Professional Summary
Overview
Work History
Education
Skills
Certification
Timeline

Barbara Busarello

Einstein/Jefferson Health System
Marlton,NJ
1
Certification
35
years of professional experience

Dynamic healthcare professional with extensive experience in clinical documentation and revenue integrity, specializing in the leadership and development of Clinical Documentation Improvement (CDI) programs. Proven track record in rebuilding and merging programs to enhance operational efficiency, including the establishment of standard operating procedures, physician education initiatives, and comprehensive training for new staff. Expertise in mentoring teams and collaborating with coding departments to ensure accurate documentation and compliance, significantly improving patient care outcomes. Committed to leveraging a robust clinical background and strong management skills to drive continuous improvement within healthcare organizations.

Work History

Manager Clinical Documentation Program/Revenue Integrity

2 Years
Einstein/Jefferson Health System | 01.2022 - 01.2024
  • Executed strategic planning and implementation of program enhancements to facilitate merger with Jefferson Enterprise CDI program.
  • Directed leadership initiatives for Level 1 Trauma Program, ensuring operational excellence.
  • Developed standard operating procedures and policies for team use. Assisted in establishing a new physician query escalation process. Supported the creation of CDI orientation and training materials. Facilitated onboarding of new CDI staff to the program. Contributed to physician education through record auditing presentations.
  • Facilitated successful mentorship and auditing for eight CDI consultants in external engagements. Optimized scheduling for general manager activities.
  • Orchestrated spouse relocation to South Carolina, ensuring seamless transition and integration.

Manager Clinical Documentation Program/Revenue Integrity

1 Year
Thomas Jefferson University Hospital | 01.2020 - 01.2021
  • CDI Leadership of Level 1 Trauma program
  • Report CDI metrics to steering committee
  • Developed Physician CDI education
  • Mentoring/Auditing 10 CDI staff and outside consultants
  • Coordinated coding efforts and performed detailed reviews of records to ensure accuracy and compliance.
  • Directed management responsibilities to enhance team performance and productivity.

Clinical Documentation Specialist

4 Years
RWJ/Barnabas Health | 01.2016 - 01.2020
  • Analyzed patient medical records to determine appropriate principal and secondary diagnoses and procedures, facilitating accurate DRG classification and risk assessment.
  • Facilitated communication with physicians to resolve issues related to unclear or incomplete health record documentation. Coordinated efforts with the coding department to optimize accuracy in billing and coding processes. Developed strategies to streamline documentation requests and improve record completeness.
  • Improved accuracy of ICD-10 DRG assignments through enhanced physician education on documentation practices. Achieved higher compliance in diagnostic documentation by facilitating training on Allscripts Encoder usage. Elevated standards of documentation for ICD-10 coding, contributing to more reliable DRG assignments.
  • Orchestrated launch of Nuance CDI program, focusing on optimizing clinical documentation processes.

Clinical Documentation Specialist

9 Years
Hahnemann University Hospital (Drexel Medicine) | 01.2007 - 01.2016
  • Initial review of patient medical records to evaluate documentation to assign the principal diagnosis, pertinent secondary diagnoses, and procedures for accurate DRG assignment, risk of mortality, and severity of illness.
  • Submitting concurrent clarifications to physicians regarding missing, unclear, or conflicting health record documentation and obtaining additional documentation within the health record. Working with Coding department for appropriate billing of codes.
  • Physician education regarding correct documentation of diagnosis being treated. Cerner, Encoder, 3M 360 CDI program ICD-10, ICD-9
  • ER Case Manager/CDS.
  • Conducts admission reviews using InterQual criteria. Communication with ER physical to clarify proper diagnosis being treated in the H&P. Observation cases called to EHR for medical review.
  • RN-Medicaid Review nurse.
  • Conducting Medicaid reviews to Department of Public Welfare using InterQual criteria and Clinical data to support inpatient necessity. Knowledge of claims systems and benefits. Initiates appeal process
  • Level 1 Trauma, Transplants
  • Start Up of CDI Program

Corporate Financial Investigations Department/RN Provider Auditor II

3 Years
Independence Blue Cross | 01.2004 - 01.2007
  • Audit hospital records in NJ/PA/DE. Review medical claims and making recommendations regarding reasonableness of charges, accurate coding of medical record. Investigates charge audits, LOC audits and extra payment (eg. AICD, Factor VIII)

Medical Policy Coordinator/RN

2 Years
Independence Blue Cross | 01.2002 - 01.2004
  • Policy development involving extensive research regarding the latest in medicine and technology. Working with outside physician consultants. Knowledge in FDA Labeling, Medicare regulations and ICD-9, CPT and HCPS coding

RN Diabetes Case Manager

1 Year
Independence Blue Cross | 01.2001 - 01.2002
  • Telephonic education on disease management, goal setting, diabetes management. Pre-certification for home care services and DME

Training Supervisor for TheraSense Program

1 Year
ICT Group | 01.2000 - 01.2001
  • Facilitated training sessions for customer service representatives on effective use and troubleshooting of new glucometer technology.

Registered Nurse

11 Years
Virtua Health System | 01.1989 - 01.2000

Assisted in medical and post-surgical procedures within a 40-bed surgical unit.

Education

Bachelor of Science Nursing

Widener University

Associate Degree

Helen Fuld School of Nursing-RN

Skills

Experience with coding software
EMR: EPIC
Cerner
Allscr Offiipts
SCM
InterQual
Systems: Iodine
JATA/NUANCE Guide & Clintegrity programs
3M 360 Encompass program
Microsoft Office proficiency

Certification

  • 2024 ACDIS Certified CDI Trainer
  • 2017 Certified Clinical Documentation Specialist (CCDS) 14002257
  • 2023-2024 ACDIS Leadership Member
  • ACDIS Pennsylvania Chapter member
  • ACDIS Member
  • —Compact State Nursing/RN License in New Jersey 26NO09354400 & PA RN355807L
  • —JATA/NUANCE Certification; 3M Certification

Timeline

Manager Clinical Documentation Program/Revenue Integrity

Einstein/Jefferson Health System
01.2022 - 01.2024Read More

Manager Clinical Documentation Program/Revenue Integrity

Thomas Jefferson University Hospital
01.2020 - 01.2021Read More

Clinical Documentation Specialist

RWJ/Barnabas Health
01.2016 - 01.2020Read More

Clinical Documentation Specialist

Hahnemann University Hospital (Drexel Medicine)
01.2007 - 01.2016Read More

Corporate Financial Investigations Department/RN Provider Auditor II

Independence Blue Cross
01.2004 - 01.2007Read More

Medical Policy Coordinator/RN

Independence Blue Cross
01.2002 - 01.2004Read More

RN Diabetes Case Manager

Independence Blue Cross
01.2001 - 01.2002Read More

Training Supervisor for TheraSense Program

ICT Group
01.2000 - 01.2001Read More

Registered Nurse

Virtua Health System
01.1989 - 01.2000Read More

Widener University

Bachelor of Science Nursing
Read More

Helen Fuld School of Nursing-RN

Associate Degree
Read More

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Barbara Busarello