Data Collection Process Improvement
Resume:
National Certified Investigator
And Inspector Training (NCIT)
Basic :
Credly.com
Council On Licensure,
Enforcement And Regulation
Online
Lodestar American Express
Leadership & Nonprofit
Management:
Nonprofit Management
Arizona State University
Tempe, AZ
Bachelor Of Science:
Allied Health Sciences
Northern Arizona University
Flagstaff, AZ
********@*****.***
Fountain Hills, AZ 85268
Skills
• Interview Techniques
• Data Collection and Analysis
• Team Building and Leadership
• Client Relationship Management
• Documentation and writing
• Process Improvement
Education And Training
Websites, Portfolios,
Profiles
https://www.linkedin.com
/in/reneemariedittlof
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Adaptable self-starter focused on client satisfaction through problem resolution. Highly organized; successful multitasker, collaborator and negotiator. Arizona Medical Board & AZ Regulatory Board Of PAs - Sr. Medical Investigator 10/2021 - Current
Successes: Passed Council on Licensure, Enforcement and Regulation (CLEAR) NCIT BASIC exam within 90 days of hire.
Arizona State Veterans' Home - Business Office Manager 07/2016 - 07/2021
Successes: Revised census tracking tool and educated staff in accurate census disposition.
Renee Dittlof
Summary
Experience
Prepare cases with pertinent investigative materials for referrals for medical consultants, Board or written reporting.
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Review complaints of quality of care and professional conduct from sources such as: NPDB, MICA, Hospital Medical Staff, FSMB, other providers and community.
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Assign appropriate allegations and corresponding Statutes to provider notice letters.
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• Manage a high volume of cases, 110 to 130, in varied stages of completion. Prepare and testify at Administrative Law Judge hearings and monthly Board meetings.
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• Lead patient/provider interviews as necessary.
Plan, develop and implement investigative processes and procedures for organize case information.
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Gather, convert and analyze data from the Pharmacy Management Program using spreadsheets and pivot tables.
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Successfully passed annual Social Security, Insurance, Veterans Administration, DHS onsite audits and inspections.
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Recouped A/R of $100,000+ by researching coverage and eligibility issues and by collaboration with Veteran Benefits Coordinator and Prescription Benefits Manager.
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Hired, trained, counseled and coached staff, performed annual reviews and monthly one on ones and annual performance evaluations.
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Initiated and verified physician and ancillary vendor contracts, approved invoice requisitions for Procurement.
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Timely and annually completed Cost Report - submitted CMS 671 report for State Survey.
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• Annually updated Urban rates, HIPPS, RUGS, Room rates and Ancillaries charges. Utilized multiple software programs: EHR; AFIS; Arizona Procurement, AHCCCS, Noridian.
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Private Practice - MDVIP Concierge Practice Manager Scottsdale, AZ
07/2014 - 07/2016
Pinnacle Healthcare Facilities - Assistant Business Manager Mesa, AZ
04/2013 - 07/2014
Business Enterprise Mapping - Document Control Specialist Scottsdale, AZ
06/2009 - 04/2013
HealthSouth Rehabilitation - Health Information Manager 04/2003 - 07/2009
Provided administrative, operational and computerized guidance and support to patients and staff.
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Analyzed reports, guided physician, staff on Meaningful Use and Physician Quality and Reporting Standards.
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• Successfully recouped Stage 2 EHR full reimbursement from CMS. Audited coding and billing financials. Guided billing on Medicare reimbursement guideline.
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Performed credentialing and compliance, including HIPAA, NPI, DEA, Insurance, GACCP and contracted Insurance.
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• Validated HL7, RX Hub and fax modem interface and operational functions. Maintained current working knowledge of CPT 3-4 and ICD 9-10 coding principles, government regulation, and third-party billing requirements.
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Resolved account issues through investigating; collaborating with Insurance case managers, ATLCS, and SSA.
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Ensured correct payer source, screened admissions for financial risk, utilized AHT EHR, Noridian, AHCCCS data.
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• A/R, A/P, Cash posting, reconciled accounts, conducted written appeals.
• Prepared month-end closing.
Cooperated with local service providers, outreach workers, case managers and agencies to facilitate services for members.
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• Managed document processes through modifying Adobe pdf.
• Submitted project documentation in Smartsheet.
• Prepared training booklets for business process improvement mappers. Utilized document control database system to allow for better tracking and revision identification.
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• Sole Inpatient and Outpatient coder of 50 bed facility.
• Hired and onboarded team members to meet immediate and expected demand. Established solid relations with leadership and staff by attending board meetings and coordinating interdepartmental information exchanges.
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• Maintained records management system
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