Corrina Rottum
Redmond,Oregon
Summary
Strategic-thinking individual experienced in turning low-performing organizations into top revenue producers. Offering engaging and pleasant personality with expertise improving customer relationships. Dynamic, collaborative, and innovative Director oversees every facet of production with strong project management, data analytics, and decision-making skills. Brings comprehensive knowledge of Value Based Care, risk adjustment, production writing, planning and technical operations. Skilled at coordinating project plans and personnel resources to complete work under tight deadlines.
Overview
22
22
years of professional experience
1
1
Certification
Work History
Clinical Documentation Integrity Director
Panoramic Health
08.2022 - Current
- Developed from ground up a clinical documentation integrity program to improve disease burden capture for Nephrologist led practices across 10 states and 12 Kidney Care Entities (KCEs) engaged in CMS CKCC value-based care
- Utilized MS Office Suite to develop comprehensive reports and presentations for board meetings and stakeholder communications
- Leveraged technology proficiency to implement innovative CDI strategies and solutions, improving overall efficiency
- Implemented innovative strategies that significantly improved Customer Satisfaction in CDI department
- Applied due diligence in the evaluation and implementation of CDI strategies to ensure compliance with regulatory requirements
- Built and directing an HCC Compliance program integrating OIG target areas, acute conditions, and other areas of risk identified in practices
- Successfully led a team in the implementation of new strategies by applying my advanced Integration Management skills, resulting in increased efficiency and productivity
- Applied high level of technology proficiency to continually upgrade and maintain critical CDI systems
- Implemented process improvement strategies that resulted in a 20% increase in CDI efficiency
- Implemented a system that regularly Provides Feedback to team members for continual improvement and strategic alignment
- Leveraged superior written and verbal communication skills to facilitate team meetings, resulting in increased productivity and morale for the CDI department
- Promoted a culture of teamwork and collaboration within the CDI team, resulting in increased productivity and workflow efficiency
- Utilized tactical decision-making skills to resolve complex issues in the CDI department, enhancing productivity and team collaboration
- Enhanced operational efficiency through strategic Problem Analysis, identifying areas for improvement within the CDI department
- Fostered a supportive work environment through effective Mentoring strategies, leading to improved team performance in CDI tasks
- Championed the integration of innovation into CDI program development, resulting in significant enhancements in service delivery
- Exhibited strong consistency in decision-making and problem-solving, significantly enhancing the effectiveness of CDI operations
- Applied strong negotiation skills in discussions with potential vendors and partners, ensuring optimal terms for the organization
- Developed all workflows, guidelines, quality assurance standards, and best practices for the CDI department
- Used performance metrics to evaluate staff performance, identify areas of improvement, and devise training programs in the CDI department
- Developed educational tools for Auditors, coders, and Nephrologists
- Developed standardized queries, query quality audits, and a quality assurance plan
- Created databases to manage all CDI work, report on closure rates, and monitor compliance concerns
- Extensive data analysis, development of data reporting dashboards, and maintenance of multiple sources of data.
01.2022 - 08.2022
- Career break to obtain Master’s degree
- Consulted for several small practice groups participating in Accountable Care Organizations (ACOs) to improve documentation
- Consulted for several small practice groups to improve documentation and revenue capture.
