LinkedIn Compliance & Risk Mgmt. | Pinnacle Healthcare Consulting

Compliance & Risk Management

Arlene Baril

MHA, RHIA, CHC

Director

 


Arlene Baril

MHA, RHIA, CHC

Director

Expertise In...

  • 40 years of healthcare experience including management/leadership
  • AHIMA certified ICD-10-CM/PCS trainer with hands-on expertise
    in 5 of the CMS PPS systems
  • Experience in HIM operations, revenue cycle assessments and charge description master reviews
  • Audit experience in RAC, APCs,
    MS-DRGs, Profee, ASC, IRF, LTAC, and third-party audits
  • Experience developing Clinical Documentation Improvement programs and staffing

William Cevallos

Administrative Analyst

 


William Cevallos

Administrative Analyst

Expertise In...

  • Data management and analysis
  • Supports audit teams with audit preparation, research and reporting
  • Broad healthcare understanding related to varied consulting projects
  • BS in Health Systems Management from University of North Carolina at Charlotte

Amy Crenshaw-Pritchett

CCS, CPC-I, CPMA, CDEO, CASCC, CANPC, CRC, CDEC, CMPM, C-AHI

Sr. Manager, HCC Coding/Audit & Education Services

 


Amy Crenshaw-Pritchett

CCS, CPC-I, CPMA, CDEO, CASCC, CANPC, CRC, CDEC, CMPM, C-AHI

Sr. Manager, HCC Coding/Audit & Education Services

Expertise In...

  • 25+ years of healthcare experience including medical billing and coding
  • High-level auditing skills encompass facility and professional fee services
  • Develops educational tools and curriculum for medical coding
  • Certified Epic Trainer
  • Approved AAPC Instructor and ICD-10-CM/PCS Instructor
  • Has worked with a variety of health systems and academic centers
  • Managed large coding departments and teams as an exceptional leader
Valerie Fitzgerald

Valerie Ivy Fitzgerald

Associate Consultant Administrator

 


Valerie Ivy Fitzgerald

Associate Consultant Administrator

Expertise In...

  • More than 20 years experience in executive administrative support
  • Broad understanding of medical coding, healthcare industry and regulatory requirements
  • Experience includes revenue cycle, reimbursement and advisory, valuation, compliance, coding and auditing services
  • Superior customer service and proficient managing invoicing and accounts receivables
Leah Fuller

Leah Fuller

COC, CPC

Managing Consultant

 


Leah Fuller

COC, CPC

Managing Consultant

Expertise In...

  • Responsible for performing quality audits and reviews for a wide variety of documentation, coding and billing assessments
  • Provides education and support information to physicians to ensure understanding of the results
  • Proficient in auditing pain management, primary care procedures, podiatry, urine drug screen laboratory testing and related services
  • Leads teams working to resolve denial follow up issues

Sheila Limmroth

CCO / Executive Consultant

 


Sheila Limmroth

CCO / Executive Consultant

Expertise In...

  • 30+ years of healthcare auditing and compliance experience
  • Built and implemented a successful corporate compliance program
  • Well-versed auditor with experience in several high-level roles
  • Member of HCCA and IIA
Kelly_Loya

Kelly Loya

CPhT, CPC-I, CHC, CRMA

Associate Partner

 


Kelly Loya

CPhT, CPC-I, CHC, CRMA

Associate Partner

Expertise In...

  • More than 25 years of healthcare experience including operational, administrative and clinical
  • Tackles complex issues including coding/billing, first responder, pharmacy, and nursing
  • Identifies/mitigates risk, improves compliance adherence, and drives operational efficiencies
  • Leveraging expertise and industry intuition, she provides multilayer data analysis for complex reviews

Jodi Nayoski

CPC-I, CCS-P, CHC, CDIP

Managing Advisor

 


Jodi Nayoski

CPC-I, CCS-P, CHC, CDIP

Managing Advisor

Expertise In...

  • Over 20 years of healthcare leadership experience
  • Has worked with a wide variety of provider types in various capacities
  • Expertise includes implementation of large-scale compliance plans
  • Develops educational tools and curriculum for medical coding
  • Facilitates courses, programs & seminars as a certified instructor

Kadence Orr

Administrative Analyst

 


Kadence Orr

Administrative Analyst

Expertise In...

  • BS in Healthcare Management from Colorado Technical University
  • Former Executive Administrator to CEO of UWASC
  • Coordinates and manages PERCS tradeshow logistics

Karen Pickering

RHIT, CCS

Senior Consultant

 


Karen Pickering

RHIT, CCS

Senior Consultant

Expertise In...

  • AHIMA-certified RHIT (Registered Health Information Technician) and CCS (Certified Coding Specialist)
  • Over 30 years of experience in coding, auditing and compliance
  • Proficient in ICD-10-CM/PCS, ICD-9-CM and CPT/HCPCS coding and auditing

David Shaw

BS, CPC

Senior Consultant

 


David Shaw

BS, CPC

Senior Consultant

Expertise In...

  • 27+ years of experience in compliance, auditing, physician education, coding and reimbursement, and accounts receivable/collections
  • Well-versed in multi-specialty workflow analysis, charge capture, practice coding, and documentation reviews
  • Developed and evaluated coding compliance, specific regulatory, billing, coding, and documentation training for multiple specialties
Tracy Sties

Tracy Stice

Administrative Assistant

 

 

Tracy Stice

Administrative Assistant

Expertise In...

Kristen Taylor

CPC, CHC

Associate Partner

 


Kristen Taylor

CPC, CHC

Associate Partner

Expertise In...

  • More than 20 years of experience in coding, revenue cycle processes and compliance for physicians/hospitals
  • Conducts operational assessments, legal investigations for billing and reimbursement anomalies, coding reviews and provider education
  • Expertise includes medical center management of the ancillary and surgical coding and billing staff across all major service lines