Sally joins Pinnacle as Managing Consultant of Pinnacle Enterprise Risk Consulting Services (PERCS), bringing nearly 20 years’ experience in coding, auditing, coding professional mentoring and management. Sally is responsible for assisting and leading PERCS inpatient and outpatient facility auditing, reimbursement projects, billing compliance, HIM operational assessments.
Sally has consulted for the healthcare industry since 2010. Prior to joining Pinnacle, she performed comprehensive coding reviews to assure correct, compliant coding practices for a variety of healthcare provider types including; acute hospitals, emergency rooms, outpatient facility, long-term acute care facilities and rehabilitation facilities. Sally has also performed documentation gap analysis assessments for ICD-10 coding during the recent Centers for Medicare and Medicaid implementation phase. Sally has performed one-on-one and group coding mentoring for clients during the implantation phase. She has assisted clients in reviewing accounts subject to scrutiny by the Recovery Audit Contractors (RAC) and other third party insurance reviewers and prepared responses and / or appeals to inquires when warranted.
Earlier in her career, Sally was the coding manager for the Facility Coding Services at Altegra Health. There she managed multiple clients and coders nationally. She has served as the Acting Compliance Officer for a veteran’s hospital, during which time she assisted in the completion of the annual compliance report and the completion of the narrative for the annual report. During her time at the VA, she participated in a VERA coding audit that resulted in the identification of a potential loss of one- million in revenue via the VERA funding model for the VA. She has also served as a DRG validator for the Florida QIO, where she performed DRG validation services for the state of Florida and California. Prior to starting her auditing career, Sally was one of a select number of coders responsible for coding of complex trauma and Medicare charts at a Level 1 Trauma / Teaching facility.