DEJA B. LEWIS
Prairieville,LA
Summary
Certified Professional Coder (CPC) with 10+ years of progressive healthcare experience spanning clinical care, medical coding, claims adjudication, and documentation integrity. Expertise in ICD-10-CM and CPT coding, medical necessity validation, and payer policy compliance. Leverages strong clinical background as a Certified Medical Assistant to ensure accurate code assignment, reduce denials, and support audit-ready documentation.
Overview
13
13
years of professional experience
Work History
Claims Specialist I – ITS CLAIMS OPERATIONS
BLUE CROSS BLUE SHIELD OF LOUISIANA
09.2022 - 09.2025
- Validated ICD-10-CM and CPT codes for professional and facility claims in accordance with CMS and payer guidelines.
- Identified coding discrepancies and documentation gaps, reducing claim rework and denials.
- Contributed to a 20% improvement in claim turnaround time through proactive error detection.
- Supported internal audits and met quality and productivity benchmarks.
- Intake Coordinator I – Clinical Inquiry
- Reviewed pre-authorization requests for coding accuracy, medical necessity, and documentation completeness.
- Verified diagnoses and procedures using Jiva, Facets, and SharePoint.
- Supported initiatives that reduced approval delays by 15%.
- Account Advisor I – ITS Provider Services
- Resolved complex provider claim escalations through interpretation of coding and documentation requirements.
- Educated providers on documentation and coding best practices.
- Exceeded performance metrics for accuracy and productivity.
Certified Medical Assistant
OCHSNER MEDICAL CENTER – Urgent Care
05.2021 - 09.2022
- Supported real-time clinical documentation in EpicCare EMR to improve CPT and ICD-10 accuracy.
- Assisted with procedures, point-of-care testing, and medication administration.
- Partnered with providers to enhance documentation quality and billing accuracy.
Certified Medical Assistant
OUR LADY OF THE LAKE HOSPITAL – Pediatric Orthopedics
01.2015 - 05.2021
- Supported orthopedic providers with fracture care and in-office procedures.
- Streamlined documentation processes to improve downstream coding accuracy.
- Collaborated with billing and coding teams to resolve claim issues.
Registered Medical Assistant
ST. ELIZABETH PHYSICIANS CLINIC
10.2012 - 03.2014
- Provided direct patient care and maintained accurate EHR documentation for billing support.
Education
Certificate - Professional Coding
Central Louisiana Technical College
Alexandria, LA03.2025
Certificate - Medical Assisting
Remington College
Baton Rouge 11.2012
Skills
- Medical Coding & Billing (ICD-10-CM, CPT)
- Modifier Application (-25, -59, -26)
- Claims Adjudication & Denial Prevention
- Medical Necessity Validation
- Clinical Documentation Integrity (CDI)
- Coding Audits & Quality Assurance
- Regulatory Compliance (CMS, URAC)
- Data Analysis & Quality Reporting
- Healthcare Information Systems
- EpicCare Ambulatory EMR
- Facets
- Jiva
- Edifecs
- Blue2
- Common Query
- SharePoint
- NPI Registry
- FEP Direct
- Microsoft Word, Excel, Outlook
Timeline
Claims Specialist I – ITS CLAIMS OPERATIONS
BLUE CROSS BLUE SHIELD OF LOUISIANA
09.2022 - 09.2025
Certified Medical Assistant
OCHSNER MEDICAL CENTER – Urgent Care
05.2021 - 09.2022
Certified Medical Assistant
OUR LADY OF THE LAKE HOSPITAL – Pediatric Orthopedics
01.2015 - 05.2021
Registered Medical Assistant
ST. ELIZABETH PHYSICIANS CLINIC
10.2012 - 03.2014
Certificate - Medical Assisting
Remington College
Certificate - Professional Coding
Central Louisiana Technical College