Paula Early
New Orleans,LA
Summary
Skilled at enhancing revenue integrity and compliance by using critical thinking and having excellent communication skills to rectify coding discrepancies and streamline billing processes My collaborative approach and proficiency in EMR/EHR systems led to significant improvements in charge accuracy, showcasing my problem-solving skills and commitment to teamwork, make me a dependable asset in any healthcare setting.
Overview
19
19
years of professional experience
Work History
Senior Revenue Integrity Liaison
University Medical Center, UMC
06.2013 - Current
- Reviewed patients medical record, charge captures reports, and billing data to ensure accurate coding, appropriate charge capture and compliance with applicable regulations.
- Ensure that documentation meets internal and external billing regulations, including Medicare/Medicaid guidelines, and follows coding standards(e.g. ICD-10, CPT, HEDIS, & HCPCS).
- Identify discrepancies and deficiencies in documentation, providing recommendations for corrective actions to maintain compliance.
- Worked closely with clinical billing, coding and revenue cycle teams to resolve discrepancies, charge capture issues and billing errors by serving as a liaison between clinical departments and the revenue cycle team to ensure cohesive communication and charge accuracy.
- Analyzed data and findings to prepare reports detailing financial information.
- Analyzed Medical Records to ensure services rendered are properly charged and billed on diagnosis, procedure codes, and payer guidelines.
- Identified control gaps in processes, procedures and systems through in depth research and assessment and suggested methods for improvement.
- Executed audits and entered data into Excel software for analysis.
- Coordinated, managed and implemented auditing projects and prepared for evaluation.
- Collected and analyzed data and feedback to identify overcharges and undercharges.
Clinical Quality Audit Nurse
University Medical Center, UMC
06.2006 - 06.2013
- Provided clinical oversight and support to healthcare teams by providing feedback and training to clinical departments on charge captures, charge issues, and regulatory charges that impact billing and coding.
- Verified the correct usage of procedures (e.g. CPT, HEDIS, HCPCS)and diagnosis ( ICD-10) to ensure charges align with cilclinical documentation.
- Identify and investigate charge discrepancies, missing charges, or incorrect coding, and work with relevant departments to resolve issues.
- Created Educational materials for staff on the best principles for documentation and charge entry.
- Collaborate with Charge Review Coordinators and Charge Review Specialists to monitor charge capture functions across all LCMC entities.
Education
No Degree - Clinical Research Nursing
Dillard University
New Orleans, LA05-2013
Bachelor of Science - Nursing
Loyola University, New Orleans
New Orleans, LA12-2011
Associate of Science - Nursing
Charity Delgado School of Nursing
New Orleans, LA05-1995
Associate of Arts -
Southern University At New Orleans
New Orleans, LA05-1989
Skills
- Excellent Verbal and written communication
- Time management
- Critical thinking
- Problem solver
- Reliable
- Dependable
- Teamwork
- Self Motivated
- EMR/EHR systems
Languages
English
Timeline
Senior Revenue Integrity Liaison
University Medical Center, UMC
06.2013 - Current
Clinical Quality Audit Nurse
University Medical Center, UMC
06.2006 - 06.2013
No Degree - Clinical Research Nursing
Dillard University
Bachelor of Science - Nursing
Loyola University, New Orleans
Associate of Science - Nursing
Charity Delgado School of Nursing
Associate of Arts -
Southern University At New Orleans
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