Lisa Compton, RN

**** *** ***, *** *******, TX **232

210-***-****

acztb4@r.postjobfree.com

CAREER SUMMARY

A Healthcare Leader with over fifteen years of progressive leadership and management experience. A proven leader with an intense focus in building positive hospital department relationships, fostering physician relationships, quality management, reduction in denial costs, positive impact on DNFB and productivity enhancement. Denial defense expertise, process expert, strategic denial reduction planning & re-engineering with the ability to initiate positive changes.

EDUCATION

2017 BSN University of Phoenix

1989 ADN Hardin-Simmons Abilene, Texas

PROFESSIONAL EXPERIENCE/ACHIEVEMENTS

2015 – Current MedPartners Consulting

Munroe Regional Hospital, (Community Health System) Current Assignment

Denial Management Nurse Consultant

Munroe Hospital is 420 bed hospital located in Ocala, Florida

At the request of Community Health System Corporate Case Management, design and implementation of a Denial Management Department reporting to the CFO and working in conjunction with the Central Business Office and the Case Management Department

Long Island Jewish Health, (Northwell Health) Assignment: October 2015 thru 2016

Denial Management Nurse Consultant

Long Island Jewish Hospital System, not-for-profit teaching hospital serving the greater metropolitan New York area. RAC 2nd Level Appeals Nurse for 11major hospitals; Outpatient Chemotherapy Denials for the Monter Cancer Center; Reports to VP of Revenue Cycle.

Development of Patient Safety Indicators (PSIs) Database

Physician Education for Clinical Documentation Improvement

Reduction in DNFB through 1 day stay Audits

Focus on 2 Midnight Rule Case Management Education

Process Improvement Implementation Project for Montier Clinic

2014 – 2014 Abilene Regional Hospital Abilene, Texas

Nurse Supervisor Women & Children’s Services/Interim Department Director

200+ bed for profit hospital; Improved Case Management & Admitting process ensuring correct patient status due to increase in patient volume; Member of Unit Base Council & March of Dimes

Oversite of 5 Departments & 95+ Employees

32 Bed Antepartum, Postpartum beds

12 Bed Labor & Delivery

16 Bed Level III NICU with full transport service – only one in 150 mile radius

140 Deliveries per month

Increased by 40% with the addition of two established OB-GYNs

Employee base increase by 30%

Implementation of Employee Orientation Program for new Graduates

2008 – 2014 Baptist Health System San Antonio, Texas

Director Denial Management Department

Recognized leader in Healthcare with 5 acute care facilities in San Antonio encompassing over 900+ beds, 2 facilities in the Valley; Recognized as high-performing in services for COPD, Colon Cancer Surgery, Heart Failure, Hip & Knee Replacement; Reported to VP of Business Services

Project Manager - Denial Management Department

All Inpatient Denials, HIM Audits, RAC & State Medicaid Audits

$1.7 million recovered in the first year

75% Recovery rate across all lines of Business

100% Recovery Rate with Medicare’s ALJ

100% Reduction in CMS Focus Study Audit for Orthopedics

Active Participant in Medicare Demonstration Project for Cardiology & Orthopedics

Extensive Physician Teaching

Contract Negotiations with a 45% reduction in Admission Denials

Pre-Denial Pilot Program with a savings of $22 million dollars over nine months

Reduction in DNFB with Process Improvement for 1 day stays

Denial Management Orientation for All 28 Vanguard Facilities

2005 – 2008 Humana Healthcare San Antonio, Texas

Supervisor of Outpatient Appeals

Oversite for all Southern & Western US Region for Humana PPO, HMO & Humana Medicare, from Texas to Hawaii; Previous Appeal Nurse Liaison for VIP Fort Automotive Contract for the states of Kentucky and Ohio prior to promotion to Outpatient Appeals.

3 calendar day turn-around time for all Appeal Requests

Worked with Automotive Union Reps in Kentucky & Ohio

Responsible for all regulatory compliance URAC, & ERISA governing Appeals

Implementation of IT tracking program for Appeal deadlines

2004 – 2005 Muro Health Consulting San Antonio, TX

Nurse Administrator Ryder HMO Family Practice Medical Group

Delivering care to thousands of seniors with Secure Horizons, UHG. Direct oversite for all clinics & clinical as well as non-clinical employees. Actively worked with Marketing initiatives to recruit & maintain members.

9 Clinics

16 Physician; 1 PA

85+ Employees

Implemented centralized nurse triage for all clinics; decrease hold times by 40%

2000 – 2004 NorthEast OB-GYN San Antonio, TX

Nurse Manager

Established OB-GYN Practice since 1977. Direct clinical oversite for all locations. Supervision and training for all clinical employees

4 Clinics

25 Clinical Employees

9 Physicians seeing approximately 100 patients per day per clinic

Revision of Policies & Procedures

Responsible for all hiring, training & termination for all clinical employees

1989 – 2000 Various Nursing Positions San Antonio & Abilene, Texas

Charge Nurse, Family Planning Supervisor, Private OB-GYN Clinic Nurse

27 as a Registered Nurse

16 of Managed Care & Commercial Experience

6 years Revenue Cycle Experience

Worked in all areas of administrative health care:

Inpatient hospital

Outpatient physician office administration

Public health

HMO physician practice.

Valedictorian of Nursing Class 1989

References Available Upon Request

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