Leah joined Pinnacle with prior experience supporting a range of healthcare provider clients. In her role, she performs high-quality audits and reviews across a wide variety of documentation, coding and billing assessments to help clients enhance accuracy, compliance and overall improvement efforts.
Leah brings strong expertise in professional fee coding, enhanced by exceptional communication, technical and organizational skills. She has extensive experience coding and auditing primary care, podiatry, and ophthalmology services, and drug screen laboratory testing. Leah has also conducted numerous reviews involving wound care procedures in the podiatry setting and has recently focused on audits related to the application of skin substitute grafts.
Her work includes performing due diligence audits, independent review organization quarterly claims reviews, and highly complex investigational audits requiring extensive research and review of applicable guidance to confirm compliance with healthcare regulatory sources. She is responsible for coding and auditing medical record documentation for professional-fee services to ensure accurate assignment of CPT, ICD-10-CM and HCPCS codes and related billing and reimbursement concepts. Supplemental to her coding and auditing expertise, Leah has contributed to reviews involving reimbursement analysis for paid services and evaluation of patient medical records to formulate evidence and policy-based reconsideration appeals, in response to Medicare redetermination denials. Her meticulous approach makes her a valuable resource for clients seeking accurate, defensible, and compliant documentation and coding practices.
Professional Designations and Affiliations: