Overview A skilled and accomplished healthcare consultant with over 25 years of experience, Jeannie possesses extensive experience in healthcare provider quality of care and Medicare payment safeguard functions, including Medicare policies and procedures, coverage and subrogation, as well as, case management, risk management, reconsideration and appeals, fraud and abuse, compliance, and provider and beneficiary education.
As an Operations Manager for a Fiscal Intermediary, Jeannie managed Part A and Part B programs and has directed a variety of Medicare projects such as projects focused on program integrity verification and validation, Medicare secondary payer, Medicare medical review (including medical necessity reviews), reconsideration and appeals, fraud and abuse, and DMERC (a.k.a. DMEPOS) program operations. Jeannie has also conducted claims research and claims scripting for 1-800-MEDICARE.
While serving as a Quality Assurance Officer for a healthcare consulting firm, Jeannie oversaw QA initiatives for a variety of client projects related to Medicare and Risk Management. She served as Subject Matter Expert on federal and state quality requirements for inpatient hospitals, ambulatory surgery centers and other healthcare providers, and developed a variety of successful business opportunities with optimal returns. Jeannie is a Subject Matter Expert in CMS Two Midnight Rule and medical necessity determinations.
Jeannie serves on the Association of Clinical Documentation Specialists (ACDIS) Regulatory Committee, tasked with reviewing regulatory policy and coding and clinical updates, commenting to agencies on behalf of ACDIS, and providing summary, interpretation, and analysis to the ACDIS membership.
Jeannie received a Master of Science in Healthcare Administration from Simmons College, Bachelor of Arts in Economics from the University of Massachusetts and an Associate Degree in Nursing from Laboure College.