Jennifer Moore

• Managed 2+ Denial Specialists
• Developed high-performing teams by providing mentorship, guidance, and opportunities for professional growth.
• Enhanced team collaboration through regular communication, goal setting, and performance evaluations.
• Facilitated cross-functional collaboration for improved decision-making processes within the organization.
• Improved project efficiency with strategic planning, resource allocation, and time management practices.
• Implemented innovative solutions to solve complex problems, resulting in increased productivity and streamlined operations.
• Optimized staff performance by designing comprehensive training programs tailored to individual needs.
• Proactively identified potential risks and implemented mitigation strategies to minimize negative impacts on projects or business operations.
• Spearheaded innovative approaches to resource allocation and strategic planning.
• Leveraged data analytics insights for informed decision-making in critical areas such as sales forecasting, budgeting, or personnel management.
• Drove significant market share growth with launch of innovative product lines.
• Enhanced stakeholder satisfaction with timely and transparent communication strategies.
• Led cross-functional teams to exceed benchmarks for SLA delivery, staying on top of challenging schedules with multiple competing timelines.
• Trained and guided team members to maintain high productivity and performance metrics.
• Assisted in recruiting, hiring and training of team members.
• Observed each employee's individual strengths and initiated mentoring program to improve areas of weakness.
• Implemented business strategies, increasing revenue, and effectively targeting new markets.
• Reported issues to higher management with great detail.
• Tracked trends and suggested enhancements to both challenge and refine company's product offerings.
• Reduced operational risks while organizing data to forecast performance trends.
• Monitored daily cash discrepancies, inventory shrinkage and drive-off.
• Denial Research Serve as primary conduit for analyzing denial data, operational processes, and accounts that fall out, leading to Denials and Revenue Loss. Assess and monitor Operational processes that contribute to Denials, providing data trending, processes observations, and level remediation feedback to Denial Prevention. Interacts with Denials Management and other key sponsors, presents a knowledgeable, efficient, and professional image by handling business in a respectful and professional demeanor, and excel in the following- Advisor – Rise to the level of trusted advisor within Conifer, with an eye on performance.
  Reporting and Analytics– Prepare and present to Operational performance trending, gaps, and next steps as appropriate
  Relationship Management Facilitate and maintain relationships through regular, pro-active communication, timely follow-through on requests and coordination of resources to meet Conifer needs
  
• Effectively communicate data or technical concepts with detail to Prevention and Operations. Strong proficiency with Excel, Access, PowerPoint along with superior Verbal and written communication skills.
• Ability to review and churn through a large number of accounts, identifying the critical areas of focus over non-impactful misses for prioritization and focus. Identify any emerging analytic needs for stakeholders to monitor impact and process gaps.
• Defining issues; identifying root causes; interpreting data; understanding data dependencies; goal setting; establishing tracking and reporting metrics; updating project plans; leader of denial subcommittees; providing performance reports and deliverable preparation
• As needed, provide project management support, analysis, and/or technical expertise for a broad array of Revenue Cycle initiatives. Has responsibility for assisting teams in support of Regional or National Analysis and Research

Company Policy. Adheres to all company policies and procedures including, but not limited to those identified within the Standards of Business Conduct and the Employee Handbook, as may be amended from time to time. Adheres to all applicable laws and regulations and the company's governance/compliance program. Responsible for reporting violations of the company's policies and procedures, Standards of Business Conduct, Compliance, governance program, laws and regulations through the company's Help Line or other mechanism that may be available at the time of the violation. Assists with internal control failure remediation efforts. Relationship Management Facilitate and maintain relationships through regular, pro-active communication, timely follow-through on requests and coordination of resources to meet client needs

• Managed 25+ employees across remote and in-person office setting
• Collaborated in standing up Global enterprise to cross work peer to peer
• Revenue Integrity Manager who has a comprehensive understanding of hospital Revenue Cycle Management coupled with strong leadership skills
• Significant experience in the following areas: hospital inpatient and outpatient coding knowledge, charge capture, and hospital reimbursement methodologies
• Leading audit teams
• Ability to approach problem-solving challenges independently, possess excellent leadership experience, strong attention to detail, and enjoys working in a fast-paced, collaborative, and team-based environment
• Manage client performance
• Effective leadership and management of audit managers and their teams
• Collaborate with internal stakeholders and other business teams to achieve process clarity and improvement (i.e
• Implementation, Account Management, Data Operations, Productivity templates)
• Monitor internal reports and metrics to facilitate resource allocation to achieve required client and team goals and objectives
• Ability to communicate effectively with a wide range of audiences such as providers, managers, staff, senior leadership, CNO, CFO
• Demonstrate independent judgment, discretion, and decision making abilities
• Leadership and analytical skills
• Communication/Organization/Quality Control/Education/Training skills
• Self-motivated, hard working individual with a high attention to detail
• Knowledge of hospital billing practices, payer reimbursement methodology, medical necessity criteria, and applicable industry based standards
• Implementing centralization teams prepping for global remote work
• Remain current on Medicare requirements and payer requirements
• Experience with Conifer:
• 5+ years of hospital revenue cycle management
• 2+ years managing audit teams
• 2 years managing observation charging
• 1 years implementing centralization teams prepping for global remote work
• Experience in managing multi system platforms
• Epic, Cerner, Meditech implementations
• Established team priorities, maintained schedules and monitored performance.
• Evaluated employee performance and conveyed constructive feedback to improve skills.
• Recruited, interviewed and hired employees and implemented mentoring program to promote positive feedback and engagement.
• Defined clear targets and objectives and communicated to other team members.
• Improved staffing during busy periods by creating employee schedules and monitoring call-outs.
• Established performance goals for employees and provided feedback on methods for reaching those milestones.
• Assisted in organizing and overseeing assignments to drive operational excellence.
• Successfully managed budgets and allocated resources to maximize productivity and profitability.
• Set aggressive targets for employees to drive company success and strengthen motivation.
• Launched quality assurance practices for each phase of development
• Reduced waste and pursued revenue development strategies to keep department aligned with sales and profit targets.