Regional Director of Coding Compliance
Summit Health Oregon/Bend Memorial Clinic
04.2018 - 12.2021
- 150 Provider Multi-Specialty Total Health Care Organization including Allergy/Asthma, Behavior Health, Cardiology, Dermatology, ENT/Audiology, Endocrinology, Gastroenterology, Hospitalist, Infectious Disease, Neurosurgery, Nephrology, Neurology, Pain Management, Orthopedics, Podiatry, Pulmonary, Primary Care, Rheumatology, Surgery (General/Trauma/Bariatrics), Urology, and Urgent Care
- Developing and implementing a comprehensive Compliance plan for Coding and Auditing including Baseline and follow-up reviews
- Implemented a review > educate > re-review process
- Following all risks and opportunities identified in Baseline and New Provider reviews until the compliance accuracy score was met
- Created an interdisciplinary committees to problem-solve regulatory, coding, and compliance concerns
- Created system automation to improve efficiency within the EMR to relieve documentation burden on providers
- Rolled out telehealth workflows within 4 days of the announcement of expanded telehealth rules in 2020 through collaboration with multiple departments
- Developed educational presentations, newsletters, and reference tools for HCC, documentation improvement, and coding for all staff and providers
- Developed and provided all education to Auditors, HCC Auditors, Coders, Off-shore coding vendors, and Coding Leadership
- This included developing a remote training program for new employees utilizing TEAMS
- Extensive research on the 21st Century Cures Act and how to strategically implement sharing of information processes within patient portals compliantly
- All research and education for Stark, Anti-kickback, HIPPA, Locums, Incident-to, and other laws surrounding billing/coding compliance for Oregon
- Responsible for ensuring that all billing practices were compliant
- Providing customer service representatives responses to coding and billing complaints and performing audits for patients that requested a coding audit utilizing E-risk
- Performed new provider on-boarding and directed New provider 3 day, 3 week, and 3 month process for education on Documentation, coding and disease burden capture
- Built Coding teams in CPT and HCC, Auditing teams in CPT and HCC, Coding Compliance teams, off-shore teams, and education teams
- Developed and implemented a 5-phase HCC risk adjustment auditing program including GAP analysis, combining GAP reports with EPIC up-coming appointments reports, pre-visit query process for chronic conditions, and post-visit validation
- Created audit process for post-visit validation and subsequent provider education
- Directed the Risk Adjustment Coding/Auditing Team to allow the organization to achieve a 90% revalidation rate in 2021 from a 38% revalidation rate in 2018
- Increased the organization’s RAF score from .57 to 1.2 from 2018 to 2021
- Worked on several Organizational pillars to improve the quality of patient care, willingness to recommend, and financial improvement through automation in the Business office
- Developed newsletters for Coding Compliance team, HCC team, and organization on various coding topics, risk adjustment topics, CMS updates, and team building
- Instrumental in turning around a $5 million dollar loss in 2018 to a 1.5-million-dollar profit in 2019, 3-million-dollar profit in 2020, and 5-million-dollar profit in 2021, achieving a historic performance in 2020 through a pandemic including a $3-million dollar quality payment in 2020
- Managing the coding of over 800,000 wRVU’s in 2021, up from 400,000 in 2018 with 6 fewer FTE’s in Coding Compliance by leveraging automation available within EPIC.
Senior Inpatient Coder
Optum 360/United Health Group
01.2018 - 04.2018
- Coding and abstracting all inpatient charts for United Healthcare owned Hospitals
- Identifying opportunities by analyzing all inpatient diagnostic services and documentation for Compliant Provider Queries utilizing Optum 360 and Cerner
- Retrospective Audits for identified areas of specific DRG risks
- Developing new compliance queries for physicians as needed for Clinical Documentation Improvement
- Providing Edit Coder services as needed for claim denials and working with billing departments to resolve denial issues, claims issues, and electronic billing issues requiring extensive research, knowledge, and education of Medicare/Medicaid guidelines, and commercial payor guidelines across multiple states, primarily California.
Revenue Integrity Auditor and Educator
St. Charles Health System
01.2017 - 01.2018
- Performing Baseline, New Provider, and follow-up reviews for all professional fee services and outpatient services
- Collaborating with inpatient CDI to support DRG assignment
- Providing clinical documentation improvement education to all providers in conjunction with the CDI team
- Providing all professional fee coding education to new providers and providers failing compliance scores
- Providing education and tools for HCC and risk adjustment coding with a focus on improving diagnostic statement specificity
- Working with Population Health to improve disease burden accuracy reporting and educational materials on HCC coding and risk scores
- Working with the Nurse Chart Auditor to identify documentation and coding issues for facility services including education on how to pull reports to analyze the data out of Allscripts, Mosaiq and Mckesson
- Creating and presenting educational modules, internal desk references, and workflows
- Educating revenue cycle coders, revenue cycle collections, and leadership to improve Collection rates, decrease denials, and increase revenue capture compliantly.
