Kelly Patterson
Topeka
Summary
Experienced auditor specializing in coding and clinical validation audits. Proven track record in compliance and clear communication, supporting successful outcomes in payor audits.
Overview
11
11
years of professional experience
Work History
Joint Medical Advisory Committee Auditor (JMAC) RN
Northwell Health
New York, NY
02.2022 - 02.2026
Conducted thorough audits for both coding and and clinical validation.
Review and respond to payor audits.
Attend JMAC calls with United Healthcare, Aetna, Emblem and Cigna where I presented my findings to support the the billed DRG including both clinical validation, coding validation, and procedural coding.
Team Leader, DRG Validation
Cotiviti Healthcare
Atlanta, GA
02.2015 - 02.2022
Led a a team of DRG auditors addressing both coding and clinical validation to support the correct DRG, both APR and DRG proficient.
Teaching on-site and remote, assisted with development of training programs to improve staff performance to ensure adherence of best practices.
Education
Bachelor of Science - RN, BSN
Washburn University of Topeka
Topeka, KS05-1993
Skills
- Attention to detail
- Team collaboration
- Audit reporting
- Decision-making
- Clear communication
- Compliance standards
- Industry expertise
Timeline
Joint Medical Advisory Committee Auditor (JMAC) RN
Northwell Health
02.2022 - 02.2026
Team Leader, DRG Validation
Cotiviti Healthcare
02.2015 - 02.2022
Bachelor of Science - RN, BSN
Washburn University of Topeka