Paulina Soto
Mount Prospect,Il
Summary
- Served as Subject Matter Expert for Data Analysis and Reporting
- (10yrs) Developing Organization Wide Reports in collaboration with Risk, Quality and Claims stakeholders.
- (10yrs) Serving as a Liaison between Stakeholders (e.g. clinical leaders, physicians and administrators)
- (5yrs) Served as the primary administrative support for the Ethics Committee, coordinating meetings, preparing agendas, and maintaining confidential documentation in alignment with healthcare regulatory standards.
- Served as a lead team member in the successful onboarding of two hospitals onto the RLDatix event reporting system, completing the project ahead of schedule and supporting cross-functional coordination and staff readiness.
Overview
17
17
years of professional experience
1
1
Certification
Work History
System Administrator
Endeavor Health
01.2014 - Current
- Designed and maintained department training dashboards and scorecards to track compliance, incident trends, and performance metrics, supporting leadership in data-driven decision-making
- Utilized Tableau to develop interactive visualizations and dashboards for Risk, Claims, and Quality data, increasing accessibility and understanding of department-level performance indicators.
- Created and distributed daily and weekly huddle reports summarizing key safety events, training progress, and operational updates to enhance team communication and accountability
- Developed and delivered targeted training sessions for department heads on the organization's Risk, Claims, and Feedback reporting systems, ensuring consistent understanding and effective use across all units
- Managed and updated department intranet resources, partnering with Learning & Development to produce video modules and step-by-step user guides that supported frontline staff and managers in navigating event investigations
- Provide continual technical and functional best practices to support applications
- Produce reports as needed for The Joint Commission, Magnet, CMS, IDPH, MAPS
- Responsible for analysis to highlight trends to assist in developing policies
- Serve a reference for RLDatix solutions to new and existing clients for software best practices
- Led the end-to-end onboarding of two hospitals onto the organization’s RLDatix platform, including infrastructure setup, system configuration, and integration with existing Electronic Health Record (EHR) systems. Customized workflows and reporting features to align with each hospital’s clinical operations and risk management needs.
Institutional Ethics Committee Administrator
Northshore University Healthsystem
05.2015 - 06.2023
- Support the Institutional Ethics Committee (“IEC”) Chairman, Vice Chairs and the Subcommittee (Education and Medicine through Literature series)
- Manage organizational ethics consultation requests and coordinating and scheduling those consults (room reservations, order catering, process stipends) for IEC chair and vice chairs
- Editor and Distributor for the Dilemmas and Dialogue bi-monthly newsletter
- Prepare and distribute ethics agenda, minutes and reference materials for monthly meetings
- Maintaining files, attendance records, membership lists, ethical case consultation summaries
Senior Coding Support Specialist
Northshore University Healthsystem
04.2009 - 03.2014
- Resolved complex coding edits in Workqueues for multiple specialties
- Collaborated with SPI billing company to analyze and resolve coding denials for Medical Group physicians, improving claim acceptance and revenue cycle performance.
- Served as team lead for the annual GPRO/PQRS Medicare Initiative, ensuring accurate quality reporting and compliance with CMS requirements.
- Trained and mentored new employees on GPRO/PQRS requirements and the effective management of specialty coding Workqueues.
- Supported Specialty Care physicians in the accurate assignment of ICD-9, CPT, and HCPCS codes, enhancing documentation accuracy and billing efficiency.
- Applied advanced knowledge of medical coding guidelines to review clinical documentation and ensure accurate charge capture for physician reimbursement.
- Reviewed and analyzed provider documentation to assign appropriate procedure, service, and diagnosis codes for accurate and timely claim submission.
Education
Master of Business Administration -
National Louis University
06.2025
Bachelor of Science - Healthcare Business and Management
National Louis University
06.2012
Associate in Applied Science - Healthcare Information Technology
Oakton College
05.2009
Skills
- Team collaboration across departments
- Adaptable in fast-paced environments
- Report Building & Data Analysis
- User Training & Documentation
- Proficient in Tableau, Microsoft Word, Excel, PowerPoint
Certification
Registered Health Information Technologist, RHIT
AWARDS
Recipient of Six Service Value Awards for outstanding results in developing projects that helped report and track data for Hospital Department Heads and various committees
Languages
Spanish
Native or Bilingual
English
Native or Bilingual
Timeline
Institutional Ethics Committee Administrator
Northshore University Healthsystem
05.2015 - 06.2023
System Administrator
Endeavor Health
01.2014 - Current
Senior Coding Support Specialist
Northshore University Healthsystem
04.2009 - 03.2014
Bachelor of Science - Healthcare Business and Management
National Louis University
Associate in Applied Science - Healthcare Information Technology
Oakton College
Master of Business Administration -
National Louis University