Carla Williams

• Promoted to Quality Outcome Coordinator for Health Directions Inc.
• Provided oversight of Professional Home Health Care Agency's daily functions via related case management duties.
• Participated in resource management activities for home health services/disciplines and supplies.
• Formulated letters of appeal to multiple levels of insurance denials to ensure proper reimbursement for services and supplies provided.
• Developed and presented various in-services for the home health care team.
• Provided oversight of documentation provided from referral sources to substantiate that the face to face encounter criteria has been adequately met for reimbursement.
• Documented patient progress accurately and efficiently, ensuring compliance with regulatory requirements.
• Reviewed ICD-10 coding for home health plans of care to determine diagnoses, symptoms, and procedures are reflective of the patient's medical record.
• Participated in Administrative Law Judge hearings (preparation and presentation) to justify skill of services and supplies provided during a home health episode of care.
• Educated therapy staff on defensible documentation standards including medically reasonable and necessary and functional goal writing.
• Provided clinical record review for pre-billing audit; record requests for insurance, disability, recovery audit contractor requests, etc.
• Served on Professional Home Health Care Agency's Quality Assessment and Performance Improvement (QAPI) Steering Committee as member and secretary.
• Provided interventions and treatments to improve patient abilities to perform daily activities, manage symptoms and prevent injury.
• Served as secretary and acting member of the Professional Home Health Care Agency Administrative Review Committee.
• Collaborated with interdisciplinary team members for comprehensive patient care and optimal results.
• Attained Certificate for OASIS Specialist-Clinical (COS-C) April 2010-2016.
• Provided OASIS education to home health nursing and therapy staff upon orientation as well as re-education during staff meetings, administrative meetings and with each revised version of the OASIS.
• Participated in Annual Agency Review for Professional Home Health Care Agency to assess the agencies activities, establish goals, develop interventions, and track progress.
• Maintained tracking and performed investigation for Potentially Avoidable Events.
• Participated in continuing education opportunities to stay current with industry trends and best practices in occupational therapy.

Skilled Nursing Facility/Long Term Care Facility

Home Health Therapist; Staff Educator.

Home Health Therapist

Day Health Center Therapist.

Occupational Therapist for home health, acute hospital, inpatient rehabilitation, outpatient, skilled nursing facility, day health care center, and school system settings. Participated in co-supervision of Eastern Kentucky University Level II students.