Registered Nurse with over 20 years experience. Experience in Cotiviti and Claim Check editing for medical claims payment for the past nine years. Maintaining Certified Professional Coder credentials yearly. Recently acquired Nursing Informatics certification. Accomplished at identifying Cotiviti edits and clinical review to determine payment appropriateness on the QNXT platform. Most current experience is in reviewing plan exception requests and working with the UM steering committee and heath plans to review and follow policy to enact these exception requests. I also have experience in medical policy imp0lementation and Propat use. Organized, decisive, and attentive to details. Eager to contribute to team success. Excited to showcase abilities in the Healthcare QM Project Program Manager position.
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State of Pennsylvania- Registered Nurse, RN515068L
Certified Professional Coder
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