Summary
Overview
Work History
Education
Skills
Timeline
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Lisa Schadtler

Fredericksburg,VA

Summary

With a proven track record at Mary Washington Health Care, I excel in Revenue Cycle Management, showcasing expertise in compliance and denials resolution. My adept use of FISS and Palmetto resulted in maintaining Compliance during a 45% audit volume increase and a zero error rate on several CMS topics.

Overview

20
20
years of professional experience

Work History

Senior Specialist Denials

Ensemble Health Partners
11.2024 - Current
  • Recruited to Governmental Audits team for leading Revenue Cycle Management experts


Billing Compliance Specialist

Mary Washington Health Care
06.2017 - 11.2024
  • Ensured compliance with multiple Governmental Auditors including the CMS MAC and RAC programs, Medicaid (Myers and Stauffer), Livanta QIO and the CERT program
  • Direct responsibility for review and submission of medical documentation to both Governmental and Commercial Auditors
  • Served as front-line contact for Palmetto reviewers for both ADR and Targeted Probe and Educate audits resulting in zero percent error rate for seven CMS topics
  • Coordinated all correspondence between three Nurses, internal Coding Auditor to ensure timely appeal filing
  • Reduced instances of non-compliance through meticulous monitoring of internal processes

Denials Specialist

Mary Washington Health Care
04.2012 - 06.2017
  • Maintained knowledge of insurance coverage benefit levels, eligibility systems and verification processes.
  • Improved claim denial resolution by thoroughly researching and identifying root causes of denials.
  • Optimized workflows within the team by assigning tasks based on individual strengths and expertise in particular payers or denial reasons.
  • Identified root cause of denials to provide plans for denial resolution.

Collections, Workers Compensation

HCA Parallon
09.2004 - 03.2012
  • Responsible for contacting numerous Payors to achieve payment of Workers Compensation claims
  • Assigned as primary contact and liasion for resolution of OCWP claims for Portsmouth Naval Shipyard employees
  • Interdepartmental coordination of claims and medical documentation

Education

Associate of Arts -

Suffolk County Community College
Selden, NY

Skills

  • Extensive use of FISS to preview audits and monitor existing claims
  • Frequent use of Palmetto and Cotiviti portals to monitor ADR and RAC claims
  • Maintained compliance with a 45% increase in audit volume over a one year period
  • Achieved zero error rate for six Targeted Probe and Educate topics
  • Responsible for cross-training Regulatory staff on audit processes
  • Onboarded and trained new Denials Specialist
  • Maintain access to multiple Commercial Auditor website to address direct requests from Reviewers

Timeline

Senior Specialist Denials

Ensemble Health Partners
11.2024 - Current

Billing Compliance Specialist

Mary Washington Health Care
06.2017 - 11.2024

Denials Specialist

Mary Washington Health Care
04.2012 - 06.2017

Collections, Workers Compensation

HCA Parallon
09.2004 - 03.2012

Associate of Arts -

Suffolk County Community College
Lisa Schadtler