Consulting company. President and Founder August 2020 – Present
• Successfully guide businesses through complex regulations by implementing, simplifying, and managing risk with a scaled approach to meet an organization's compliance and regulatory needs.
• Plan and execute compliance work plans that are practical, efficient, and a good fit for the business culture.
• Identify the root cause of payer denials and workflow problems and target revenue integrity tough spots. Assist organizations in corrective processes to prevent future payer denials.
• Develop information governance plans documenting critical elements that provide direction and enhance decision-making procedures.

• Partnered in compliance program and risk assessments to capture and assess accurate, comprehensive documentation in compliance and revenue cycle workflows. I assisted with developing compliance work plans governed according to regulatory standards.
• Conducted research and wrote monthly industry articles covering regulatory updates.

• Facilitated new chargeable items and service lines for billing operations while maintaining quality and compliance standards.
• Directed hospital and physician new service lines and charges, including implementation of project—development
dashboards, leadership reports, and presentation materials through Microsoft Teams.

• Initiated insight and guidance on coding and billable charges related to government and third-party payers.
• Developed policies and procedures to support and govern an efficient, accurate, and compliant chargemaster.

• Conducted compliance audits and developed internal controls to promote adherence to applicable federal and state laws and private health plan requirements.
• Analyzed compliance risk to determine proactive measures and education to support organizational compliance with associated regulations.

• Applied clinical expertise in utilization review and coding applications to manage over $25M in insurance-payer healthcare audits.
• Developed tools and managed software systems to track and trend inpatient/outpatient and clinic denials and rejections, creating actionable plans to avoid, reduce, and resolve payor denials.
• Implemented Intersect Healthcare Veracity Denials Management Software system to track and trend denials and appeals workflow and facilitated an internal physician advisory pathway to respond to overpayments and accelerate process improvement objectives.
• Functioned as a liaison between audit contractors and insurance payors to enforce regulatory compliance and contract provisions.

• Directed the HIM operations and workflow of a Critical Access Hospital (CAH) by analyzing data and focusing on opportunities to improve the health information documentation workflow, identify and correct chargemaster errors, implement quality improvement metrics, and provide health professional and board education.
• Oversaw the medical and ancillary staff documentation, insurance enrollment, credentialing privileges, and claim reimbursement.
• Improved HIM operations through computer software and system upgrades, policy and procedure updates, medical staff bylaw revisions, health record audits, state reporting submissions, and quality metrics implementation.