Lori A. Zerkle
New Haven
Summary
Professional reviewer with strong analytical skills and meticulous attention to detail. With over 19 years of OASIS, POC and medical necessity review experience , able to provide accurate reviews and helpful education and feedback to clinicians. Possesses expertise in detailed evaluation, and maintaining objectivity. Known for reliability and flexibility, consistently upholding high standards in every review conducted.
Overview
20
20
years of professional experience
1
1
Certification
Work History
Quality Reviewer Specialist
LHC Group
07.2023 - Current
- Maintained strong attention to detail while reviewing numerous documents daily, ensuring consistent quality and accuracy.
- Reduced turnaround time for reviews by effectively prioritizing tasks and managing deadlines.
- Conducted comprehensive OASIS reviews to ensure accuracy and compliance.
- Reviewed and evaluated Plans of Care to ensure compliance with quality standards.
- Worked directly with clinicians to improve OASIS accuracy and maintain proper Plan of Care.
- Delivered OASIS education to clinicians during identified opportunities.
Patient Care Manager
LHC Group/Pleasant Valley Home Health
09.2018 - 07.2023
- Developed strong interdisciplinary team collaboration, resulting in better patient outcomes.
- Collaborated with physicians and other healthcare professionals to develop comprehensive treatment plans for patients.
- Promoted a positive work environment by fostering effective communication, teamwork, and employee engagement.
- Ensured compliance with healthcare regulations by implementing policies and procedures for the highest quality of care.
- Educated and evaluated clinical and support staff regarding care quality management regulations and standards of care.
- Developed and reviewed individualized care plans to enhance patient health, prevent hospital readmissions, and ensure accuracy of Plan of Care.
- Reviewed OASIS and POC documentation to ensure compliance with healthcare standards and guidlines.
- Facilitated accurate OASIS scoring and revision of patient care plans through education of clinician's.
- Performed thorough medical necessity reviews to ensure appropriate patient care, compliance with physician orders, and documentation supporting medical necessity present.
Home Health RN Case Manager
Ohio Valley Home Health
09.2004 - 09.2018
- Conducted comprehensive medical necessity reviews to ensure adherence to patient care plans, physician orders, and supporting documentation.
- Reviewed OASIS and Plan of Care (POC) to maintain high standards of patient care and regulatory compliance.
- Trained new clinician employees on documentation requirements, agency and regulatory policies, and Medicare/Medicaid guidelines.
- Assisted clinicians in accurately scoring OASIS assessments and developing comprehensive Plans of Care.
- Contributed to the creation, assessment, modification, and execution of agency protocols.
- Performed utilization management reviews of home care episodes.
Education
Hearing And Speech Sciences
Ohio University
Athens, OHAssociate of Science - Nursing
Hocking College
Nelsonville, OH06-2001
Skills
- Attention to detail
- Excellent written and verbal communication skills
- Able to independently problem solve, use critical thinking, and use sound nursing judgment to make optimal decisions
- Excellent time management and organizational skills
- RN case management / supervisor experience and quality review experience
- Dependable
Certification
COSC-C
Timeline
Quality Reviewer Specialist
LHC Group
07.2023 - Current
Patient Care Manager
LHC Group/Pleasant Valley Home Health
09.2018 - 07.2023
Home Health RN Case Manager
Ohio Valley Home Health
09.2004 - 09.2018
COSC-C
Hearing And Speech Sciences
Ohio University
Associate of Science - Nursing
Hocking College
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