Michelle Phillips

Certified Risk Adjustment Coder (CRC, CPC-A) specializing in HCC and ICD-10-CM coding for Medicare Advantage and Medicaid populations. Experienced in chart abstraction, clinical documentation review, and claims validation aligned with CMS-HCC methodology, with consistent 95%+ QA accuracy.

I bring over 20 years of compliance-focused experience applying regulatory standards, identifying documentation discrepancies, and maintaining audit-ready records in high-volume environments. This background strengthens my approach to risk adjustment coding, ensuring defensible HCC capture, documentation integrity, and reimbursement accuracy.

My work is grounded in analytical precision, regulatory awareness, and early-stage fraud, waste, and abuse recognition. I am seeking remote opportunities in Risk Adjustment Coding, Coding QA/Documentation Review, or Chart Abstraction roles where compliance, accuracy, and risk awareness drive measurable value.

HCC • CMS-HCC • ICD-10-CM • Risk Adjustment • Chart Abstraction • Documentation Review • Claims Validation • QA Accuracy • Audit Support • FWA Awareness • Revenue Integrity

I am a Certified Professional Coder (CPC‑A) and Certified Risk Adjustment Coder (CRC) with hands‑on experience reviewing medical records, abstracting diagnoses and procedures, and assigning accurate ICD‑10‑CM, CPT, and HCPCS codes. I maintain 91–95% QA accuracy while working in high‑volume environments and have a strong understanding of CMS, AHA Coding Clinic, and HIPAA compliance. My background includes documentation integrity review, resolving payer‑provider coding discrepancies, and collaborating with clinical staff to ensure complete and compliant documentation.

High School Diploma with additional professional medical coding education through AAPC. Hold CPC‑A (Certified Professional Coder Apprentice) and CRC (Certified Risk Adjustment Coder) credentials. Completed AAPC Practicode program to gain hands-on coding experience and proficiency in ICD‑10‑CM, CPT, and HCPCS coding guidelines. Maintain ongoing CEUs focused on HCC, CMS updates, and coding compliance.