Compliance & Risk Management
Arlene Baril
MHA, RHIA, CHC
Senior Consultant
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
Charles Brown
Director
Expertise In...
- Twenty years of proven success in healthcare sales and management
- Regional director of sales and client services for national consulting firm
- Expertise in aligning vast Pinnacle resources/talent with client needs
- Client advocate ensuring Pinnacle’s custom approach to client solutions remains at the forefront
Amy Crenshaw-Pritchett
CCS, CPC-I, CPMA, CDEO, CASCC, CANPC, CRC, CDEC, CMPM, C-AHI
Senior Consultant
Amy Crenshaw-Pritchett
CCS, CPC-I, CPMA, CDEO, CASCC, CANPC, CRC, CDEC, CMPM, C-AHI
Senior Consultant
Expertise In...
- 25+ years of healthcare experience including medical billing and coding
- High-level auditing skills encompass facility and professional fee services
- Has worked with a variety of health systems and academic centers
- Managed large coding departments and teams as an exceptional leader
- Develops educational tools and curriculum for medical coding
- Certified Epic Train the Trainer
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
CPC
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
Jeannie Kelly
RN, CCDS, BS, MHA
Managing Consultant
Expertise In...
- Skilled and accomplished healthcare consultant with over 25 years of experience
- Extensive experience in provider quality of care and Medicare payment safeguard functions
- Directed a variety of Medicare projects, including program integrity verification, secondary payer and medical review reconsideration
- Serves on the Association of Clinical Documentation Specialists (ACDIS) Regulatory Committee
Kelly Loya
CPhT, CPC-I, CHC, CRMA
Associate Partner
Expertise In...
- More than 25 years of health care experience including operational, administrative and clinical
- Tackles complex issues given her background – 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
Allison Luke
JD, CHC
Executive Consultant
Expertise In...
- More than twenty-seven years of healthcare law and compliance experience
- Experience working with hospitals, physician offices, home health providers and others
- All aspects of effective compliance program development and maintenance, including policy development and review, audits, training and investigations
- Licensed attorney
- Frequent speaker on healthcare compliance matters
Jodi Nayoski
CPC-I, CCS-P, CHC, CDIP
Director
Expertise In...
- Director with 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 and seminars as a certified instructor
Kelly Nueske
CIA, CMA, CPA, RN, CHC, CRMA
Executive Consultant
Expertise In...
- Expertise includes internal audit, compliance programs, billing compliance, investigation/defense support and risk mitigation
- More than 30 years of healthcare operations experience in various management, compliance and internal audit roles
- Held positions in quality/utilization management, internal audit and patient financial services
- Registered nurse in cardiology and neurology
Angie Paine
CPC, CPC-I, CPMA
Senior Consultant
Expertise In...
- More than 15 years of healthcare experience
- Extensive background in revenue cycle, compliance, medical coding, team leadership and training
- Oversees compliance, IRO, and internal audit services
- Identifies risks & opportunities to improve compliance w/gov payor reqs./operational efficiencies
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