April Ard

• Assessed, monitored and authorized inpatient.
• Made accurate, timely and consistent coverage determinations for patients.
• Used medical and clinical review guidelines and parameters to maintain consistency in MD review process, appropriate utilization levels and compliance with facility policies and procedures.
• Collected preoperative, operative and postoperative data components through hospital EMR.
• Utilized electronic medical record systems to store, retrieve and process patient data.
• Followed up with medical staff regarding missing information in patient records.
• Verified accuracy of patient information in medical records.
• Assisted in training new staff on medical record processing and filing procedures.
• Researched and resolved medical record discrepancies.
• Obtains and promotes appropriate clinical documentation through extensive interaction with physicians, nursing staff, and other patient caregivers to ensure that the documentation of the level of service rendered to the patient and the patient’s clinical complexity is complete and accurate
• Performs clinical evaluation of the medical record including physician documentation and clinical results
• Facilitates modifications to clinical documentation through concurrent interactions with physicians and
• Ensures the accuracy and completeness of clinical information used for measuring and reporting physician and medical center outcomes. Tracks response to CDS and trends completion of Navigant CDI monitor
• Assists in screen processes, making referrals, interacting with case managers and clinical nurse specialists to ensure continuity of patient care
• Maintains appropriate non-leading queries concurrently to physicians
• Educates physicians, case management, charge nurse and other departments as needed

Develop, coordinate and implement community outreach in services regarding Home Health and Hospice. Worked closely with leadership to remove barriers to admissions; worked with Medical Director and Director of Nursing to implement new programs and processes. Develop and maintain relationships with acute care, sub acute care through the multitude of downstream providers to ensure productive relationships. Meet with families and patients to discuss all aspects of Home Health and Hospice determining their needs to ensure continuity of care for our patients transitioning into home care. Meet and exceed monthly goals. I am currently the training officer for new administrative staff in using the local EMR systems including Epic, Meditech and Cerner. I have used Meditech for the past 20 years and Epic for the last 6. I am also familiar with the various versions of Epic that the different local facilities use

Cultivate referral relationships including with physicians, discharge planners along with patients and their family members. Manage assigned territories along with building new business through acute care hospitals, skilled nursing facilities, long term care, physician clinics and community outreach programs. Provide and arrange educational in services to enlighten referral sources on the admission criteria needed for admission into LTAC. Assist in development of new programs and services including quality improvement initiatives in the Post-Acute Medical System through ongoing assessment of the needs of professionals, families, patients and local communities. Coordinate and complete onsite assessments on potential patients by reviewing the medical record and identifying all aspects related to pre-certification financial coverage and admission criteria. I also work with obtaining financial information for the patients which includes obtaining benefits and retrieving authorizations needed for admission. This includes working closely with case management to ensure proper understanding of patients expected length of stay and the treatment plan set forth to ensure optimal outcomes for our patients. As a Clinical Navigator I coded uses DRG and CPT-10 each potential admission with the assistance of a certified Corporate coder to ensure proper length of stay and reimbursement expectations.

Responsible for all aspects of respiratory therapy including Level III nursery, experienced in high risk deliveries and neonatal ventilators including oscillator ventilation. Adult intensive care including arterial sampling from arterial lines, care of coronary arterial bypass grafts (CABG) and weaning from ventilators. I am experienced in pediatric patients along with general respiratory care. I worked here full time for 6 years and the remaining 11 years I worked on a part time basis

Conduct patient assessments and identify patients for potential admission into the LTAC system. I was responsible for managing the referrals and admissions that are generated through their assigned hospitals and territories by representing the hospital with professionalism to referral sources. Designs and manages the marketing strategies for their assigned hospitals. Conduct one on one contacts with potential referral sources, maintain positive relationships with current referral sources. I utilized educational opportunities to present the hospital to referral sources. I identified, contacts and manage potential clients. I sourced potential, appropriate patients for hospital. I coordinated transmission of clinical and benefit treatment to patients, families and outside agencies. I acted as liaison for outside agencies, non-plan facilities, and outside providers. I reviewed and assessed patients to determine admission criteria including diagnosis code.

• Supported business growth through strategic planning and process development.
• I started as a Marketing Representative and I was able to increase referrals dramatically which led to a promotion to Business Development Director and eventually to Chief Operations Officer. My responsibilities were: Target and recruit potential physician investors in each local area along with working with the physicians through the investment process. I maintained physician relationships to ensure a profitable sleep lab. I chose the future locations of all new sleep labs, negotiated leases and supervised construction and interior decoration. I created timelines for opening sleep labs along with all necessary steps to ensure smooth opening. Worked with physicians to begin interpreting their own patient sleep studies and worked with their staff for effective billing and collections for these services. Supervised all aspects of sleep management for 9 sleep labs including marketing, insurance verification, scheduling, technical department, billing and collections, DME set-ups and follow-up compliance. Completed and negotiated all Medicare, Medicaid and Private Payors Insurance contracts for each sleep lab. I worked directly with hospital administration for maximum reimbursement with hospital contracts. Developed and implemented policies and procedures designed to promote company philosophy within and outside the company. I worked in every aspect of sleep medicine that may not be included in the previous points. Supervised staff and maintained physician relationships in San Antonio, Tx
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