Rachel Shelley Rn

Rachel Shelley, RN, CRC, CPC, currently serves as the Manager of Risk Adjustment Coding at Capital Blue Cross since January 2022, previously holding the position of Government Programs Senior Nurse Coder. Rachel's extensive experience includes working as a Clinical Quality Management Analyst at Highmark Health, Lead Clinical Review Analyst at AdvanceMed Corporation, and Medical Review Lead Nurse at Novitas Solutions, Inc. Notable skills include reviewing and analyzing complex healthcare claims, ensuring accurate coding compliance with ICD-9, ICD-10, CPT, and HCPC standards, and coordinating educational interventions to enhance staff performance in medical decision-making. Prior experience as a Registered Nurse at Lewistown Hospital involved delivering patient care in emergency situations and managing both physical and psychosocial patient needs.