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Christine Downing

@christinedowning

Message

Experienced risk adjustment medical coder specializing in HCC/CRG documentation review and accurate ICD-10 capture.

United States

Message

What I'm looking for

I’m looking for a remote role focused on risk adjustment chart review—capturing chronic and severe acute conditions with CMS Risk Adjustment and Official ICD-10 guidelines, maintaining high accuracy and production expectations while supporting correct reimbursement.

I’m a Certified Professional Coder (CPC) and Certified Risk Adjustment Coder (CRC) (AAPC member) with a strong foundation in medical terminology and coding from CPT, ICD-10, and HCPCS, backed by 25 years of work experience. I focus on remote risk adjustment chart review to appropriately capture chronic and severe acute conditions, ensuring correct HCC categories and ICD-10 diagnosis codes are assigned on claims.

Since 2007, I’ve worked in remote coding and coding review, overreading medical records and verifying support for chronic conditions with CMS Risk Adjustment and Official ICD-10 guidelines. In roles like Clinical Documentation Coder, Coder at Cotiviti, and Coding Review Consultant at Inovalon, I maintained 95%+ accuracy and production expectations while reviewing and optimizing documentation to support accurate reimbursement.

Experience

Work history, roles, and key accomplishments

Clinical Documentation Coder

Village MD

Nov 2021 - Feb 2026 (4 years 3 months)

Conducted concurrent post-visit review and verification of support for chronic conditions to enable CMS Risk Adjustment. Abstracted correct HCC categories and ICD-10 diagnosis codes on claims while maintaining 95%+ accuracy and production expectations remotely.

Medical Coding CPT ICD 10 HCPCS HCC Coding Diagnosis Coding Data Abstraction Remote Coding

Coder 1

Cotiviti, Inc

Jun 2016 - Nov 2021 (5 years 5 months)

Performed Medicaid code capture through comprehensive review of clinical documentation to ensure accurate diagnosis and procedure reporting. Completed remote HCC coding while maintaining over 95% accuracy and production requirements by capturing supported ICD-10 diagnoses.

Medical Coding CPT ICD 10 HCPCS HCC Coding Coding Validation Remote Chart Review

Remote Coding Review Consultant

Inovalon

Nov 2007 - Jun 2016 (8 years 7 months)

Overread medical charts and performed initial coding to capture ICD-9/ICD-10 codes supporting appropriate HCC and CRG codes. Maintained accuracy and productivity requirements in risk-adjustment medical record reviews for multiple clients remotely.

Risk Adjustments Medical Coding ICD 9 ICD 10 Coding HCC Coding Clinical Risk Group (CRG)Chart Reviews Coding Validation Remote Coding

Certified Surgical Coder

Charlotte Surgical Group

Nov 2005 - Nov 2007 (2 years)

Accurately coded general/vascular surgery encounters using CPT, ICD-9, and HCPCS for facility and office-based procedures. Informed and educated physicians regularly on recent changes in healthcare coding and billing issues.

Medical Coding CPT ICD 9 HCPCS Surgical Coding Charge Capture E M Coding & Compliance Provider Education

Reimbursement Specialist

Dilworth Surgical Specialists

Jul 2001 - Oct 2005 (4 years 3 months)

Posted surgical and office visit charges using current/valid CPT and ICD-9 codes, managed payments and adjustments, and audited EOBs to ensure claims were processed per contractual agreement. Researched and appealed underpaid, unjustly keyed, or denied claims and supported billing via EDI and CMS-1500 while maintaining AR aging for insurance and patient responsibility.

Medical Billing CPT ICD 9 EOB Auditing Appeals Insurance Follow Up Patient Billing

Patient Account Representative

Sentara Health Systems

Mar 1999 - Jul 2001 (2 years 4 months)

Supported inpatient and outpatient account follow-up for multiple local hospitals, including requesting claim reprints/rebills and updating insurance and demographic information. Worked with patients, insurance companies, and physicians to advance commercial insurance follow-up and resolution.

Medical Billing Insurance Follow Up Claims Processing Customer Service Patient Accounts Demographic Updates Claim Rebilling Insurance Coordination