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

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
  • Develops educational tools and curriculum for medical coding
  • Certified Epic Trainer
  • 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

Senior Consultant

 


Leah Fuller

COC, CPC

Senior 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
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...

  • 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

Angie Paine

CPC, CPC-I, CPMA

Managing Consultant

 


Angie Paine

CPC, CPC-I, CPMA

Managing 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

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
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