Clinical Documentation Integrity Specialists.
Resume:
Linda Frederick RN
Maryville, TN 37803
adokhp@r.postjobfree.com
Professional Experience:
Rosewell Park Cancer Center, New York May 2021 to present
Clinical Documentation Specialist – Remote
Remotely review medical records of inpatient accounts for clinical documentation integrity.
Resolve discrepancies with coding staff before charts are bill complete.
Collaborate with other staff remotely regarding clinical documentation strategies.
Communicate with physicians, nurse practioners, and specialists regarding documentation clarification to capture severity of illness and risk of mortality.
Performant Corporation, San Angelo, TX Remote November 2018 to May 2021
Medical Review Auditor
Perform retrospective medical claim audit reviews for Government and Commercial payers.
Audit for medically appropriate services on inpatient settings.
Document all findings with support for appeals processing.
Experience with ICD-9, ICD-10 HCPCS coding.
Maintain high quality work while meeting strict deadlines. Excellent written and verbal communication skills.
Work independently and with team members effectively.
Blount Memorial Hospital, Maryville, TN September 1997 to Present
CDI Specialist October 2012 to Present
Involved in new CDI program at Blount Memorial, Trained with JA Thomas Associates
Use of CDMP/CDE One software along with references of 3M coding package / now Nuance CDE
Demonstrate leadership in partnering with physicians for improved documentation for quality reimbursement, Identifying HCC risk adjustment, SOI/ROM, and support Core Measures. Participates in regular education on new diagnosis, denial issues, and compliance.
Review denials from insurance companies and reconcile / rebill with documentation evidence for diagnosis billed
Clinical Validation / Concurrent medical record review to prove support of currently documented diagnosis.
Present educational sessions that will influence the physician's documentation practices
Query physicians in clarification for coding specificity
Capture Hierarchical Conditions Categories.
Experience with ICD-9 and ICD-10 Coding. Willing to obtain coding credentials if needed.
Work closely with coding staff to capture all coexisting co-morbidities, current diagnosis and procedures performed.
Work closely with nursing staff, case management, quality, and Hospitalists to resolve missing documentation needed for total patient acuity. Always available for team interaction.
Certified Clinical Documentation Specialist / a member of ACDIS
Attends regular Seminars and Conventions to obtain current information and practices.
Patient Care Coordinator - Cardiac Care and Surgical Intensive Unit April 2011 to October 2012
Monthly scheduling of employees, Oversee Unit function, work closely with staff, attend Critical Care meetings for standard of care
Employee Evaluations, Employee new hires
Mentor and Orientation of new employees
Monitor chart documentation compliance
House Supervisor April 2009 to April 2011
Supervise daily operations of hospital functions
Work closely with staffing office to assign staffing as needed
Help floor RN's as needed and speak with family and patients regarding care
Take care of any issues that may arise on shift
Clinical Educator - Emergency Room May 2002 to April 2009
Oversee education of new procedures and policies
Check off annual competencies of all employees
Mentor and orient new employees
Review and revise policy to current standards of care
Monitor chart documentation compliance
Charge Nurse - Emergency Room May 2002 to April 2009
Oversee daily operation of Emergency department function and employees
Daily duties as staff RN
Supervise up to 15 RNs on shift for compliance and safety of care for patients.
Critical Care RN - Emergency Room May 2002 to April 2009
Assessment / triage of all age patients, medication administration, assist physician at bedside as needed
Operation of all emergency equipment
Proficient in ACLS, PALS, and TNCC, SANE
LPN Float Pool – BMH September 1997 to May 2002
Float to all areas of the hospital and perform patient care, medication reconciliation and assist RN with other duties as necessary
Certifications:
CPR, ACLS, PALS, TNCC, SANE, DMAT volunteer, Decon Certified,
CCDS # CDO1700081
License:
Registered Nurse State of Tennessee, Multistate issued
Education and Training:
Roane State College -2004
BMH LPN School -1995
Associate of Applied Science in Accounting-1984
Clinical Documentation Certification ACDIS 2017
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