Summary
Overview
Work History
Education
Skills
Accomplishments
Certification
Timeline
Generic

Paula Boneau

Katy,TX

Summary

Results-driven Clinical Documentation Specialist known for high productivity and efficient task completion. Possess specialized skills in medical coding, clinical information management, and regulatory compliance. Excel in critical thinking, teamwork, and effective communication to ensure accuracy and integrity of clinical documentation.

Overview

47
47
years of professional experience
1
1
Certification

Work History

Clinical Documentation Specialist

Steward Health Care
Port Arthur, TX
02.2010 - Current
  • Examined medical records for precise and thorough documentation using the EMR and working within the Iodine product.
  • Sending physicians queries through the EMR and Iodine product.
  • Synthesized data acquired from diverse origins like radiology, lab findings, and pathology results
  • Identified discrepancies in documentation with providers and resolved inconsistencies in a timely manner.
  • Monitored compliance with regulatory standards for the Clinical Documentation Improvement program.
  • Developed and implemented policies and procedures related to clinical documentation improvement initiatives.
  • Assisted physicians in development of comprehensive patient care plans through accurate coding and effective communication of results.
  • Provided education to healthcare professionals on proper utilization of ICD-10 codes and other relevant coding guidelines.
  • Collaborated with interdisciplinary teams to identify opportunities for improvement in clinical documentation processes.
  • Identified areas of risk related to incomplete or inaccurate documentation practices.
  • Participated in regular meetings with physicians, nurses, case managers, coders, therapists. to discuss changes or improvements needed for clinical documentation processes.
  • Compiled data from various sources such as EMRs, physician notes and other documents into a single source document.
  • Performed periodic audits of medical records to verify accuracy of coded diagnoses and procedures.
  • Developed strategies designed to improve quality outcomes associated with specific diagnosis groups.
  • Actively participated in special projects related to improving overall quality scores within the organization.
  • Determined quality of care provided to patients through careful assessment of medical documentation.
  • Uncovered discrepancies in health records and contacted physicians to provide further documentation to clarify concerns.

Director of Case Management

Renaissance Hotel
Port Arthur, Texas
04.2001 - 02.2010
  • Oversaw the daily operations of the case management department including staffing, budgeting, and quality assurance.
  • Identified, assessed, and managed high-risk cases in need of intensive care coordination.
  • Coordinated with community health resources to ensure optimal patient care outcomes.
  • Conducted regular meetings with the case management staff to review current cases and discuss best practices.
  • Collaborated with healthcare providers to develop individualized treatment plans for patients.
  • Provided ongoing education to case managers on pertinent regulations affecting their practice.
  • Maintained a comprehensive database of patient records for use in tracking progress and evaluating results.
  • Negotiated contracts with insurance companies for authorization of services.
  • Analyzed utilization trends within the facility in order to identify areas for improvement.
  • Facilitated interdisciplinary team meetings regarding complex cases requiring additional support or guidance.
  • Streamlined discharge planning to create efficient, patient-oriented care strategies.
  • Collaborated with multidisciplinary team to establish record of comprehensive patient care plans.
  • Assisted with Physician Credentialing Review.
  • Reviewed appeals and denials for all governmental and nongovernmental insurances with a physician director.
  • Interpreted regulations and policies to establish compliance with operational requirements.

Home Health Patient Coodinator

Home Care Specialties
Port Neches, Texas
01.1994 - 01.2001
  • Developed and implemented patient intake forms to ensure accurate information was collected.
  • Coordinated follow-up care for discharged patients and monitored progress towards recovery goals.
  • Acted as liaison between physicians, staff members, patients, families, and third-party payers.
  • Processed referrals from primary care providers for specialist consultations or treatments.

Utilization Review Nurse

Doctor's Hospital ER
Port Neches, Texas
01.1988 - 01.1994
  • Assessed patient medical records to determine the appropriateness of requested services and procedures.
  • Conducted reviews of inpatient utilization for compliance with admission criteria and concurrent review requirements.
  • Provided education to providers regarding utilization management processes and protocols.
  • Collaborated with multidisciplinary teams on developing strategies for improving care quality and controlling costs.
  • Reviewed denial letters issued by insurance companies to ensure that they were appropriate and timely.
  • Monitored pre-authorization requests to ensure that all necessary information was received prior to approval or denial of services.
  • Developed case management plans based on individual patient needs and eligibility criteria.

ICU Staff Nurse

Doctors Hospital
Port Neches, TX
01.1978 - 01.1988
  • Assessed, monitored and evaluated patient's condition in the ICU.
  • Provided direct care to critically ill patients including administering medications, performing treatments and providing emotional support.
  • Collaborated with physicians and other healthcare professionals to develop individualized treatment plans for each patient.
  • Maintained accurate records of vital signs, fluid intake and output levels, daily weights and laboratory results.
  • Managed ventilators, tracheostomy tubes and intravenous lines while monitoring oxygenation levels and hemodynamic parameters.
  • Monitored cardiac rhythms on telemetry monitors; recognized arrhythmias and initiated corrective measures when necessary.
  • Counseled patients' families regarding end-of-life decisions, health maintenance or any other relevant topics related to their loved ones' care plan.
  • Actively participated in quality improvement initiatives aimed at improving patient outcomes.
  • Assisted physicians during invasive procedures such as intubations or bronchoscopies.
  • Implemented infection control policies within the ICU environment ensuring optimal safety for both staff members and patients alike.

Education

Case Management Certification - Case Management

American Institute of Outcomes Case Management
New Orleans, LA
05-1996

Licensed Vocational Nurse - Nursing

Lamar University
Beaumont, TX
05-1974

Skills

  • Clinical documentation management
  • Record auditing
  • Proficient in Iodine
  • Skilled in Meditech Software
  • Documentation improvement
  • Experienced with Cerner Software
  • Problem-solving capabilities
  • Regulatory Compliance
  • Strong attention to detail
  • Electronic Health Records Management

Accomplishments

  • Nursing Excellence of the Year 1984
  • Employee of the Year 2005

Certification

  • LVN
  • CMC

Timeline

Clinical Documentation Specialist

Steward Health Care
02.2010 - Current

Director of Case Management

Renaissance Hotel
04.2001 - 02.2010

Home Health Patient Coodinator

Home Care Specialties
01.1994 - 01.2001

Utilization Review Nurse

Doctor's Hospital ER
01.1988 - 01.1994

ICU Staff Nurse

Doctors Hospital
01.1978 - 01.1988

Case Management Certification - Case Management

American Institute of Outcomes Case Management

Licensed Vocational Nurse - Nursing

Lamar University

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Paula Boneau