Tom Risi, Ccs

Tom Risi, Ccs Email and Phone Number

DRG Validator @
Tom Risi, Ccs's Location
New York City Metropolitan Area, United States
About Tom Risi, Ccs

Healthcare professional with over ten years experience in revenue recovery, health insurance, and hospitals. Inpatient/outpatient coding, DRG validation, denial management, Accountable Care Organization support, medical records, client relations, and publication drafting. Certified Coding Specialist (CCS). Rutgers alum.

Tom Risi, Ccs's Current Company Details
Health/ROI

Health/Roi

DRG Validator
Tom Risi, Ccs Work Experience Details
  • Health/Roi
    Drg Validator
    Health/Roi Apr 2014 - Present
    Metuchen, Nj
    * Recovered over $2M for NYC hospital systems in FY 2022.* Conducted coder education in-services, focusing on hospital-specific coding trends* Published article for HFMA, detailing financial reimbursement for inpatient ICD-10 coding changes specific to the COVID-19 pandemic* Department trainer for new auditors* Assisted in drafting proposals and responding to RFPs for new clientsCurrently, I review inpatient medical record coding for a number of New York City and New Jersey hospital systems - identifying opportunities for revenue recovery via DRG validation. Extensive experience with both MS and APR DRG groupers. Additional expertise in: client educational services, denial management, RFP responses, NTAP identification, drafting/submitting articles to professional organizations, and submission of questions to Coding Clinic. In 2023 my role expanded to include training of new auditors/validators, with focus on fundamentals of coding conventions and grouper methodologies.
  • Qualcare Inc.
    Business Analyst
    Qualcare Inc. Oct 2012 - Apr 2013
    Piscataway, Nj
    *Compiled clinical & financial Employee Shared Savings Program data into monthly client reports.*Executed specialized cost trend analytics at clients’ requests.*Streamlined and revised Accountable Care Organization (ACO) reporting Standard Operating Procedures (SOPs).I presided over a number of distinct Accountable Care Organizations' data and client needs. In addition to monthly metrics reporting, I spearheaded client outreach and managed provider reporting concerns. Provided analytic support, instituting program changes for enhanced client experience.
  • Astera Cancer Care
    Office Assistant
    Astera Cancer Care Jun 2007 - Oct 2012
    East Brunswick, Nj
    * Systematically compiled and secured confidential patient insurance information.* Assembled and stored information for inactive and deceased patients.* Facilitated patient check-in and insurance intake.Facilitated the day-to-day operation of an Oncology practice. Acquired extensive experience in customer service, medical records, and data entry via patient interfacing, front desk reception, and contact with medical facilities.
  • Qualcare Inc.
    Disease Management Intern
    Qualcare Inc. Jan 2012 - May 2012
    Piscataway, Nj
    * Bolstered single-client member enrollment by 3%, generating over $9,000 in revenue. * Developed and implemented departmental Standard Operating Procedure (SOP)changes, saving over $16,000 per year.My primary goals focused on improving the efficiency and outreach of the "Keeping In Touch" program. I instituted a number of program changes to optimize departmental efficiency. My enrollment outreach and workflow revision simultaneously boosted single-client enrollment by 3%, while collectively generating $25,000. Proposed changes to reporting metrics, allowing a more transparent display of data.
  • Independent Pharmacy Alliance Of America
    Intern
    Independent Pharmacy Alliance Of America Jun 2011 - Aug 2011
    Cranbury, Nj
    * Analyzed state legislation impacting Pharmacy Benefit Managers (PBMs) & independent pharmacies.* Identified key obstacles precluding independent pharmacies’ competition with chain pharmacies and mail-order prescription programs.Researched proposed state legislation for the IPA's Executive Director of Government Affairs. Prioritized bills in both the New Jersey Senate and House based on relevance to IPA's mission goals. Organization facilitated more direct lobbying, relevant to independent pharmacies' needs.
  • Robert Wood Johnson University Hospital
    Volunteer
    Robert Wood Johnson University Hospital Sep 2004 - Jun 2007
    New Brunswick, Nj
    * Assisted Performance Improvement (PI) department in day-to-day activities.* Processed patient satisfaction surveys, improving in-patient experience.Improved inpatient experiences via data entry of satisfaction surveys. These responses were later utilized by hospital staff to implement appropriate procedural changes to enhance the hospital's care. Provided resources to incoming hospital visitors, ensuring accurate delivery of hospital information.

Tom Risi, Ccs Education Details

Frequently Asked Questions about Tom Risi, Ccs

What company does Tom Risi, Ccs work for?

Tom Risi, Ccs works for Health/roi

What is Tom Risi, Ccs's role at the current company?

Tom Risi, Ccs's current role is DRG Validator.

What schools did Tom Risi, Ccs attend?

Tom Risi, Ccs attended Rutgers University-New Brunswick, Rutgers University-New Brunswick.

What are some of Tom Risi, Ccs's interests?

Tom Risi, Ccs has interest in Bass Guitar, New York Giants, Music, New York Mets, Creative Writing.

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