Jessica Wiggs RN,BSN,CPC,CRC

• Managed CDI department staff, overseeing workflow analysis and productivity management.
• Developed and implemented strategic planning processes for CDI initiatives.
• Collaborated with stakeholders to analyze provider metrics and align departmental goals.
• Facilitated physician documentation reporting, ensuring compliance with AAPC and CMS guidelines.
• Implemented pre-visit chart review process to identify potential risk adjustment conditions.
• Established chart review workflow guidelines alongside coding manager for team efficiency.
• Educated staff and providers on proper coding practices utilizing adult learning principles.
• Created visualizations of complex data sets using Tableau, PowerPoint, and Excel.
• Conducted weekly meetings with team members to discuss upcoming tasks and project deadlines.

• Directed daily operations of QDR department, supervising 15 employees to enhance productivity.
• Developed workflows focusing on Risk Adjustment and HCC capture improvement.
• Collaborated with stakeholders to analyze provider metrics and drive strategic planning.
• Facilitated second-level reviews of physician documentation for coding compliance.
• Educated staff and providers on CMS coding practices utilizing adult learning principles.
• Created educational materials on risk adjustment documentation and coding standards.
• Managed scheduling to optimize coverage during peak periods and projects.
• Monitored operations and reviewed metrics to assess company performance.

• Managed CDI department staff, focusing on workflow analysis and productivity management.
• Developed CDI workflow to enhance Risk Adjustment and HCC capture processes.
• Contributed to CDI strategic planning and process improvement initiatives.
• Facilitated clinical documentation reviews ensuring compliance with AAPC coding standards.
• Educated staff and providers on CMS coding guidelines using adult learning principles.
• Collaborated with quality, coding, auditing teams, and physician champions to enhance documentation.
• Reviewed patient charts during RADV audits to ensure accurate risk adjustment coding.
• Performed quality reviews to monitor adherence to HCC metrics and provider feedback.

• Aligned policies and procedures with Wellmed operating guidelines across various purchased entities.
• Conducted comprehensive review of policies and procedures for compliance with best practices and laws.
• Collaborated with subject matter experts to develop new policies and standard operating procedures
• Participated in meetings with senior officers to discuss policy changes and new initiatives.
• Devised significant policy and procedure improvements based on research findings and reports.

• Audited physician documentation for compliance with AAPC coding standards and CMS guidelines.
• Educated staff and providers on coding practices using adult learning principles.
• Delivered training on HEDIS measures to ensure provider compliance.
• Reviewed patient charts to capture all relevant risk adjustment codes.
• Provided education and feedback on HCC metrics and chronic condition identification.
• Provided clinical leadership and support to junior staff on complex cases.
• Analyzed medical data to identify trends and develop strategies for improvement of documentation and coding.
• Performed data analysis using statistical programs and generated reports for review.
• Ensured compliance with applicable regulations related to CDI initiatives.
• Maintained up-to-date knowledge of emerging technologies related to CDI initiatives.
• Maintained data integrity and performed routine data audits.

Covered administrative duties during practice manager absence in clinic.

• Planned, organized, and directed nursing staff activities effectively.
• Applied clinical judgment to assist floor nurses with patient care decisions.
• Trained other nurses on patient care and daily tasks, supporting growth and professional development.
• Adhered strictly to HIPAA regulations while handling confidential information.
• Conducted chart audits to ensure proper billing and closure of encounters.
• Resolved patient concerns and grievances to enhance patient services.
• Participated in Nursing Leadership Council to improve clinic workflow and patient experiences.
• Managed all aspects of clinical nursing care, including check-in and discharge education.
• Assisted with pain management procedures and radiology setups for optimal patient recovery.

Maintained a safe environment for all patients through strict adherence to infection control policies.

• Managed Texas Vaccines for Children program, ensuring accurate administration and reporting.
• Updated patient charts consistently during shifts to uphold meticulous recordkeeping standards.
• Advocated for patients by respecting and supporting fundamental rights and values.
• Performed administrative duties in absence of practice manager to ensure continuity of operations.
• Conducted chart audits to verify closure of encounters and accuracy of billing processes.
• Communicated with staff to integrate Patient Centered Medical Home model into daily workflows.
• Resolved patient concerns and grievances to enhance overall patient service experience.

• Covered administrative duties in absence of practice manager to ensure continuity.
• Utilized ADIET framework for effective communication with diverse patient demographics.
• Managed Texas Vaccines for Children program to enhance immunization efforts.
• Conducted chart audits to verify closure of encounters and accuracy of billing.
• Collaborated with staff to integrate Patient Centered Medical Home model into daily operations.
• Resolved patient concerns and grievances, promoting enhanced service delivery.
• Planned, organized, and directed the activities of nursing staff members.
• Applied clinical judgment and comprehensive knowledge of facility policies to assist floor nurses with patient care decisions.
• Ensured all staff members had proper training before beginning duties on the unit.
• Administered oral, IV and intra-muscular medications and monitored patient reactions.
• Resolved conflicts between healthcare personnel or patients and families when necessary.

• Supervised nursing care delivery and evaluated patient flow from Emergency Department to inpatient rooms.
• Provided quality direct care through daily monitoring and assessment of medical conditions.
• Developed and implemented nursing care plans tailored to patient needs.
• Communicated effectively with patients across diverse age groups and ethnic backgrounds.
• Coordinated patient discharges, facilitating connections to external services and appointments.
• Evaluated patients, recognized and addressed complications and coordinated treatment with other members of critical care team.
• Maintained a safe environment for all patients by adhering to infection control policies and procedures.

• Conducted initiation and termination of hemodialysis treatment procedures.
• Delivered direct quality care through assessment and vital sign monitoring before, during, and after treatments.
• Executed acute interventions as necessary to address patient needs.
• Maintained and updated patient charts, ensuring compliance with vaccination requirements.
• Formulated and implemented comprehensive nursing care plans for optimal patient outcomes.
• Maintained a safe environment for all patients by adhering to infection control policies and procedures.
• Evaluated patients, recognized and addressed complications and coordinated treatment with other members of critical care team.