- Licensed practical nurse for 24 years, worked inpatient/outpatient care facilities in primary care, pediatrics, internal medicine and women’s health.
- Extensive anatomy and physiology knowledge. Seasoned in medical and clinical documentation as well as abstraction
- Clinical investigation > 3 years working with Optum Medicare Waste and Error operations. Review of clinical information, interpretation of coding guideline/requirements. Identifying over billing patterns, trends waste and errors.
- manages daily case assignments with an emphasis of quality.
- investigate, review and provide clinical and/or coding expertise in application of medical and reimbursement policies within the adjudication process.
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