RS

REBECCA SHEAFFER

ad28dd@r.postjobfree.com 843-***-**** Myrtle Beach, SC 29577

Salutations. I have been telecommuting with Cotiviti since 2022 and thoroughly enjoyed working for such an exemplary employer. I have been able to expand my very diverse skillset daily, have been presented with many opportunities for growth. My background includes 7 years as a Registered Respiratory Therapist, 5 years as an acute care Registered Nurse, and 9 years in Facility Medical Necessity Reviews, DRG Reviews, Clinical Validation Reviews, Reconsideration Reviews, and Appeal Reviews.

Document Management

Medical Record Security

Data Entry

Data Security Procedures

ICD-10-CM and ICD-10-PCS Coding

Electronic Health Record Applications

Medical Terminology

Patient Data Identification

Proficiency in Microsoft Suite

Certified Inpatient Coder

DRGs Patient Assignments

Protected Health Information

Records Review

EMR Systems

Records Scanning

Inpatient Coding

Cotiviti South Jordan, UT

Medical Coder, CIC

10/2022 - 08/2023

Work autonomously to investigate, review, and provide coding in the application of medical and reimbursement policies within the post-pay claims process. Perform complex conceptual analyses after precise extraction of key clinical and coding documentation. Apply relevant governmental regulation, payer protocols, and sanctioned coding guidance, determine case outcome and prepare detailed written correspondence with findings, when applicable. Optum Eden Prairie, MN

Post-Pay Facility Lead

02/2022 - 09/2022

Work autonomously to investigate, review, and provide coding and clinical expertise in the application of medical and reimbursement policies within the post-pay appeals adjudication process. Perform complex conceptual analyses after precise extraction of key clinical and coding documentation. Apply relevant governmental regulation, payer protocols, and sanctioned coding guidance, determine case outcome and prepare detailed written correspondence with findings, when applicable.

Optum Eden Prairie, MN

Senior Recovery/Resolution Analyst

10/2015 - 02/2022

Work autonomously to investigate, review, and provide coding and clinical expertise in the application of medical and reimbursement policies within the pre- and post-pay claims process. Perform complex conceptual analyses after precise extraction of key clinical and coding documentation. Apply relevant governmental regulation, payer protocols, and sanctioned coding guidance, determine case outcome and prepare detailed written correspondence with findings, when applicable.

Novitas Solutions Mechanicsburg, PA

Nurse Analyst

01/2012 - 06/2013

Perform retrospective medical necessity reviews and DRG audits, rendering decisions under the Recovery Audit Program using Centers for Medicare and Medicaid Services National Requirements as well as the Medicare Summary

Skills

Experience

Administrative Contractor local policies.

Pinnacle Health Harrisburg, PA

Registered Nurse, Acute Dialysis

02/2012 - 12/2012

Safely prioritize, implement, and complete hemodialysis, exclusively in the acute care environment. Efficiently and effectively construe changes in patient response to treatment and respond accordingly. Safely organize and institute peritoneal dialysis, when applicable. Provide caring and compassionate education and training to patients regarding disease process and therapy. York Hospital York, PA

Registered Nurse, Medical-Surgical Unit

02/2008 - 02/2012

Coordinate and provide direct patient care in an acute care medical setting utilizing the Relationship Based Care Nursing Model. Implement and adapt palliative and/or end-of-life care measures for patients entering the final stage of life. Efficiently, effectively, and thoroughly communicate patients care needs to Physicians, Allied Health Practitioners, and oncoming staff. Delegate care to patient extenders while overseeing the safety of care provided. Perform timely, thorough, and accurate documentation of all assessments, progress notes, plans of care, education, and ad hoc charting. Provide caring and compassionate communication and education to patients. Hanover Hospital Hanover, PA

Registered Respiratory Therapist

04/2003 - 02/2008

Provide respiratory based patient care in diverse medical settings including medical units, surgical units, intensive care, pediatrics, post-anesthesia care, acute rehabilitation, and emergency care. Provide caring and compassionate communication and education to patients. Operate and maintain associated respiratory machinery and laboratory equipment per hospital and governmental standards.

Hanover Hospital Hanover, PA

Registered Respiratory Therapist

04/1991 - 05/1993

Provide respiratory based patient care in diverse medical settings including medical units, surgical units, intensive care, pediatrics, post-anesthesia care, acute rehabilitation, and emergency care. Provide caring and compassionate communication and education to patients. Operate and maintain associated respiratory machinery and laboratory equipment per hospital and governmental standards.

Excelsior College Albany, NY

Associate of Applied Science in Nursing

05/2008

University of Maryland - Baltimore Baltimore, MD Master of Science in Microbiology/Molecular Biology 05/1999

York College of Pennsylvania York, PA

Bachelor of Science in Respiratory Therapy

05/1993

Certified Inpatient Coder (CIC), AAPC, 2017

Education and Training

Certifications

Contact this candidate