Salome Uzobuife
Fishkill,NY
Summary
Accomplished in detailed review of charts, assigning correct working DRG, conducting data quality reviews on multi-specialty inpatient records to validate the ICD-10-CM, ICD-10-PCS, and DRG/APR assignment, missed secondary diagnoses and procedures, and ensure compliance with regulatory and reporting requirements, reconciling coding/MS-DRG/APR-DRG discrepancies and validation of patient safety indicators (PSIs) and hospital-acquired conditions (HACs).
Overview
14
14
years of professional experience
1
1
Certification
Work History
Second Level Reviewer
Hackensack Meridian Health System
10.2024 - Current
- Review inpatient medical records that have already been coded to identify opportunities to clarify missing or incomplete diagnoses and assign correct working DRG
- Reconcile coding/MS-DRG/APR-DRG discrepancies or proposed changes by the Clinical Documentation Quality Improvement (CDQI)and Patient Financial Services (PFS) departments, insurers, and vendors.
- Reconciles DRG discrepancies between DRGS/APR's and the Clinical Documentation Quality Improvement (CDQI) department.
- Review and Validates the accuracy and appropriateness of the DRG assignments flagged pre-billing
- Detailed review to find reason for unbilled accounts or PFS edits diagnoses, procedures or DRGs, Resolves edits and rebills cases in3M.
- Reviews PSIs, PDX, Performs Clinical Documentation Quality Reviews to capture measures including Mortality, risk adjustment(RA), SOI,ROM, LOS by using various methodologies such as Vizient, Elixhause
- Verified the discharge status code and all other data elements affecting the DRG assignment; and verified diagnoses identified as HAC's were coded with the correct POA indicator
CDI Specialist
Memorial Sloan Kettering Hospital
10.2020 - 10.2024
- Reviews concurrent medical record for documentation compliance including completeness and accuracy for severity of illness (SOI), risk of mortality (ROM), and quality.
- Reviews medical records of hospitalized patients to identify the most appropriate principle diagnosis and to assign a working DRG. Performs initial reviews, concurrent reviews and retrospective reviews to ensure the DRG accurately reflects the principal diagnosis and all comorbid conditions after study.
- Completes accurate and timely record review to ensure the integrity of documentation compliance.
- Completes accurate and concise input of data into CDI Software resulting in accurate metrics
- Obtained through the reconciliation process. Understands and supports CDI documentation strategies (upon completion of didactic training) and continues to educate self by attending monthly mandated education sessions and using educational tools, videos and provided Webinars
- Maintained strong attention to detail while reviewing numerous documents daily, ensuring consistent quality and accuracy.
- Maintained monthly metrics tracking designated activities
Chart Reviewer
Mount Vernon Clinic
01.2012 - 08.2020
- Identified opportunities for process improvement through careful analysis of chart review outcomes.
- Contributed to an increase in overall patient satisfaction through detailed examination of medical records and proactive issue resolution.
- Ensured compliance with healthcare regulations by thoroughly assessing charts for proper documentation.
- Strengthened the organization's commitment to patient privacy by maintaining strict adherence to HIPAA regulations during all chart review activities.
- Determined whether claims examiners or management questions could be appropriately addressed or referred to other team members.
Epic Analyst
HCI Group
07.2019 - 09.2019
- Evaluated new software releases from Epic, recommending upgrades based on cost-benefit analyses.
- Built strong relationships with stakeholders across multiple departments, fostering trust and cooperation essential for project success.
- Supported successful go-live events, minimizing disruptions to daily operations.
- Collaborated closely with other analysts in the design, testing, and implementation of specialized projects that addressed unique organizational needs.
- Served as a liaison between IT and end-users, bridging communication gaps and fostering collaboration.
Education
Associate of Applied Science - Nursing
Mount Saint Mary College
Newburgh, NYM.D. - MBBS
University of Nigeria
Bachelor of Science - Biological Sciences
University of Nigeria
Skills
- Documentation compliance
- Clinical workflow knowledge
- Active Listening
- Process Improvements
- Team Collaboration
Certification
- CDIP: AHIMA
- CCS: ACDIS
- CPC: AAPC
- MBBS: NMA
- ECFMG: USMLE
- BSc Nursing
Timeline
Second Level Reviewer
Hackensack Meridian Health System
10.2024 - Current
CDI Specialist
Memorial Sloan Kettering Hospital
10.2020 - 10.2024
Epic Analyst
HCI Group
07.2019 - 09.2019
Chart Reviewer
Mount Vernon Clinic
01.2012 - 08.2020
Associate of Applied Science - Nursing
Mount Saint Mary College
M.D. - MBBS
University of Nigeria
Bachelor of Science - Biological Sciences
University of Nigeria
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