Janice Amon, Ccds, Ccs, Chc Email & Phone Number

San Diego, Ca, Us

San Diego, Ca, Us

$4B revenue, San Diego County’s largest not-for-profit healthcare system. Oversees and executes a high-quality, effective coding and billing audit Compliance Program. Supervises and mentors the Compliance team’s direct day-to-day operation. Awarded System’s Centers of Recognized Excellence (C.O.R.E.) Finance Pillar team award for coordinating “Appropriate Shift in Patient Status” multidisciplinary Project contributing to $7.58M revenue improvement amidst COVID-19 challenges  Established the department’s audit tools, guidelines, policies, and procedures contributing to the team’s audit efficiency Led activities and functions for health system charge master maintenance to ensure compliance with pricing transparency, monitoring and charge capture optimization Collaborated with Legal team and led high-risk investigations (Anti-kickback, Stark, False Claims) resulting in risk reduction from government audits Spearheaded state and federal healthcare regulations, coding and billing, risk adjustment, hierarchical condition categories (HCCs), clinical documentation, medical necessity, and patient status assignment education to executives and staff Improved system wide controls in place to mitigate risks for non-compliance regarding National Coverage Determination (NCD) & Local Coverage Determinations (LCD), Admission Orders, and Medicare’s Inpatient-Only Procedures policies  Accomplished system wide physician education about copy and paste standards, E/M 2021 documentation guidelines, and Medicare’s coverage for payments rules and regulations Led system wide committees including Denial’s Committee resulting in denials reduction  Implemented the department’s quality assurance review of external audits including Telehealth, Skilled Nursing Facilities (SNF), Inpatient and Outpatient Rehab, Home Health, Hospice, Radiation Oncology, and Behavioral Health Audits

San Diego, Ca, Us

 Chartered an interdepartmental collaboration “Quality, Clinical Documentation Improvement, Clinical Analytics, Coding, Case Management, Clinical, and Compliance (QCx6)” Project, that helped provide clinical documentation and coding education, and process improvement sessions to 35+ QCx6 leaders and staff Develops processes to manage changes in charge master functionality to maintain updates for data reporting and analytics Executed a wide array of audits including DRG validation, clinical validity, Outpatient Facility, HCCs, Professional, E/M Level, Patient Status, and NCD/LCD medical necessity audits ensuring SHC is coding and billing accurately Developed Audit Workplan concentrating on SHC’s enterprise risk in alignment with the OIG, CMS, and DOJ’s current audit focus causing a pro-active Compliance Program Analyzed company’s data and audit findings achieving corrective action plans and system-wide process improvements

Plano, Texas, Us

$840M revenue, currently changed to CorroHealth, a leader in the healthcare industry, achieved #1 client rating for Outsourced Coding, CAC, CDI in Ambulatory & Physician Organizations. Led & trained multiple health system’s medical staff in preparation for the transition from ICD-9 to ICD-10-CM & PCS 2015 Nationwide Implementation. 2014 - Present Auditing and Education / CDI Consultant, TrustHCS, current duties include:• Conducts CDI assessment and validation audits for a variety of clients• Conducts coding compliance and/or DRG validation audits for a variety of clients• Conducts ICD-9 & ICD-10 CM and ICD-10 PCS quality documentation, ICD-9 & ICD-10 CM and PCS coding validation, re-coding and/or DRG shift analysis projects for a variety of clients• Completes data entry of audit findings and analyzes findings prior to creating a final report summarizing statistical measures, strengths, and opportunities for growth• Prepares CDI & Coding educational materials either topic specific or based on audit results• Created Curriculum for Remote CDI Program • Presents educational material and audit report findings to facility executive leadership, HIM and coding staff as assigned• Trained Specialty Physicians for ICD-10-CM & ICD-10-PCS Documentation including but not limited to Neurosurgeons, Vascular Surgeons, IM, Family Medicine, Cardiologists, Pulmonologists, & more

St Paul, Mn, Us

$35B revenue, multinational fortune 500 company partnered with MedPartner’s in hiring Clinical Documentation leaders to launch first of its kind CDI software application (3M 360). Led CDI and Coding Program Evaluations for clients inclusive of 40 - 300 Record Audits. Pioneered the implementation and integration of 3M 360 into various medical record platforms including EPIC for 40+ top hospitals and health systems across the nation.  Supervised 3M 360 client sales calls and project engagement, application testing, and end-user training  Developed client project’s scope of work and 3M 360 Application User’s Guide Directed client’s executives on best practice for Clinical Documentation & Coding Improvement Program by providing recommendations on operational workflow processes on accurate capture of MCC/CC, SOI/ROM levels, and more  Conducted data analysis review of various hospitals’ data compared to MedPar’s data and provided recommendations for revenue opportunities

Tampa, Fl, Us

Roles and responsibilities are as above as 3M 360 Encompass Trainer

San Diego, Ca, Us

$4B revenue, an award-winning health system operating 45 hospitals and >300 outpatient locations in 14 states. Led and provided training for new and current CDI team members. Accomplished concurrent and retrospective reviews with concurrent coding of MS-DRG, clinical validation audits, performance improvement (PI), and quality measure reviews. Increased the hospital’s quality performance metrics and optimized revenue with high CC/MCC & SOI/ROM capture rates  Improved the hospital’s Case Mix Index by guiding case managers to discharge patients in a timely manner Trained inpatient coding staff for DRG reconciliation, DRG validation analysis, and second level review  Analyzed and tracked denials data and provide recommendations to prevent or reduce these denials Composed appeal letters utilizing InterQual/Milliman Admission criteria that overturned numerous payer denials Founded the hospital’s coders and physician education initiatives by developing Documentation Improvement Compliance Bulletins

Bachelor'S Degree, Health Science

Associate'S Degree, General Education

Doctor Of Medicine (Md), Medicine