Experience

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  Palo alto medical foundation

  Oct 2004 - Oct 2015

  ● Spearheaded and successfully piloted Dedicated Coder Program involving on-site engagement with hundreds of physicians, providing firsthand training in medical record documentation, coding, and billing practices. Resulted in clinical documentation integrity, increased revenue, reduced incorrect/false claims, and denials.● Lead Trainer for Analysts I & II providing oversight and quality assurance, troubleshooting, and providing solutions for daily coding, billing and documentation issues, provider outreach, training, and education.Key Achievements: ● Launched and ran a one-year program with full oversight working at the elbow with Physicians; implemented process improvements and variation reductions in procedures and workflows. This resulted in clinical documentation integrity, reduced incorrect claims, and 75% reduction in back-end edits.● Mentored and upskilled dozens of new and existing employees on optimizing engagement with physicians, department workflows, coding guidelines and evaluating and augmenting work queue edits.● Educated thousands of clinicians at various stages of their career on how to use the EHR, document for services performed, and precise reporting of procedures and diagnoses Show less

  • Auditor & Educator

    Oct 2008 - Oct 2015

  • Patient Account Representative

    May 2007 - Oct 2008

  • Receptionist

    Oct 2005 - May 2007

  • Medical Records Clerk

    Oct 2004 - Oct 2005
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  Sutter health

  Oct 2015 - Jan 2020

  ● Project Owner (PO) for Epic Electronic Health Record (EHR) Copy & Paste functionality, led project roll out team in defining guidelines for the safe/effective use of the tool, created a system policy. Partnered with MD stakeholders to enhance compliant adoption, engaged IT to create Epic Crystal reports leveraging transparency in tool usage, mitigated risk to providers and patients. ● PO for Modifier 25 education spanning across 5 affiliates, collaborated with leadership, third party vendor and multiple cross functional stakeholders to ensure seamless seminars. Monitored usage across the enterprise, provided case studies used as live examples, POC for issues, reviews, questions leading up to & stemming from sessions, created a system policy. ● PO for high-risk project impacting acquisition of free-standing psych hospital. Curated project plan and delivered multi phased education to providers, updated/created charge capture documents, and provided recommendations for internal control measures. Resulted in clinician wide education, compliant billing/coding, and mitigated imminent future risk.● PO for all Billing & Coding policies affecting enterprise. Led team in auditing, revising, creating, and deleting policies; interviewed dozens of policy owners representing active polices to ensure accuracy.Key Achievements:● Took EHR Copy & Paste from immaturity with no safeguard to a viable tool w/ ongoing metrics for monitoring; system policy implementation, compliant physician adoption, drastic decrease in time spent charting.● Revamped Rev Cycle process for an acquired affiliate, resulting in compliance without the ability to utilize technology and automation due to dated systems.● Educated thousands of clinicians, coders, leadership on accurate use of Modifier 25, an ongoing issue under scrutiny with the OIG, CMS, and DOJ. Implemented internal controls, reinforced revenue integrity, decreased incorrect claims and safeguarded patients from improper claim filings. Show less ● Mitigated risk within Sutter Health's Ethics and Compliance Services (ECS) by conducting auditing and monitoring activities to identify potential compliance risks, conducting in-depth research, and leading investigations.● Managed corrective action planning, authored comprehensive reports capturing both core and incidental findings, fostering process improvements, and ensuring accurate reporting.● Individual contributor to three Ethics and Compliance workgroups, assisting in the achievement of target objectives outlined in the 2016 work plan to support the Compliance Program.● Undertook ad-hoc projects for VPs, Directors, Managers, and Compliance Officers, including conducting panel interviews, aiding in investigations, and extrapolating metrics to inform future business strategies.Key Achievement:● Promptly operated at the level of Senior Auditor, within 15 months recruited and promoted into Data & Coding Compliance Consultant role via Director of ECS. Show less

  • Data & Coding Compliance Consultant

    Feb 2017 - Jan 2020

  • Compliance Auditor- Ethics & Compliance Services

    Oct 2015 - Feb 2017
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  Blue shield of california

