Cynthia L. LaPradd

I am eager to accept any position that provides opportunities for additional training and career advancement in the healthcare industry. During the course of my career, I have dedicated myself to continued learning and education, with a goal of furthered self-improvement. I believe that my willingness to learn new skill sets, as well as my strong work ethic, allows me to offer my employer a well-rounded employee who is both capable and willing to accept challenges as they arise.

• Payments and adjustment review.
• AR follow up.
• Excellent decision-making skills.
• Time management ability.
• Customer service skills.
• Fluent in handling multiple projects/audits/tasks with the ability to prioritize time sensitive items.
• Knowledge of Medicare/Medicaid regulations and McKesson InterQual criteria.
• Computer Skills- MS Word, Excel, PowerPoint, EPIC, Kronos, Clintrac and Insurance provider systems.
• Educate and train new staff in the Utilization Review role.
• Review assigned cases and obtain authorization for admission, concurrent and retrospective cases.
• Organizing work schedules, coverage, as well as approval of PTO for Utilization Review Staff.
• Enhance incoming revenue, when possible, through effective communication with the Professional Staff and appropriate documentation.
• Communicate on an ongoing basis with physicians/ insurance providers/patients/families regarding denials and appeals.
• Communicate and coordinate with other areas such as HIM, Patient Access, Billing, Coding and physicians’ offices to achieve appropriate status and authorization.
• Work closely with Case Management and Social Services in making sure patients are in appropriate status (inpatient vs. observation), as well as establish an optimum discharge plan.
• Work Variances Reports identifying underpayments.
• Work with RCM department and payors in getting claims resolved.
• 39 years’ experience within the health care industry.
• Secretary/Treasurer with Southwest Va. Healthcare Quality Association.

• RHIT
• CRCR