Cheryl Heidebrink

Experience

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  Mercy Health Partners

  May 1999 - Jun 2008

  Precertification Nurse

   Responsibilities include reviewing and assessing the medical record for medical necessity of stay and determining the appropriate status for that stay.  Worked closely with the physician offices and other departments to facilitate the patients admission / testing. Working knowledge of DRG, ICD and CPT coding. Extensive experience with medical insurance companies in the precertification process. Development of policies and procedures.  Developed and designed the website for the precert department.  Representative at the monthly insurance resource committee meetings.  Member of Standards of Behavior Committee Show less

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  Mercy Health (formerly Catholic Health Partners)

  Jul 2008 - Nov 2010

  Case Manager

  Responsibilities include utilization review management. Expertise in the application of InterQual criteria to ensure appropriateness of stay. Communication with the physician advisor team for medical necessity determination.Complete requirements and notification as required by the managed care organization.Conducted webinar on MIDAS database system for new users of the system.Represent Case Management at the monthly utilization review committee meeting.

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  CGIFederal

  Dec 2010 - now

  Registered Nurse Trainer

  My responsibilities include development of and training for the Clinical Audit Team, including new hire training and continuing education and maintaining the training plan and training calendar to keep team leads and management aware of the plan.I create power points, quick guides and training tips to assist the auditors in learning new subject matter. After the training is completed, I provide training support to the auditors to ensure retention of the subject matter. I coordinate with the training team in the development of Inter-rater reliability quizzes after a training session is completed. If required, I provide detailed training support to an auditor that needs additional training and training support to increase their quality and productivity. Collaborates with QA team and Appeals team to identify training needs and issues. Show less