Simone Leach-Williams

Clinical Quality Auditor - United Healthcare/Optum360

Orlando, FL 32811
simonewill7@gmail.com

Experience in MS4, Meditech, Cerner, Citrix, GE Centricity, EPIC, 3M & Optum Encoder, and MD Audit.
1099 Contract Coder with AviaCode.
Certified Professional Coder with AAPC since 2007.

WORK EXPERIENCE

Clinical Software Implementation

United Healthcare - January 2014 to Present
Create retrospective and prospective inpatient & outpatient coding audits for quality and educational
milestones.
Responsible for ramping up coding projects with training and productivity goals & deadlines.
Create educational presentations for WEBEX training for remote coders starting at hospitals where Optum
computer assisted coding software products have been launched.

HIM Consultant
Kforce Healthcare Government Solutions - Tampa, FL - February 2013 to January 2014
Audited and coded outpatient and inpatient hospital stays, same day surgeries, and specialty office visits.
Traveled to work as interim coding manager on several site hospitals until position could be filled locally.
Established an organized coding process for productivity and quality coding of inpatient and outpatient hospital
accounts.
Responsible for training and hiring of coding staff for under staffed hospital coding departments.

Clinical Appeals Auditor

Medicare Advent Gov. Services - Fort Meade, MD - August 2012 to January 2013
Audited HEDIS claims for Medicare Palmetto, GBA.

Reviewed DRG's for appropriate submission to Medicare per CMS guidelines to determine whether

Medical documentation was sufficient enough for payment of submitted hospital claims.

Compliance Auditor
University of MD Medical Center - Baltimore, MD - August 2011 to May 2012
Applied knowledge of government regulations as they relate to auditing of coding and payment of

Provider service.

Prepared researched information on audit findings to present feedback to different departments such as

Finance, Medicine, Coding, and multi-specialty departments. Instructed education classes in Coding, Anatomy
& Physiology, Compliance and Medicare Guidelines.

Medical Biller/Senior Coder

Orlando Healthcare Hospital - Orlando, FL - May 2009 to May 2011
Conducted coding and revenue integrity audits.

Organized claims analysis projects researching coding and underpayment trends.

Assigned ICD-9, CPT, and E/M codes to outpatient/inpatient pediatric pulmonary, neurosurgery, emergency,
OB-GYN and orthopedic medical records.
Organized in service AAPC seminars for coding staff.
Oncology Certified Coder

Coder
Florida Oncology Physicians - Orlando, FL - November 2007 to May 2008
Orlando, FL
Assigned radiation treatment CPT and ICD-9 codes for inpatient and outpatient oncology patients.

Assigned E/M inpatient and outpatient consultation codes.

Participated in physician teaching of radiology oncology procedure codes.

Provider Vendor
NC Medicaid - Raleigh, NC - October 2004 to November 2007
Traveled statewide to different provider offices to audit claims and teach billing methods for submission of

claims under CMS guidelines.

Processed and reviewed claims for payment to provider.

EDUCATION

Information Technology
DeVry University Online
January 2015 to Present

BSN in Nursing
North Carolina A & T State University
August 2000 to January 2003