Debra Pierce has a diverse background in the healthcare industry that includes provider and payor operations, compliance, and consulting with clinical and business acumen. She has broad expertise across specialties, disciplines, and settings, with special focus on medical coding and reimbursement, including E/M, CPT, ICD-10-CMPCS, HCPCS Level II, HCCs, revenue codes, and modifier application. She has led functions across the revenue cycle — encompassing coding, billing, documentation, auditing, compliance, medical necessity, charge entry, reimbursement, and denials — while leveraging data analytics and research to drive accuracy, insights, and operational improvement.
Debra is well-versed in regulatory and compliance frameworks, including guidance from HHS OIG, CMS, LCDsNCDs, NCCI edits, and other industry standards. She has supported audit and compliance initiatives involving attorney-client privilege, expert witness engagements, litigation support, self-disclosures, CIAs, IRO reviews, FWA matters, PATH and NPP requirements, payor disputes, RADV audits, transactional due diligence, and outsourced internal audit functions. She has designed and executed statistically sound sampling and extrapolation methodologies using tools such as RAT-STATS and has operated within extensive EMR and Financial Management Systems.
She has consulting experience from independent to Big Four environments, frequently retained by or through health law attorneys on behalf of payors or providers for legal and regulatory matter healthcare expertise. Prior to joining Stout, Debra was a Senior Manager at Forvis Mazars, LLP where she managed and executed healthcare clinical documentation and coding compliance engagements for a range of client types on recurring and special project bases, including internal compliance, transactional coding due diligence, performance improvement, third-party audit, investigational, educational, and disclosure purposes. She has also held consulting positions at Informa Pharma Intelligence, Crowe, LLP, and Ernst & Young, LLP.
Practice Areas
Focus Industries
Education
Preliminary Surgery Residency, Michigan State University Department of Surgery
M.D., University of Cincinnati College of Medicine
M.B.A., Ohio University
B.S., Biological Sciences / Pre-Medicine, Wright State University
Licenses & Designations
Professional Coder (CPC) and Instructor (CPC-I)
Professional Medical Auditor (CPMA)
Risk Adjustment Coder (CRC)
Certified Coding Specialist (CCS)
Revenue Cycle Representative (CRCR)
Specialist Payment & Reimbursement (CSPR)
Professional Memberships
American Academy of Professional Coders (AAPC) – Member
OH Local AAPC Chapter, Member and Past Multi-Term Education Officer, Columbus
2008 AAPC Region 6 & Local Chapter Coder of the Year Award Recipient
American Health Information Management Association (AHIMA) – Member
Ohio Component Association (OHIMA) – Member
Healthcare Financial Management Association (HFMA) – Past Member
Central Ohio HFMA Chapter, Past Committee Member, Communications Co-Chair
The Institute of Internal Auditors (IIA) – Past Member
American College of Surgeons (ACS) – Past Member