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Noreen Rhoades, BS, CPC, CCA, CHCA

Noreen Rhoades, BS, CPC, CCA, CHCA

Special Projects Coordinator/Reimbursement Specialist

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  • Timeline

  • About me

    Program Integrity Manager Community Health Plan of Washington

  • Education

    • University of Wisconsin-Madison

      -

    • Western Governors University

      2015 - 2019
      Bachelor of Science (B.S.) Health Information Management

    • University of Washington

      2011 - 2012
      Regulatory Compliance

  • Experience

    • The Polyclinic

      Jan 1997 - Apr 2001
      Special Projects Coordinator/Reimbursement Specialist

      Supervisor for Business Office staff. Performed audits for appropriate documentation and coding standards, identifying any risk areas. Trained physicians and staff on documentation, coding and billing standards.

    • Neurosurgical Associates Ltd

      May 2001 - Mar 2002
      Business Office Manager

      Managed business operations and supervised the billing and coding staff. Created and implemented effective business office processes and policies.

    • The Brigham Group-Fairview Hospital

      Jun 2002 - Feb 2003
      Referral/UR Coordinator

      Updated referral process,developed and trained staff to use the registration tools. Audited admissions for medical necessity and pre-certification.

    • Medica Health Plans

      Feb 2003 - Jul 2004
      Coding Administrator

      Expert resource for coding, reimbursement and policy questions for a provider network of 159 hospitals and 17,000 physicians. Developed and delivered provider education on coding and billing standards.

    • Suby, Von Haden & Associates Healthcare Services, LLC

      Nov 2004 - Jun 2005
      Coding Specialist

      Abstracted and coded radiology services, resolved coding denials.

    • University of Washington Physicians

      Jul 2005 - Nov 2010
      Compliance Analyst

      Project lead for special projects, focused reviews, risk assessments and government audits. Performed provider audits ensuring appropriate documentation and billing.

    • Seattle Children's

      Nov 2010 - Mar 2016
      Corporate Compliance Analyst

      Healthcare proactive and reactive audits for professional fee billing and facility billing. Compliance and coding training for professional and allied providers.

    • Community Health Plan of Washington

      Jun 2016 - now

      Manages projects for integrity. Audits documentation with codes billed. Post payment review and project work for all types of claims. Auditing inpatient facility claims and documentation.

      • Business Process Operations Integrity Program Manager

        Feb 2019 - now

      • Sr. Claims Reimbursement and Coding Specialist

        Jun 2016 - Feb 2019

  • Licenses & Certifications

    • Certified Healthcare Chart Auditor

      AHCAE

    • Certified Coding Associate

      AHIMA

    • Certified Professional Coder

      AAPC

    • ICD-10 CM/PCS Trainer

      AHIMA