RIVIERA R. LAMBERT
Milwaukee,WI
Summary
Experienced Health Information Management (HIM) Manager with a strong background in CMS and Wisconsin DHS compliance, HIPAA, medical records governance, audits, and survey readiness within skilled nursing and long-term care settings. Proven leader in staff and executive training, policy development, QAPI participation, and legal record support. Certified in dementia care, substance use counseling (SAC-IT), and medical reimbursement, with extensive interdisciplinary collaboration experience.
Overview
12
12
years of professional experience
1
1
Certification
Work History
Health Information Management (HIM) Manager
Luther Manor Health Care Center
2021.10 - Current
- Direct medical records operations; ensure CMS, Wisconsin DHS, and HIPAA compliance; train employees, managers, directors, and executive leadership; participate in IDT, QAPI, and Infection Control committees; audit MDS, BIMS, nursing assessments; support GDR and medication reviews; oversee ROI and legal requests; support audits, surveys, and legal cases.
HIM Manager
Luther Manor Nursing Home
2021.10 - Current
- Led operational improvements enhancing quality of care and resident satisfaction.
- Implemented training programs for staff, increasing service efficiency and compliance with regulations.
- Developed and enforced policies ensuring adherence to health and safety standards.
- Coordinated interdisciplinary team meetings to align care strategies and address resident needs.
- Managed and motivated employees to be productive and engaged in work.
- Oversaw procurement of supplies, negotiating contracts to manage budget effectively.
- Conducted performance evaluations, providing constructive feedback to support employee development.
Medical Coder
Wheaton St. Joseph Hospital
2015.08 - 2018.01
- Assigned ICD-10-CM, CPT, and DRG codes; reviewed documentation for compliance; queried providers; processed denied claims and appeals.
- Reviewed and coded medical records using ICD-10 and CPT coding systems.
- Ensured compliance with regulations through accurate documentation and coding practices.
- Collaborated with healthcare providers to resolve coding discrepancies and improve accuracy.
- Mentored junior coders, fostering skill development and adherence to best practices in coding.
Release of Information (ROI) Specialist
HealthPort Technologies
2014.05 - 2015.06
- Processed and released medical records in compliance with HIPAA and state regulations; handled legal and insurance requests.
- Analyzed ROI metrics to enhance financial performance and operational efficiency.
- Developed strategic reports to support executive decision-making and resource allocation.
- Streamlined data collection processes, improving accuracy of financial analyses.
- Collaborated with IT to optimize analytics tools for enhanced reporting capabilities.
- Mentored new hires within the ROI team, fostering a supportive learning environment that contributed to overall staff retention rates.
Administrative & Operations Intern
Froedtert Memorial Health
2013.11 - 2014.03
- Interned under Gary Colpaert, Vice President of Clinical & Support Services; assisted with operations, staff meetings, Lean process presentations, and development of training policy materials.
- Supported implementation of new scheduling systems to optimize resource allocation.
- Monitored inventory levels, facilitating timely procurement of supplies and equipment.
- Studied with senior staff to develop deep understanding of team processes and full operational activities.
- Handled administrative and data entry work for staff.
- Promoted a positive work environment by being proactive in addressing concerns, offering assistance, and maintaining open lines of communication with colleagues.
Education
Associate Degree - Medical Administrative Assistant
Bryant & Stratton College
Wauwatosa, WI05.2014
Bachelor of Science - Psychology
University of Wisconsin–Milwaukee
Milwaukee, WI05.2026
Skills
- Health Information Management (HIM)
- CMS & Wisconsin DHS Compliance
- HIPAA & Privacy Oversight
- QAPI & Performance Improvement
- Policy Review & Development
- Survey Readiness & Audits
- Risk Management & Legal Support
- Infection Control Documentation
- MDS, BIMS & Nursing Assessment Audits
- Psychotropic Monitoring & GDR
- Medication Review (Pharmacy & Providers)
- Point Click Care (PCC)
- Staff, Manager & Executive Training
- Customer service
- Team leadership
- Time management
- Decision-making
- Verbal and written communication
- Complex Problem-solving
- Staff training and development
- Staff management
- Task delegation
- Goal setting
- Documentation and reporting
- Relationship building
- Operations management
- Strategic planning
- Project management
- Cross-functional teamwork
- Customer relationship management (CRM)
- Project planning
- Policy implementation
- Shift scheduling
- Schedule preparation
- Conflict resolution
- Workforce management
- Performance evaluations
- Business administration
- Work prioritization
- Policy and procedure development
- Recruiting and interviewing
- Data analysis
- Risk management
- Partnership development
- Regulatory compliance
- Teamwork and collaboration
- Disciplinary techniques
- Computer skills
- Effective communication
- Problem resolution
- Positive attitude
- Adaptability and flexibility
- Attention to detail
- Multitasking
- Problem-solving
- Multitasking Abilities
- Excellent communication
- MS office
- Professional and courteous
- Scheduling and coordinating
- Negotiation and conflict resolution
- Problem-solving aptitude
Accomplishments
- Supervised team of 5 staff members.
- Documented and resolved policies and procedures which led to pasing state survey .
- Collaborated with team of 15 in the development of infection control policies.
- RESEARCH McNair Scholars Program — Research on insurance barriers to mental-health access among African American women
- Froedtert Memorial Health — Administrative & Operations Intern | 2013–2014 Interned under Gary Colpaert, VP of Clinical & Support Services Lean workflow presentations • policy & training development • operations exposure
Certification
- Certified Medical Reimbursement Specialist (CMRS)
- Certified Dementia Practitioner (CDP)
- Substance Abuse Counselor-In-Training (SAC-IT)
- Medical Coding Diploma
- Electronic Medical Records (EMR) Certificate
- HIPAA Compliance Certification
- McNair Research Scholar
Timeline
Health Information Management (HIM) Manager
Luther Manor Health Care Center
2021.10 - Current
HIM Manager
Luther Manor Nursing Home
2021.10 - Current
Medical Coder
Wheaton St. Joseph Hospital
2015.08 - 2018.01
Release of Information (ROI) Specialist
HealthPort Technologies
2014.05 - 2015.06
Administrative & Operations Intern
Froedtert Memorial Health
2013.11 - 2014.03
Associate Degree - Medical Administrative Assistant
Bryant & Stratton College
Bachelor of Science - Psychology
University of Wisconsin–Milwaukee
Personal Information
Title: Health Information Management (HIM) Manager