Expert Details
Health Care Compliance
ID: 736056
Ohio, USA
I earned my MD in 1994 and my MBA in 1999. I’ve been an American Academy of Professional Coders (AAPC) - Certified Professional Coder (CPC) since 1996, and have followed that up with certification as an instructor (CPC-I) in 2008 and Certified Professional Medical Auditor (CPMA) in 2018. My concentration is on physician / professional fee coding, compliance, auditing, billing and documentation, but I have also worked from the hospital / facility perspective. My coding expertise includes CPT, E/M, ICD10, HCPCS level II and HCCs. I’ve worked in employment roles for cancer, adult and pediatric hospitals, as well as a consultant for a big-four, mid-size, and my own consulting company.
I also completed a one-year residency in General Surgery for the academic year 2012-2013, serving as a refresher in clinical medicine, exposing me as a clinical user to electronic medical records, and providing additional insights into clinicians and the practice of medicine. My strengths include my blend of clinical and coding expertise and my attention to detail.
Education
Year | Degree | Subject | Institution |
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Year: 2013 | Degree: MD, PGY-1 | Subject: General Surgery Preliminary Internship | Institution: Michigan State University |
Year: 1999 | Degree: MBA | Subject: Business Administration | Institution: Ohio University |
Year: 1994 | Degree: MD | Subject: General Medicine | Institution: University of Cincinnati College of Medicine |
Year: 1989 | Degree: BS | Subject: Biological Sciences | Institution: Wright State University |
Work History
Years | Employer | Title | Department |
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Years: 2000 to Present | Employer: Undisclosed | Title: Health Care Compliance Consultant | Department: |
Responsibilities:Provide professional billing, coding, documentation, compliance and other medical business and legal services and support to the healthcare industry. |
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Years | Employer | Title | Department |
Years: 2017 to 2019 | Employer: Crowe Healthcare Risk Consulting, LLC | Title: Compliance Audit Manager | Department: Compliance |
Responsibilities:Managed healthcare client engagements primarily for audit work, in both external and internal audit capacities. |
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Years | Employer | Title | Department |
Years: 2015 to 2016 | Employer: Nationwide Children's Hospital | Title: Supervisor, Coding and Charge Entry | Department: Pediatric Academic Association, Inc. / Professional Billing |
Responsibilities:Managed the Coding and Charge Entry departments (20 internal employees and external contract coders, as needed) for Pediatric Academic Association, Inc., a 500+ teaching physician and advanced practice nurse multispecialty group practice. |
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Years | Employer | Title | Department |
Years: 1998 to 2000 | Employer: Ernst & Young, LLP | Title: Senior Consultant | Department: Healthcare Litigation Advisory Services |
Responsibilities:Served clients as part of the Healthcare Litigation Advisory Services and Healthcare Consulting Services teams. |
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Years | Employer | Title | Department |
Years: 1996 to 1998 | Employer: DMF of Ohio, Inc. / The Ohio State University Medical Center | Title: Coding and Reimbursement Manager and Specialist | Department: Department of Internal Medicine |
Responsibilities:Managed and executed coding, compliance, contracting, credentialing and reimbursement functions for The Ohio State University Department of Internal Medicine, a then-independent 170+ teaching physician and advanced practice nurse multispecialty group practice. |
Career Accomplishments
Licenses / Certifications |
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American Academy of Professional Coders (AAPC) member Certified Professional Coder (CPC), 1996 Certified Professional Coder- Instructor (CPC-I), 2008 Certified Professional Medical Auditor (CPMA), 2018 |