Breana Stillo Email and Phone Number

•Manages the design of data tables and performs database maintenance for all data sets related to physician services and billing operations. •Coordination of activities to ensure health information is complete and accurate in all systems.•Critically evaluate information gathered from multiple sources, reconcile conflicts, and distinguish user requests from the underlying true needs.•Evaluates the appropriateness of services and procedures billed based on supporting documentation; evaluates appropriateness of diagnoses (ICD) and procedural (CPT) codes billed for services; evaluates adequacy of documentation; evaluates level of service billed for evaluation and management (E/M) services, evaluates appropriateness of modifier usage; makes determinations of overpayments and underpayments and performs other related analysis and evaluations.•Participate in studies of new and/or existing programs, and special projects to determine feasibility and resolve problems including organizational, procedural, technical and fiscal research and analysis.•Prepares basic analyses to evaluate and modify existing process to generate additional efficiency, support new/expanded services and facility/equipment acquisitions.•Identifies areas for improvement based on operations of service to improve capacity, efficiency and overall effectiveness. Implements and monitors identified changes to assure success.•Develops trend analysis reports that monitor key performance indicators and compares them to internal and external benchmarks.•Develops and maintains Access databases and queries while using SQL•Assist with exclusions process by scrubbing data and working exclusions

Responsible for project management including implementations, RFPs, financial reporting and special projects. - Manage RFP/RFI process and multiple new client implementations as it relates to the communication, coordination, set up and transition from an implementation state to a maintenance state- Maintain plan design information for each client- Work with PBM to resolve financial and service issues- Maintain client database, participate in conference calls and meetings- Prepare exhibits and content for presentations and reports- Assist the team as needed with completing key/critical tasks impacting the success of the overall project.- Collaborate with internal colleagues, external vendors and clients as needed

Conduct payer audits, ensures timely response to audit requests and determines appropriate responses to audit findings, in collaboration with a multi-disciplinary team.-Coordinate with Medical Records/ROI to obtain documentation to ensure timely submission to audit requests-Track, monitor and reconcile governmental audit activities and correspondence through monitoring Fiscal Intermediaries/Medicare Administrative Contractors websites -Develop and maintain various governmental audit dashboards, including metrics, trending analyses and benchmarking information-Coordinate governmental audit committee activities and materials for meetings including agendas, dashboards, analyses, reports, etc.-Conduct and prepare data analysis and trending activities to identify potential vulnerabilities related to governmental audit issues and activities-Provide education to administrative and clinical staff including business offices, patient financial services, case management and utilization management-Perform analytics of Revenue Cycle Compliance data for B.O.D. reporting

Managed and oversaw research projects designed to improve patient outcomes and to better understand adverse effects of pharmaceutical treatments. Each research study with its varying time lines and stages required me to be very detail oriented and involved in order to complete the projects on time and to the client’s expectations.-Interviewed and hired staff for research studies-Managed and trained staff of 2-6 people on HIPAA, NEIRB, Privacy Boards and the background of each research study-Created timelines and flowcharts for study completion and created goals for employees-Oversaw multiple research study projects in different stages of completion -Created and managed multiple access databases and complex queries-Formulated detailed weekly excel status reports for each study being conducted

Gained experience in the health information management field in the Clinical Excellence department.· Worked with NDNQI data to create graphs to determine if there was a correlation with employee hours and patient acquired troubles.· Assisted with the production of physician and nurse report cards.· Produced flow charts for process improvement plans for the clinical documentation specialists· Assisted Safety Officer with their JCAHO Consultant.

Worked in the Health Information Management department as well as cancer registry, coding and scanning department.· Assisted the coding manager for inpatient and outpatient, and practiced CPT and used the 3M encoder· Sorted and scanned documents that were not in their electronic medical record· Performed rounds throughout the Health Information Management department gaining experience in all areas of the department