• Temporary Interim director while sudden loss of current director, while holding Manager position and held day to day operation
• Managed multi-level staff and teams within the Revenue Integrity teams
• Managed daily calls, emails, meetings daily
• Enhanced team collaboration through regular communication, goal setting, and performance evaluations.
• Established a culture of continuous improvement by fostering open communication channels and empowering employees to voice their ideas.
• Cultivated a positive work environment that fostered employee engagement, increased retention rates, and boosted overall team morale.
• Managed budgets effectively to ensure optimal use of resources while maintaining financial stability.
• Strengthened internal controls by reviewing existing policies and procedures, ensuring compliance with regulatory requirements.
• Facilitated cross-functional collaboration for improved decision-making processes within the organization.
• Improved project efficiency with strategic planning, resource allocation, and time management practices.
• Implemented innovative solutions to solve complex problems, resulting in increased productivity and streamlined operations.

• The Audit Coordinator is responsible for facilitating aspects of the Recovery Audit Contractor (RAC) program, as well as other Medicare Regulatory audits
• The position will review audits and ensure they are responded to in accordance with established deadlines
• The Audit Coordinator position requires strong project management skills as multiple cases must be handled, in varying stages of the process, according to specified timeframes
• The position also requires strong analytical skills, displays a professional and helpful manner at all times, creating a positive image for EMRC
• Responsibilities:
• The responsibility of this position is to be the CBO liaison for RA -reviews and any other governmental Regulatory audits
• The position requires updating prescribed Audit tracking tool and patient accounting systems, working with the Central Billing Office and affiliates to complete their billing for ancillary services, resolve payment and refund issues along with coordinating with follow-up staff on patient account issues related to payer audits
• Performed all aspects of the Recovery Audit (RA) program, as well as third party payer audits
• Review audits and ensure they are responded to in accordance with established deadlines
• Monitors the work queues in the RA management and billing software to ensure that they are reviewed in a timely manner and ensure that deadlines are met
• Serves as a resource to the facilities Audit coordinators to assist with gathering information and record keeping from multiple stakeholders on multiple cases in various stages of RA appeal and coordinates responses to the RA within specified timeframes
• Process Medicare RA recoupments and interest to facilitate timely appeal process
• Responsible for all aspects of the rebilling including Medicare, Medicaid, Probe denials when a determination was made to file the inpatient claims as outpatient, which this process includes but not limited to: instruct CBO to reverse all rebill payments, and maintaining spreadsheets for reporting purposes
• Ensure that all the required updates from other departments are received in a timely manner
• Completes special projects, system implementations, team member training, and routine reports as assigned and in such a manner that deadlines are met
• Maintain spreadsheets that document activity for each payer
• Complete adjustments and/or corrections from pre-billing edits, errors or unprocessed items and work with personnel in other areas of the department researching payments and adjustments
• Make corrections of posting errors and identify areas for process improvement or education process
• Follow-up accounts documenting appropriate information thoroughly on accounts and institute any necessary actions to ensure that the completed claims are submitted timely
• Participates in departmental and interdepartmental meetings as appropriate
• Maintained professional knowledge by attending multiple Medicare and Medicaid not limited to commercial insurance workshops annually.
• Conducted financial, operational and compliance audits.
• Evaluated operating effectiveness key processes systems place throughout organization, sharing insights gained management team help drive continuous improvement initiatives aimed optimizing overall operational efficiency levels.