Coding Analyst Team Lead/Supervisor
Adaugeo Health Care Solutions/Praxis/High Lakes Health Care
06.2002 - 01.2017
- Multispecialty Organization including Primary Care, Endocrinology, OB/GYN, Rheumatology, Dermatology, Neurology, Podiatry, Orthopedics, Urology, Immediate Care, Surgery, Psychology, Behavior Health, Gastroenterology and Physical Therapy
- Managing coding daily operations for all professional fee and facility coding staff including creating an audit work plan, daily coding work plans, peer review, and delegation of work among coding analysts and data entry specialists
- Developed a comprehensive HCC program including educational presentations to kick off the HCC initiative, ongoing audits, and queries for documentation improvement
- Comprehensive education on HCC, risk adjustment, and the MEAT/TAMPER concepts for providers, coders, and auditors
- Developing all internal guidelines and workflows for a team of remote coders and data entry specialists
- Auditing all specialties and developing reports to Management and Providers
- Working with EMR trainers to create templates, workflows, and smart forms within Intergy that would allow providers to document more efficiently and with better quality
- Including History form templates, AWV/IPPE, Transitional care management, chronic care management, pediatric, and specialty templates
- Leveraging system automation to reduce resources used in the Business office
- Mapping of ICD9 to ICD10 within Intergy to ensure a seamless transition
- Working all denials with denial codes related to coding (medical necessity, pairing, below the line, etc.) and utilizing findings to educate coders, billers, and develop system automation rules specific to payor requirements
- Creating monthly newsletters regarding any CMS updates, HCC coding education, AWV and IPPE’s, and compliance law changes relating to coding compliance
- Staying up to date on changes and updates regarding CMS policies and procedures and detailed familiarity with Noridian policies
- Distributing and communicating these policies to all staff throughout the organizations owned by Adaugeo
- Educating providers and staff regarding all phases of Clinical Documentation Improvement, including E/M (95/97 guidelines), ICD10, HCC and CPT coding relating to professional fees and outpatient coding.
Education
Masters of Science in Health Care Leadership -
Western Governors University
01.2023
Bachelors of Science in Health Care Management -
Western Governors University
01.2018
Skills
- Strategic Planning
- Verbal and written communication
- People Management
- Operations Management
- Project Management
- Team Management
- Creativity and Innovation
- Strategies and goals
- Project Coordination
- Data analytics and database development
Accomplishments
- Used Microsoft Excel to develop database for tracking and trending risk adjustment activities, provider engagement, and revalidation results.
Certification
- Registered Health Information Technician (RHIT)
- Certified Professional Medical Auditor (CPMA)
- Certified Risk Adjustment Coder (CRC)
- Certified Professional Compliance Officer (CPCO)
- Certified Documentation Expert Outpatient (CDEO)
- Certified Gastrointestinal Coder (CGIC)
- Certified Evaluation and Management Auditor (CEMA)
Affiliations
- American Health Information Management Association (AHIMA) - 1040838
- National Alliance of Medical Auditing Specialists (NAMAS) - 12840
- American Academy of Professional Coders (AAPC) - 01313027
Emr Abstracting Systems Encoders Used
- EPIC
- Athena
- Allscripts
- Cerner
- ECW
- AMD
- Aprima
- Acumen
- Practice Fusion
- Intergy
- Mosaiq
- McKesson
- Fresenius
- Davita
- Nthrive
- Optum 360 CAC
- Optum Encoder Pro
- HCC Coder
- True Coder
- Select Coder
- 3M
References
- Katy Good, 508-878-0587, Sr. Director Quality Improvement Panoramic Health
- Steven Henry, 954-558-3854, SVP Health Care Economics Panoramic Health
- Navid Akkar, 815-764-5624, Sr. IT Manager Panoramic Health
- Damon Underwood, 240-643-0841, Former Operations Manager at St. Charles
- Karla Becker, 541-419-0496, Former Manager at High Lakes Health Care
- Jeff Stewart, 541-410-2033, 541-693-2621, Former CEO at High Lakes Health Care
- Michael Feldman, MD, 650-619-7597, Quality Physician Leader Summit
- Debbie Foster, 360-536-3800, Population Health Manager Summit
- Seth Meyers, 541-241-4822, IT/IS Manager Summit
- Justin Sivill, 309-533-1954, Former COO at Summit/BMC
- Andi Miller, 541-390-5241, Former colleague RDO at Summit/BMC
- Ilana Bach, 541-419-0739, Current Coworker
Timeline
Clinical Documentation Integrity Director
Panoramic Health
08.2022 - Current
01.2022 - 08.2022
Regional Director of Coding Compliance
Summit Health Oregon/Bend Memorial Clinic
04.2018 - 12.2021
Senior Inpatient Coder
Optum 360/United Health Group
01.2018 - 04.2018
Revenue Integrity Auditor and Educator
St. Charles Health System
01.2017 - 01.2018
Coding Analyst Team Lead/Supervisor
Adaugeo Health Care Solutions/Praxis/High Lakes Health Care
06.2002 - 01.2017
Masters of Science in Health Care Leadership -
Western Governors University
Bachelors of Science in Health Care Management -
Western Governors University
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