Karen Pickering

Karen brings over 30 years of experience in coding, auditing and mentoring to hospitals and other healthcare facility clients. Karen performs inpatient and outpatient hospital coding and billing reviews for a multitude of healthcare settings to ensure correct, compliant coding and reimbursement practices.  She has also performed documentation gap analysis for ICD-10 coding during the Centers for Medicare and Medicaid’s (CMS) implementation phase. She assists clients in reviewing accounts subject to scrutiny by the client’s Recovery Audit Contractor (RAC), as well as preparing responses and/or appeals to inquiries when warranted. Karen is proficient in ICD-10-CM/PCS, all ICD-9-CM and CPT/HCPCS coding. Utilizing her array of skills, she has provided training and mentoring for client staff, clinicians and her fellow coding professionals. 

Karen has consulted for the healthcare industry since 2008.  Her previous experience allows her to offer monthly education webinars for coders of various backgrounds and lead and participate in client exit interviews with hospital administration to discuss the findings, observations and operational risk impacts. Attendees of those meetings often include compliance officers, compliance professionals, finance executives, HIM management and staff. Karen is also the sole proprietor of Elite Coding Services where she conducts on-site and remote MS-DRG, RAC, APC, Rehabilitation, Partial Hospitalization and CMS's Hierarchical Condition Categories (“HCC”) audits. In a previous role, she created an HCC Risk Adjustment program for a large Independent Practice Association (IPA) medical group where she conducted coding audits, provided education and sourced a coding ‘hotline.’ She also possesses skills to conduct data analysis to identify trends with help from Information Technology experts.

Karen is a Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS) and member of the American Health Information Management Association. She completed a Medical Record Technology independent study through the AHIMA in Chicago, IL and received her AHIMA CCS Certification through Cypress Community College in Cypress, CA.