Kelly Schwinger Email & Phone Number

I’m an accomplished registered nurse and clinical reviewer with experience overseeing quality assurance and regulatory compliance. Over the past several years I have developed expertise across various practical and administrative facets of the nursing profession. I gained experience in providing direct care to patients in clinical and emergency settings and developed a quick-thinking and analytical mindset to direct patient triage and transfer, oversee inventory, and develop assessments and procedures for plans of care. In 2018, I had the opportunity to join Noridian Healthcare Solutions as a Clinical Reviewer. In this role I applied my in-depth knowledge of nursing processes and standards of care to guarantee full compliance with all relevant guidelines and regulations, make billing determinations based on Medicare policies, and ensure optimal levels of quality assurance. I’m proud to have added quantifiable value in meeting and exceeding goals within my department and was promoted to Senior Clinical Reviewer in 2021. My accomplishments include achieving greater than 98% quality assurance scores and exceeding expectations in minimum efficiency productivity standards. I have spearheaded QA process optimization and recommended improvements to Medicare and Medicaid programs. Key Strengths: Clinical Review | Medical Review | Quality Assurance | Medicare Claim Processing | Clinical Audit Requests | Plan of Care Development | Medical Review Inventory | Therapeutic Communication | Regulatory Compliance | Medical Documentation | Team Building & Leadership Let’s connect! Or email me at kellyschwinger@outlook.com