With more than 20 years of experience in post-acute care compliance and clinical reimbursement systems, this registered nurse provides consulting and subject-matter expertise in matters involving Medicare and Medicaid compliance, skilled nursing facility operations, and reimbursement practices. Their work includes extensive experience in consultation and compliance analysis, with work informed by leadership roles in compliance program development, auditing, and regulatory oversight within post-acute care settings. Educational background includes a bachelor’s degree in business administration and an associate degree in nursing. This expert holds professional designations including Registered Nurse (RN), Resident Assesment Coordinator (RAC-MT), QAPI Certified Professional (QCP-MT), and Director of Nursing Services (DNS-MT).

Their expertise includes compliance auditing and reporting, denials management, and Medicare and Medicaid billing and collections, as well as MDS/PPS training, systems review, and regulatory survey preparation. Key areas of work involve development and maintenance of compliance policies and procedures, evaluation of reimbursement systems, and assessment of nursing and rehabilitation facility programs. Additional experience includes commercial contract negotiation, cost analysis, and oversight of patient management systems, which may be relevant in matters involving billing accuracy, reimbursement disputes, and regulatory compliance failures.

In leadership roles, this expert has served as president and chief executive officer of consulting and care coordination organizations, with responsibilities including development of patient management systems, care coordination programs, and compliance frameworks designed to align with federal and state healthcare regulations. Professional involvement includes board-level participation with the American Association of Nurse Assessment Coordination (AAPACN), advisory roles with the National Government Services Provider Advisory Group, and leadership positions within the Association of Long Term Care Financial Managers, reflecting engagement in industry standards and regulatory policy.