  Sept 2020 - May 2022

  Provider operational governance consultant

  ● Led teams in Corrective Action Plan’s (CAP) to address systemic discrepancies stemming from the Consolidated Appropriations Act (CAA), targeted departments to collaborate with to enhance provider and patient transparency and experience, addressed root causes, and achieved measurable improvements including reducing TAT from 90 days to two days.● Identified opportunities for improvement and worked cross-functionally to develop business solutions, assessed accuracy of business rules in effect to alleviate customer abrasion and increase efficiencies.● Engaged with clients daily to deliver educational content complying with system and regulatory guidelines.● Arbiter of Open Enrollment Tiger Team; monitored, tracked, and resolved hundreds of multifaceted incidents systemically affecting the enterprise. Key Achievements: • Led Operational Governance practices defined by the Consolidated Appropriations Act and created a hybrid approach to addressing systemic issues while simultaneously enhancing transparency with stakeholders.• Increased access to care for millions of members and provided resolution of issues or complaints specific to Provider Network Data.• Trained Senior Analysts on monitoring incidents affecting the enterprise, optimizing cross collaboration to remediate incidents, and reporting to our business partners. Show less

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  Divurgent

  May 2022 - Dec 2023

  Talent acquisition recruiter

  ● Partnered with senior leadership on strategic business planning for competitive assessments, service offerings roadmap, maximizing & enabling sales, risk assessments and lessons learned.● Creation of documents in support of repository and source of truth for broadcasting jobs from Target Recruit (CRM) to LinkedIn, procedural enhancement overview for C2C consultants, improvements for Client Service intake from clients, and process overview for engagement with VMS accounts.● Cultivated and maintained strong relationships with Client Service VPs to scale sourcing of top talent and sustained candidate pipeline via routine candidate engagement. ● Efficiently managed up to hundreds of applicants, through an average of ten active candidates from initial contact, negotiations, delivery of comprehensive job offers, Statement of Work (SOW) documents, through post-interview follow-up and onboarding.● Successfully recruited and placed dozens of high caliber candidates, resulting in notable increased revenue to Divurgent, positions included Senior Epic Business Intelligence Developers, Predictive Healthcare Product Managers, Principal Trainers, Epic Certified HB Billing & Claims Analysts, Agile Implementation Program Managers, Predictive Healthcare Scrum Master Project Managers, Senior Optimization Project Managers, Medi-Cal Compliance & Business Analysts, Epic Implementation Directors, BPO Claims SMEs, and Communications Strategists.Key Achievements: • Led process improvements and created procedure documents for optimization of broadcasting jobs from CRM, C2C onboarding, client service intake and engagement with VMS accounts. • Collaborated with senior leadership to maximize and enable sales by identifying gaps in client and candidate experience resulting in client retention and amplified candidate experience. • Pivoted and recruited into Talent Acquisition, successfully recruited and placed dozens of consultants and generated company revenue and growth. Show less

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  Uc davis health

  Jan 2024 - now

  Clinical applications trainer

  ● Mitigates risk to the organization via cross- functional collaboration and stakeholder management with Revenue Integrity Health Information leadership and Coding Quality Assurance leadership to identify, address and optimize workflows, providing education to coding staff and making recommendations for policy updates and implementations. ● Complex analysis and development of assessment processes, identifying inaccuracies, investigating improper conduct, and delivering valuable quality assurance insights to remediate. ● Curates and delivers educational content on guidelines, regulations, policies & procedures as they relate to observed patterns within workflows and enhancing process improvements.● Performs regularly scheduled and focused coding assessment reviews, maintaining highest Quality Assurance completion rates while providing support cross functionally. ● Tracks and trends data for various departmental committees and identifies future training needs; anticipates, develops, and updates staff educational curriculum.Key Achievements: • Promptly and continually built trust with varied stakeholders and provide mentorship and training to Providers, Executive Leadership and Coding staff.• Trending gaps in processes, and shedding light on areas of opportunity to reduce risk to the organization resulting in updated and reinforced policies and procedure artifacts. • Working cross functionally with revenue integrity and coding operational leadership to enhance and streamline workflows, engage employees in change management, and provide consultative review and feedback on operational gaps. Show less