Detail oriented, RAC-CT certified Claims and Denials Specialist and licensed occupational therapist with 20 years of successful experience in Medicare/Managed Care regulatory requirements and therapy program management. Recognized consistently for performance excellence and contributions to success in contract therapy industry. Strengths in process improvement, team management, and quality assurance/improvement activities.
· Co-developed company-wide internal auditing process, facilitating communication and review for independent review organization (IRO) and Corporate Integrity Agreement (CIA).
· Developed centralized ADR/documentation request process and implementated training; resulting in 40% decrease in costly technical denials company wide, and increased efficiency and accuracy of responses to Medicare, Managed Care, and external auditing entities.
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