Jessica Claire
  • , , 100 Montgomery St. 10th Floor
  • Home: (555) 432-1000
  • Cell:
Professional Summary

Enthusiastic middle revenue cycle professional eager to contribute to team success through hard work, attention to detail and excellent organizational skills. I am a Coding, HIM, CDI and Revenue Integrity expert with 17+ years experience. My professional passion relates to clinical documentation integrity, coding, health information management, case/utilization management, utilization management, quality improvement and physician education. Self-motivated with orientation towards goal achievement and outcomes assessment. I’m also skilled in developing multi-facility oversight and implementing efficient work processes, reducing costs through improved staffing plans and improving quality metrics and reimbursement with physician documentation. Demonstrated success in project completion, project management, team building and organizational design. Excellent communicator, dedicated to providing superior customer service, and improving patient satisfaction.

  • Performance Assessment
  • Program Optimization
  • Data and Analytics
  • Focus and Follow-Through
  • Policy Development and Enforcement
  • Training Management
  • Business Leadership
  • EHR: EPIC, Cerner, Meditech,
  • Encoder: 3M, Optum, TruCode
  • Microsoft Suite (PowerPoint, Excel, Word, Outlook)
Work History
Managing Director, 05/2009 to Current
Apex SystemsWichita, KS,
  • Conduct gap analysis, identification of risk, opportunity and develop findings and recommendations, including development of a “Center of Excellence”
  • Proficient in ICD-10-CM Diagnosis/Procedures/CPT Codes, MS-DRG reimbursement and clinical documentation impacting quality
  • Facilitated thousands of physician education sessions across the United States communicating the importance and need for accurate and complete clinical documentation/coding and impacts to quality and reimbursement metrics
  • Direct experience in working to oversee CDI Specialists in development of CDI programs in the acute and outpatient care setting
  • Vast knowledge of Coding, Rev. Integrity and CDI program infrastructure, workflow and reporting/metrics
  • Project leader which encompasses multiple aspects of clinical operations, client relationships with a focus on collaboration
  • Design innovative new offering for current product offerings of CDI, Coding, ICD-10, Transcription, Care Management Utilization Review, Physician Education, and HIM departments
  • Have been involved with 300+ hospital over career directly assisting and sustaining Coding & CDI programs
  • Develop and implement strategy to achieve revenue improvements and cost take out targets
  • Lead multi-disciplinary teams to capture revenue and cost opportunities by applying process improvement techniques
  • Develops trusted partnerships with key executives in Revenue Cycle and Clinical Operations and work to achieve targets and identified new opportunities
Manager, 06/2004 to 05/2009
United Natural Foods IncMadison, WI,
  • Managed development of processes and technology designed to document and calculate nursing activity for outpatient billing
  • Responsibilities included developing project plans, managing execution developed plan, managing cross functional team consisting of Nursing, Finance, and IT Directors, drafting change control processes, interfacing with production and testing teams, designing infrastructure for program success, and facilitating meetings, presentations, and discussions to drive client team toward project objectives
  • Served as engagement manager for Clinical Documentation Integrity (CDI) programs for hospitals and leading academic medical centers nationwide.
Transplant Financial Services Intern, 05/2003 to 08/2003
Mayo ClinicCity, STATE,

Analyzed demographic, financial, and insurance eligibility for potential kidney and pancreas transplant patients. Collaborated and researched with collaborative team of six people to ensure insurance benefits and eligibility for transplant. This research improved our patient’s understanding of benefits and assisted in front-end office functions. Worked directly with insurance agencies to assist patients in understanding monetary responsibilities she/he may have after transplant.

B.A.: Business, Business Communications & Psychology , Expected in
Augustana University - Sioux Falls, SD,
Certified Professional Coder (CPC): , Expected in 2009
AAPC - ,
  • K to $6M annually and an average of 30% improvement in quality indicators.
  • Managed cross-functional teams of consultants, physicians, case management managers, medical records personnel, and vendors in implementation of process improvement programs, including process design and user training.
  • Managed multiple projects and clients simultaneously and presented deliverables to various levels including Health Information Management (HIM) and Case Management Directors, VPs of Finance and Quality, CEOs, CFOs, CMOs, and COOs.
  • Managed teams of consultants and analysts to develop and produce high level dashboards and detailed reports for clients to monitor metrics such as Medicare reimbursement trends and areas of potential opportunity.
  • Developed educational sessions for internal staff on topics related to Clinical Documentation Improvement.

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School Attended

  • Augustana University
  • AAPC

Job Titles Held:

  • Managing Director
  • Manager
  • Transplant Financial Services Intern


  • B.A.
  • Certified Professional Coder (CPC)

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