Isaac Corpuz
Gastonia
Summary
Clinical Reimbursement Director with expertise in reimbursement strategies and clinical documentation compliance. Demonstrated success in optimizing billing processes and enhancing patient care coordination. Proficient in data analysis and promoting interdisciplinary collaboration to implement quality improvement initiatives. Focused on achieving optimal outcomes through strategic decision-making and effective communication.
Overview
27
27
years of professional experience
1
1
Certification
Work History
Clinical Reimbursement Director
Twin Rivers Health And Rehabilitation
Cleveland
09.2019 - 05.2025
- Facilitated training for MDS coordinators on resident assessment instruments (RAI) process.
- Reviewed and coordinated PDPM and case mix data to secure appropriate reimbursement.
- Ensured accuracy in clinical documentation and compliance with OBRA and RAI guidelines.
- Collaborated with insurance companies and medical billing staff to enhance billing processes.
- Evaluated care plan processes to align with residents' required levels of care.
- Coordinated Medical/Medicare appeal processes for precise payment decisions.
- Tracked, measured, and reported quality indicators to develop strategies for improved outcomes.
Director of Nursing
Hermitage Health Center
Elizabethton
03.2011 - 09.2019
- Mentored new nurses to facilitate smooth transitions into organization.
- Developed reports summarizing patient outcomes from various data sources.
- Participated in interdisciplinary teams to address patient care concerns and devise solutions.
- Conducted performance evaluations for nursing staff, providing recommendations for improvement.
- Facilitated communication between departments to enhance operational efficiency.
- Oversaw daily operations of nursing department, including staffing, scheduling, and budgeting.
- Monitored compliance with healthcare regulations and laws to ensure quality standards.
- Resolved staff conflicts professionally while promoting positive workplace relationships.
RN Supervisor
Lakebridge Health Care Center
Johnson City
04.2009 - 01.2011
- Collaborated across departments to ensure quality patient care throughout hospital system.
- Maintained updated knowledge of healthcare regulations to promote organizational compliance.
- Attended healthcare management conferences focusing on budgeting and human resources.
- Provided clinical leadership and direction for nursing staff, ensuring adherence to care standards.
- Evaluated patient records to identify service delivery improvement opportunities.
- Investigated patient and staff incidents, documenting findings accurately.
- Ensured all documentation met legal requirements prior to submission.
- Analyzed data from surveys and incident reports to enhance operational efficiencies.
MDS Coordinator
Four Oaks Health Care Center
Jonesborough
08.2007 - 03.2009
- Analyzed trends from Minimum Data Set to inform care strategies.
- Compiled utilization review and quality indicator reports for management.
- Monitored resident progress and updated MDS records accordingly.
- Audited monthly MDS submissions for compliance and accuracy.
- Developed individualized care plans based on assessment findings.
- Provided training to nursing staff on current MDS regulations.
- Coordinated timely submission of regulatory documents, ensuring completeness and accuracy.
- Facilitated interdisciplinary meetings to address resident concerns related to MDS process.
RN Supervisor
Valley Health Care Center
San Bernardino
02.2006 - 04.2007
- Facilitated interdisciplinary meetings with physicians, nurses, and therapists to optimize patient treatment plans.
- Developed and implemented policies enhancing safety and well-being of patients and staff.
- Maintained up-to-date knowledge of healthcare regulations to ensure organizational compliance.
- Provided clinical leadership to nursing staff, ensuring adherence to established care standards.
- Evaluated patient records for service delivery improvements and quality enhancement opportunities.
- Advocated for patient rights in challenging scenarios, including end-of-life situations.
- Conducted thorough investigations of incidents involving patients or staff, documenting findings appropriately.
- Managed recruitment and training processes for new medical and facility personnel.
Hemodialysis Nurse
Hospital Angeles
Guadalajara
03.2004 - 12.2005
- Ensured compliance with all applicable laws, regulations and standards related to hemodialysis nursing practice.
- Maintained accurate records of all treatments provided including medications administered, laboratory values obtained and any adverse reactions experienced by the patient.
- Assisted in training new staff members on policies and procedures specific to hemodialysis units.
- Consulted with nephrologists regarding complex cases requiring specialized medical interventions.
- Collaborated with physicians, nurses and other healthcare professionals to develop individualized plans of care for each patient.
- Provided direct patient care in the dialysis unit, including pre and post-treatment evaluation of patients.
- Recognized potential problems that could arise during a treatment session and took appropriate action when needed.
- Counseled patients on how to manage symptoms associated with end stage renal disease.
- Assisted with setting up dialysis machines, preparing solutions for hemodialysis treatments and ensuring proper functioning of equipment.
- Referred patients to specialized health resources or community agencies to furnish additional assistance.
- Advocated for patient needs with interdisciplinary team and implemented outlined treatment plans.
- Utilized computerized Resource and Patient Management System (RPMS) and Electronic Health Record (EHR) system.
- Conducted specified laboratory tests to help detect conditions and determine diagnosis.
- Prepared medical equipment and tools to aid physician during examination and treatment of patients.
Registered Nurse
Instituto Mexicano del Seguro social
Guadalajara
06.1998 - 03.2004
- Counseled patients on medication side effects and necessary lifestyle modifications for improved health outcomes.
- Participated in multidisciplinary meetings to devise comprehensive patient care plans.
- Assessed, planned, implemented, and evaluated nursing care for assigned patients.
- Collaborated with healthcare professionals to develop individualized treatment strategies for each patient.
- Administered medications and treatments while monitoring patients for adverse reactions and side effects.
- Trained and mentored new registered nurses on hospital policies and best practices.
- Ensured compliance with state and federal regulations regarding healthcare delivery standards.
- Provided emotional support to patients and families during challenging situations.
Education
Bachelor of Science - Nursing
Escuela Superior De Enfermeria
Tepic Nayarit México 06-1997
Skills
- Clinical documentation and compliance
- Reimbursement strategies
- Data analysis
- Patient care coordination
- Quality improvement
- Billing processes
- Staff training
- Interdisciplinary collaboration
- Effective communication
- Process improvement
- Team collaboration
- Multitasking and organization
- Risk management
- Business strategy
- Decision-making
- Financial management
Certification
- RAC-CT certification
- CMAC certification
Languages
Spanish
Professional
English
Professional
Timeline
Clinical Reimbursement Director
Twin Rivers Health And Rehabilitation
09.2019 - 05.2025
Director of Nursing
Hermitage Health Center
03.2011 - 09.2019
RN Supervisor
Lakebridge Health Care Center
04.2009 - 01.2011
MDS Coordinator
Four Oaks Health Care Center
08.2007 - 03.2009
RN Supervisor
Valley Health Care Center
02.2006 - 04.2007
Hemodialysis Nurse
Hospital Angeles
03.2004 - 12.2005
Registered Nurse
Instituto Mexicano del Seguro social
06.1998 - 03.2004
Bachelor of Science - Nursing
Escuela Superior De Enfermeria
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