Compliance & Risk Management
Helen Avery
CPC-I, CHC, CPC
Senior Consultant
Expertise In...
- Senior consultant with more than 25 years of leadership experience
- Expertise includes coding, audit, rev. cycle operations, compliance, enterprise risk management and litigation support
- Specialties include Rural Health, RadOnc, Radiology, Ambulance, Laboratory, Anatomic Pathology, Durable Medical Equip & Dialysis
Sharon Blackwood
MT (ASCP), MBA, CHC, CHPC
Executive Consultant
Expertise In...
- Leadership experience across all aspects of compliance and privacy
- Includes corporate integrity agreement remediation, IRO services for focus arrangements, audit and revenue cycle
- Experience with national, publicly–traded systems and non-profit, multi-facility organizations
- Develops compliance and privacy programs, conducts training and consults with clients
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
Leah Fuller
CPC
Consultant
Expertise In...
- Experienced in Evaluation and Management (E/M) services
- Proficient in auditing pain management, primary care procedures, podiatry, urine drug screen laboratory testing and related services
- Assists with highly complex investigational audits involving extensive research, review and analysis to confirm regulatory compliance
- Experience with multiple EHR and Billing Systems: Cerner, Epic, AllScripts, NextGen, Athena, Centricity, eClinicalWorks
Jeannie Kelly
RN, MHA, BA, CCDS, LHRM
Senior Consultant
Expertise In...
- Skilled and accomplished healthcare consultant with more than 25 years of experience
- Extensive experience in healthcare provider quality of care and Medicare payment safeguards
- Subject Matter Expert on federal and state quality reqs for hospitals, ASCs and other providers
- Subject Matter Expert in CMS Two Midnight Rule and medical necessity determinations
- 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
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...
- 30 years healthcare operations experience in management, compliance and internal audit roles
- Internal audit, compliance program development, implementation and assessments, billing compliance, investigation and defense support and risk mitigation expertise
- RN specializing in cardiology and neurology and also held positions as quality management specialist, utilization management specialist, internal audit director and more
Angie Paine
CPC, CPC-I, CPMA
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
