Life Care Planner, Medical Billing, Vocational

Specialties & Experience of this Expert Witness

Additional Information

A licensed Registered Nurse with over 30 years of experience. I have provided care for and developed treatment plans for a multitude of patients, including those patients experiencing orthopedic conditions that require inpatient and outpatient rehabilitation, patients with burn injuries, patients with spinal cord injuries, patients who have experienced with amputations, patients with visual impairments, and patients with acquired brain injuries. I trained as and began working as a medical and vocational case manager in 2006, becoming certified in 2007. As a case manager, I perform assessment, planning, implementation, coordination of care, monitoring, evaluation, and outcomes management in a variety of practice settings. My work as a case manager included medical billing audit, utilization review, as well as appeals and denials of hospital services which included medical and procedural coding, medical necessity, and cost review. In 2011, I became a certified disability management specialist. As a certified disability management specialist, I regularly performed comprehensive individual case analysis regarding the impact of physical, cognitive, and mental conditions to functional capacity and employment outlook with consideration to applicable benefits as well as a review and assessment of products, services and strategies to ensure quality care, recovery, and cost effectiveness. I began working in the capacity of a legal nurse consultant in 2006, becoming certified in 2015. As a legal nurse consultant, I have performed critical analyses of clinically related issues in a variety of legal settings involving, for example, claims of medical malpractice, personal injury, workers compensation claims, and products liability, both in the criminal and civil context. I completed my formal training in life care planning in 2017, which included coursework in medical procedural coding and cost analysis. In 2018, I became a Certified Nurse Life Care Planner. As a life care planner, I develop life care plans for those individuals who are injured or ill and require ongoing medical and rehabilitative care. In my roles as a Certified Case Manager and Life Care Planner, I have prepared Medical Cost Projections and have performed Medical Bill Audits, both of which entail reviewing medical and billing records to determine if the charges are usual, customary, and reasonable within the geographic area for a documented service. These projections and audits require an astute understanding of medical billing and coding, which I have obtained through my education, training, and experience.