• Responsibility for the quality of care delivered, ensuring a safe environment for the patient, and other members of the medical team
• Participate in the development and modification of the plan of care
• Educate patients based on their individual needs, ensuring they understand their plan of care, the steps they need to take to improve their health and maintain a healthy lifestyle
• Maintaining post op care on a Women's and Children's pathway
• IV and oral medication rounds
• Participation in team in learning and preparing Magnet status
• Improved patient outcomes by administering medications, monitoring vital signs, and documenting relevant information.
• Cared for wounds, provided treatments, and assisted with procedures.
• Assisted with admissions, appointments, transfers, and discharges.
• Documented accurate and complete patient information to address patient problems and expected outcomes.
• Demonstrated excellent technical skills in wound dressing changes, IV therapy administration, catheter insertion, and other routine nursing procedures.
• Managed patient care through closely monitoring respiration, blood pressure, and blood glucose levels.
• Facilitated efficient communication between patients, families, and healthcare providers to promote continuity of care across settings.
• Managed time-sensitive tasks effectively under pressure while maintaining composure during critical situations or emergencies.
• Collaborated with interdisciplinary healthcare teams to ensure continuous quality improvement in patient care delivery.
• Adapted quickly to changing patient needs, adjusting care plans accordingly to ensure optimal outcomes in diverse clinical scenarios.
• Performed routine evaluations of each patient's status, needs, and preferences.
• Obtained patient vital signs and input/output measurements from inpatients.
• Comforted and counseled patients and families throughout care process.
• Administered controlled narcotics, inserted IVs, and performed catheterizations.
• Provided compassionate palliative care for terminally ill patients while supporting their emotional needs during end-of-life stages.
• Mentored new nursing staff to enhance professional development opportunities within the team dynamic.
• Collaborated with interdisciplinary team of healthcare and social service providers to address patients' needs through effective intervention and care planning.
• Monitored, tracked, and conveyed important patient information to healthcare staff to help optimize treatment planning and care delivery.
• Educated patients and families on health promotion, disease prevention, and self-care management strategies.
• Evaluated patients to identify and address wounds, behavioral concerns, and medically relevant symptoms.
• Used aseptic techniques to provide sterilized wound care and dressing applications.
• Maintained a safe and therapeutic environment for patients through effective risk assessment and crisis intervention strategies.
• Delivered updates in patient status to charge nurse, recording changes in medical records.
• Offered immediate assistance in emergency and routine paging situations to evaluate needs and deliver care.
• Assisted with feeding and monitored intake to help patients achieve nutritional objectives.
• Delivered culturally competent care that respected diverse patient populations'' unique values, beliefs, and traditions.
• Ensured regulatory compliance by adhering to infection control protocols and maintaining accurate documentation of patient data.
• Increased patient satisfaction scores by consistently delivering high-quality nursing care tailored to individual needs and preferences.
• Educated patients and caregivers on medical diagnoses, treatment options, chronic disease self-management and wound management.
• Answered incoming phone calls from patients to provide basic assistance and triage medical concerns.
• Promoted a culture of teamwork through active participation in unit meetings, performance improvement initiatives, and collaborative problem-solving efforts.
• Minimized staff and patient infection risk by cleaning and disinfecting equipment instruments.

• Float position to fill daily call ins or vacations
• Ability to adapt in all areas of facilities, able to start where someone left off and perform quality work
• Daily duties where in multi medical range of specialty areas
• Responsible for collecting complete, accurate medication information, securing pre-certifications / pre-authorizations from insurance companies; will assist in the development of policy and procedures; assist in resolution of problems with departmental activities
• Effective communication and customer relations skills, and the ability to be self motivated
• Member of the patient care team, contributing to the health management of the patients; many in assistance to section physicians and under the direction and supervision of the Patient Care Manager; maintain primary responsibility for all technical procedures and the operation and care of the nursing unit in the department
• Maintained accurate documentation of all relevant clinical data, ensuring compliance with regulatory standards.
• Managed patient care through closely monitoring respiration, blood pressure, and blood glucose levels.
• Administered controlled narcotics, inserted IVs, and performed catheterizations.
• Obtained patient vital signs and input/output measurements from inpatients.
• Assisted with admissions, appointments, transfers, and discharges.
• Performed wound care treatments using sterile techniques, promoting healing and preventing complications.
• Adhered to treatment plan instructions when administering medications and treatments to patients.
• Documented accurate and complete patient information to address patient problems and expected outcomes.
• Participated in ongoing professional development opportunities to enhance knowledge base and skillset as an LPN.
• Demonstrated adaptability in working with diverse patient populations across various healthcare settings.
• Performed routine evaluations of each patient's status, needs, and preferences.
• Answered incoming phone calls from patients to provide basic assistance and triage medical concerns.
• Accurately recorded interactions in medical charts, documenting accidents and interventions applied.
• Used aseptic techniques to provide sterilized wound care and dressing applications.
• Assisted in the management of chronic health conditions by providing education, support, and follow-up care.
• Offered immediate assistance in emergency and routine paging situations to evaluate needs and deliver care.
• Educated patients and caregivers on medical diagnoses, treatment options, chronic disease self-management and wound management.