Experience

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  Various companies

  Jan 1990 - Jan 2014

  Other work experience

  Staff Physical Therapist – The Virginian, Fairfax, VA – 2013 to 2014Consulting Therapist – Nightingale Foundations, Bangalore, India – 2007 to 2011Supervisor of Physical Therapy, Various Facilities – Theracare, Munster, IN – 1997 to 2004Supervisor of Physical Therapy – Millers Merry Manor (NovaCare/Theracare), Hobart, IN – 1997 to 1999Supervisor of Physical Therapy – Meadowood Retirement Community (NovaCare), Bloomington, IN – 1996 to 1997Staff Physical Therapist – Health Professional International, Northwest Indiana – 1993 to 1996Staff Physical Therapist – Our Lady of the Resurrection, Chicago, IL – 1993 to 1994Chief Physical Therapist – State Leprosy Control, Gujarat, India – 1991 to 1992Physical Therapist – Home Health Care, Gujarat, India – 1991 to 1992Chief Physical Therapist – Gujarat Refinery Hospital, Baroda, India – 1991 to 1992Chief Physical Therapist – Shri Santram Physiotherapy & Polio Center, Nadiad, India – 1990 to 1991 Show less

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  Various home health agencies – northern virginia area

  Apr 2014 - now

  Physical therapist

  ➤ Successfully decreasing rehospitalization of high-risk patients by reducing fall risk, improving patient education, and advising patients/families on adverse side effects of medication.➤ Receiving consistent recognition as an exceptional clinician among peers and patients, while managing a diverse caseload of patients and establishing timelines to ensure reimbursement and prevent loss of company revenue.➤ Directly supervising PTAs and training new employees, as well as implementing the use of evidence-based outcomes in documentation and serving as the key facilitator for all organization PTs to incorporate these outcomes.➤ Contributing to care coordination and quality, patient-centered approaches through interdisciplinary planning.➤ Expertly providing PT evaluations and treatments to homebound patients, utilizing comprehensive care plans, innovative solutions, and preferred technology for point-of-care documentation. Show less

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  Legacy healthcare llc

  May 2014 - Dec 2016

  Rehab director

  ➤ Strategically directed and managed the overall operations of the Rehabilitation Department within a large Assisted Living community, including setting development goals and conducting ongoing evaluation on program effectiveness.➤ Implemented and enforced objectives measures, ensuring medical necessity and evidence-based practices in order to avoid over-utilization and to ensure reimbursement.➤ Coordinated site therapy personnel schedules and staffing needs, ensuring company efficiency standards and sufficient coverage, while ensuring staffing pattern met caseload requirements and adherence to State Practice Act requirements.➤ Successfully managed all Medicare claims reviews and denials, including coordinating ADR and appeals processes, as well as completed end-of-month billing and served as a resource for residents in regard to ancillary billing questions.➤ Effectively supervised and directed all Therapists in implementation of treatment plans, served as a resource to the multi-disciplinary staff, and collaborated with patients and families to implement individualized rehabilitation plans.➤ Supported MSMs, ARMs, and RMs with interviewing and hiring of new staff in accordance with company guidelines, as well as coordinated orientation and training of staff to meet company, State, and Federal standards. Show less

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  Lotus health

  Dec 2016 - now

  Utilization reviewer

  ➤ Working with various Home Health Care agencies in the area to provide reviews of processes and cases, including auditing Clinicians' charts to aid management with implementation of new documentation standards.➤ Coordinating directly with patient, family, physician, hospital, and other external customers with respect to the appropriateness of care from diagnosis to outcome.➤ Efficiently assessing patients' clinical needs against established standards to ensure that the level of care and length of stay are medically appropriate, while evaluating necessity, appropriateness, and efficiency of medical services provided.➤ Providing comprehensive, accurate, and independent medical peer reviews of charts for Medicare and private insurance, including ensuring compliance with documentation for Medicare B and home health requirements.➤ Utilizing clinical information, and knowledge of medical necessity criteria to effectively communicate plans of care to insurance case managers, facility staff, and healthcare partners.➤ Successfully coordinating and aiding in the implementation of care, as well as monitoring and coordinating services rendered outside of the network and local area, including negotiating fees for such services as appropriate.➤ Advocating for the member and family among various sites to coordinate resource utilization and evaluation of services provided, while encouraging member participation and compliance in the case/disease management program efforts.➤ Effectively interacting and communicates with multidisciplinary teams telephonically and in person, striving for continuity and efficiency as the member is managed along the continuum of care.➤ Understanding fiscal accountability and its impact on the utilization of resources, proceeding to self-care outcomes, while maintaining organized documentation in electronic health records and spreadsheet tracking systems. Show less