coding, medical
documentation, and physician queries abstracting and data collection.
Ensure that all coding and data entry for each form is complete and entered in to the system.
Verify that all conditions were coded to the highest level.
Provider Coding Specialist Nov 2010 to Mar 2013
HealthSpring － Baltimore, MD
Ensures compliance with all applicable federal, state and local regulations, in addition to organizational
standards, practices, policies and procedures.
Monitor coding and abstracting quality by conducting and/or coordinating ongoing audits to ensure coding quality
and performance improvements.
Edit or query providers as needed for diagnostic codes assigned to encounter visits using the ICD-9-CM coding
system.
Conduct Quality Assurance audits and qualitative/quantitative review of medical records to verify completeness
and accuracy of diagnosis.
Identify coding errors/omissions on the returned forms.
Work directly with BPHP program team to identify, resolve and implement new and ongoing policies and
procedures.
Traveling/ HCC Medical Records Reviewer May 2008 to Oct 2010
Risk Adjustment Management LLC － Miami, Florida
Travel to communities and performed onsite field audits as assigned Performs focused reviews on encounters as
needed to support various coding and revenue cycle initiatives as appropriate.

2. Audit and analyze coding documentation for accuracy and completeness of coded medical records Codes and
abstract the medical records of same day surgery, emergency and hospital/physician encounters in accordance
with established ICD-9 CM Official Guidelines for coding and reporting.
Provide coding education and training to physicians and staff Prepare and share summary reports of medical
review with project manager.
Coding/Office Manager May 2006 to May 2008
All Walks of Life Mental Health Agency － Baltimore, Maryland
Abstract clinical information from physician medical records and assign appropriate ICD-9 and CPT codes to
patient records according to established procedures.
Bill Medicaid claims electronically, follow-up on denied claims make necessary adjustments for resubmission.
Verify Insurance, Get authorization for services, Schedule appointments.
Provides training to essential personnel, Order office supplies and equipment Process payroll data, Compiles and
report statistics Review and verify component parts of the medical record to ensure accuracy of diagnosis,
operations and special therapeutic procedures that conform to official coding guidelines for reimbursement.
Review insurance carrier payment denials and recommend appropriate corrections.
Accounting Clerk III Jan 2002 to Jan 2006
Maryland Department of Health and Mental Hygiene － Baltimore, MD
Perform basic accounting and bookkeeping functions.
Approved pharmacy invoices for payment.
Audited accounts payable process for accuracy, approvals and completeness.
Maintain bank ledgers, bank reconciliation and confidential client files according to the center policies and
guidelines.
Account Administrator Jan 1998 to Jan 2002
Group Benefits Service － Hunt Valley, MD
Installed new accounts into the database.
Process applications for new and existing groups.
Respond to client inquiries via telephone or mail.
Process additions, terminations, changes, reinstatements and transfers.
Follow-up on unpaid claims as requested.
Receipts Analyst/Enrollment and BillingTechnician Jan 1990 to Jan 1998
Blue Cross Blue Shield of Maryland, Inc. － Owings, MD
Handled all aspects of enrollment and billing for new and existing accounts.
Process accounts receivable statements, received payments and perform collection procedure for overdue
accounts.
Thoroughly investigated past due invoices and minimized number of unpaid accounts.
Maintained appropriate ledgers.
Resolved credit and account problems.
Issued refunds, adjustments, and handled accounts receivable inquiries.
Prepare the necessary documentation for month-end closing.
Education and Training
CCI @ Johns Hopkins University, Baltimore Maryland Medical Coding and Billing Master Certificate Program,
Social Work July 2006
Morgan State University
Social Work
Skills
Healthcare: Audit, Coding, Billing, ICD-10 Educator and People skills. Enthusiastic, Resourceful, advanced problem-
solving and great organizational skills, Certified Physician Medical Record Coder, Internal medicine, utilizing
Healthcare Best Practices, HIPAA compliance, HMO, indemnity and commercial insurance. Policy development and
implementation.