About

Work Experience

• Special Investigations Unit Clinical Auditor (RN), Health Alliance

  Sep, 2023 - Jul, 20251 year 10 months

  • Managed multiple cases across various service lines, ensuring compliance with regulatory and coding standards.

  • Maintained detailed electronic records to track case progress and meet project deadlines.

  • Utilized multiple healthcare software programs for case management, data analysis, and reporting to support informed decision-making.

  • Collaborated in cross-functional workgroups to improve processes and drive efficiencies.

  • Provided expertise in provider audits, data integrity, and pre-contract investigations to enhance system accuracy.

  • Reviewed electronic medical records (EMRs) for coding and billing accuracy per standards of care and medical necessity.

  • Continuously expanded expertise in health insurance regulations and compliance best practices.

• Patient Care Manager (RN), OSF Heart of Mary Medical Center

  Jul, 2019 - Sep, 20234 years 2 months

  Patient Care Manager for the departments-Surgery, Ambulatory Care, Recovery, and Anesthesia.

  • Audited and optimized electronic surgical documentation to ensure compliance with quality care, revenue integrity, and regulatory standards.

  • Served as a credentialed trainer for EPIC Optime, providing education on intra-procedure workflows, scheduling, billing, and preference card management.

  • Assessed and updated annual competencies for perioperative departments, ensuring alignment with best practices and compliance requirements.

  • Conducted data analysis and reporting for quality improvement initiatives, presenting findings to the hospital quality committee.

  • Managed revenue assurance, budgeting trends, and capital requests, leveraging data insights to enhance financial performance.

  • Collaborated with surgical staff, anesthesia providers, and physicians to integrate evidence-based practice into workflow optimizations.

  • Partnered with supply chain management to analyze and refine inventory strategies, reducing waste and improving cost efficiency.

• Surgical Business Manager, OSF Heart of Mary Medical Center

  Dec, 2017 - Jul, 20191 year 7 months

  Manager specializing in perioperative operations, process optimization, and cross-functional collaboration. Skilled in charge capture, surgical audits, payroll management, and data analysis to drive efficiency and compliance within the surgery department.

• Circulator - Surgery - Registered Nurse, OSF Heart of Mary Medical Center

  Jul, 2015 - Dec, 20172 years 5 months

Skills

Education

References