Expert Details

Medical Billing, Coding, and Bill Auditing

ID: 741006 Florida, USA

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Expert is a medical bill auditor and Certified Professional Coder with more than 35 years in medical billing, coding, and auditing. She holds a Doctorate in Health Services with a concentration in Public Health Policy from Walden University and an M.S. in Business Administration from Strayer University.

Expert's career covers both sides of the claim. On the provider side, she audited and trained more than 120 physicians at Essentia Health on E&M, ICD-10, and HCC coding, served as a compliance auditor and RAC liaison at Greater Baltimore Medical Center, and audited physician practices for Baptist Health. On the payer side, she built the claims and audit operation at MedStar Family Choice and spent more than three years investigating fraud, waste, and abuse in Centene's Special Investigative Unit. She has also worked revenue recovery projects for Duke University Health System.

Since 2023, Expert has worked as a medical bill analyst, testifying on the reasonableness of medical charges. In about 20 months she gave 99 depositions and trial appearances in Florida, Texas, Oklahoma, and federal court. She has taught billing and coding for more than two decades, most recently at Hillsborough Community College.

Education

Year Degree Subject Institution
Year: 2025 Degree: Ph.D. Subject: Health Services, Concentration in Public Health Policy Institution: Walden University
Year: 2005 Degree: Master of Science in Business Administration Subject: Business Institution: Strayer University
Year: 1996 Degree: Bachelor of Science in Management Subject: Management Institution: Coppin State College

Work History

Years Employer Title Department
Years: 2023 to Present Employer: Undisclosed Title: Consultant, Medical Bill Analyst and Auditor Department: Med Legal
Responsibilities:
Audit medical bills and provide expert testimony on medical billing in litigation.
Years Employer Title Department
Years: 2025 to 2026 Employer: Hillsborough Community College Title: Adjunct Faculty, Medical Billing and Insurance Department: Health Services
Responsibilities:
Taught medical billing and insurance concepts from the approved curriculum, primarily online.
Years Employer Title Department
Years: 2023 to 2024 Employer: Baptist Health Title: Physician Practice E&M Auditor/Educator Department: Compliance
Responsibilities:
Audited physician billing and educated providers on Evaluation and Management coding, ICD-10 diagnosis coding, and inpatient code selection, then prepared audit reports and post-audit provider education.
Years Employer Title Department
Years: 2019 to 2023 Employer: Centene Title: Medical Coding Auditor Department: Special Investigative Unit (SIU)
Responsibilities:
Investigated allegations of potential fraud, waste, and abuse under state and federal policies, documented each investigation, and referred findings to the appropriate authorities.
Years Employer Title Department
Years: 2016 to 2023 Employer: Central Lakes College: Minnesota North Title: Adjunct Faculty, Advanced CPT and ICD-10-CM Department: Health Services
Responsibilities:
Taught advanced medical coding courses online.
Years Employer Title Department
Years: 2014 to 2019 Employer: Essentia Health Title: Senior Coding Partner Department:
Responsibilities:
Audited and educated more than 120 providers on E&M, ICD-10, and Hierarchical Condition Category (HCC) coding. He developed system-wide training material and coding tools, monitored compliance with government and third-party billing rules, and worked with EHR analysts to build compliant provider coding templates.
Years Employer Title Department
Years: 2013 to 2013 Employer: Duke University Health System (via ITI Healthcare) Title: Implementation Consultant (Contractor) Department: PRMO Division
Responsibilities:
During the health system's move to EPIC, compared the legacy and new systems to audit and resolve denied inpatient claims and recover revenue.
Years Employer Title Department
Years: 2011 to 2012 Employer: Greater Baltimore Medical Center Title: Compliance Auditor Department:
Responsibilities:
Performed audits set by the Internal Audit and Compliance Committee, trained new employees and medical residents on compliance and E&M documentation, supported the Central Billing Office, and served as the Recovery Audit Contractor (RAC) liaison.
Years Employer Title Department
Years: 2009 to 2011 Employer: MedStar Family Choice Title: Claims Manager and Auditor Department:
Responsibilities:
Built the health plan's claims and audit infrastructure, audited external vendors (claims, lab, pharmacy, ophthalmology, and substance abuse), wrote claims policies, and reviewed provider documentation for fraud and risk, reporting findings to the Compliance and Executive committees.
Years Employer Title Department
Years: 2009 to 2014 Employer: University of Phoenix Title: Adjunct Faculty Department: Health Services
Responsibilities:
Taught EMR, medical billing, and medical coding online.
Years Employer Title Department
Years: 2007 to 2009 Employer: Duke University Health System (via ITI Healthcare) Title: Contractor Department: PRMO Division
Responsibilities:
Trained new staff on billing and auditing, analyzed accounts receivable and denied claims, and tracked payer trends and compliance issues.
Years Employer Title Department
Years: 2004 to 2007 Employer: CCI at Johns Hopkins University Title: Senior Medical Administration Instructor Department:
Responsibilities:
Taught EMR, medical billing, medical coding, and claims processing, and recommended curriculum updates.

Additional Experience

Expert Witness Experience
Medical billing expert witness with experience providing testimony for the defense across roughly 75 cases: 75 depositions, 14 de bene esse (preserved trial testimony) depositions, and 10 trial appearances in Florida, Texas, Oklahoma, and a current case in California (as of 2026).

Career Accomplishments

Associations / Societies
• American Academy of Professional Coders
• American Medical Billing Association
• Community Engagement Board Member, Curriculum Advisory Committee
Licenses / Certifications
Certified Professional Coder (CPC), American Academy of Professional Coders
Publications and Patents Summary
Consultant Reviewer for Stedman’s Medical Dictionary for the Health Professions and Nursing, 6th Edition, Illustrated, 2007.

Fields of Expertise

Expert medical billing, medical billing, Medical Billing and Collections, medical coding, Audit, Healthcare claims, Healthcare Claims Auditing, Healthcare Consultant, Healthcare Reimbursement, hospital claims, medical reimbursement, Compliance Audits, medical bill auditor, Certified Professional Coder, CPC, CPT coding, ICD-10-CM, inpatient coding, HCC coding, E&M auditing

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