Sandra Griffith

• Contributed as senior member to interwell health clinical documentation support program, enhancing documentation quality and value-based care objectives.
• Assisted in building cds team through active participation in hiring, candidate evaluation, and onboarding preparation.
• Led onboarding and training for new team members, providing guidance on clinical documentation workflows and quality assurance standards.
• Served as subject matter expert for peers, reinforcing documentation integrity and compliance with CDS principles.
• Conducted quality assurance reviews to ensure documentation accuracy aligned with clinical standards and regulatory requirements.
• Collaborated with interdisciplinary stakeholders to promote accurate capture of diagnoses and patient complexity critical for cds analytics.
• Supported program maturity during interwell health integration by standardizing workflows and facilitating knowledge transfer across the team.

Clinical Documentation Reviewer with extensive experience evaluating medical records to ensure accurate, complete, and compliant clinical documentation in accordance with ICD‑10‑CM, CMS, and regulatory guidelines. Skilled in identifying documentation gaps, querying providers, and supporting accurate capture of diagnoses, risk adjustment factors, and patient complexity. Proven ability to work independently while maintaining high quality and productivity standards in fast‑paced, value‑based care environments. Strong collaborator with providers, coding, and clinical teams to improve documentation integrity, compliance, and organizational outcomes.

• Assisted physicians in accurately capturing and addressing Hierarchical Condition Categories (HCCs) as a coding expert. I work independently and complete all tasks promptly. By identifying gaps in existing documentation processes, I have created effective solutions that have helped improve efficiency.
• I have experience in establishing policies and procedures to maintain the prompt quality of work. I am skilled in utilizing Microsoft Excel and have assisted management in streamlining the department's current workflows to increase team efficiency.
• Proficient with Next Gen and Epic EMRs.

• I utilized Power BI/Qlikview to create comprehensive reports, analyzing claims data for the provider groups assigned to me. My main focus was identifying areas of improvement related to documentation and coding, including risk scores, MER, and opportunities that were missed. This allowed me to provide constructive feedback and work with the provider groups to optimize their performance.
• I was an integral part of developing and implementing the Coding and Documentation Education and Training (CaDET) program for MidSouth Market.
• Other responsibilities included assisting in the development of new hire training, and performing training for several new hires, as well as assisting with yearly CMS RADV audits.
• I am proficient in ICD-10 documentation and coding guidelines, and I am familiar with multiple EMR systems and eConnections such as Juxly Vault and Healow Insights. I am also knowledgeable with Hedis and Stars Measures, as well as CPT II codes. My great communication skills have allowed me to build great working relationships with providers and their corporate leadership. I am proficient with virtual provider meetings while presenting data using PowerPoint slides.
• Performed on-site coding audits to determine accuracy and compliance with coding guidelines.
• For my outstanding performance, I received three-star awards.

• Maintained daily production of 75-100 records; coding accuracy 95%+
• Reviewed outpatient records and interpreted documentation to identify diagnoses and procedures.
• Monitored changes in coding regulations to provide recommendations for compliance.
• Reviewed patient charts to better understand health histories, diagnoses, and treatments.
• Followed up with medical staff regarding missing information in patient records.

• Following the hospital discharge, I reached out to the members to assess their needs and provide them with the necessary support. This helped them get the required assistance and made their recovery journey more comfortable. By staying proactive, we can make a significant impact on their lives and ensure their well-being.

• Coordinated an outpatient Dobutamine Clinic for patients with end-stage CHF.

• Responsibilities included starting an IV or accessing a port, infusing Dobutamine over 3-4 hours, monitoring patients via telemetry and routine vital signs, and conducting required monthly labs.

• Reduced patient wait times by effectively managing patient flow and resource allocation.

• Ordered all pharmacy supplies and kept track of inventory levels.

• Experience working in various units such as Telemetry, Med-Surg, Rehab, Post-Partum, and ER.Demonstrated excellent technical skills in wound dressing changes, IV therapy administration, catheter insertion, and other routine nursing procedures.
• Facilitated efficient communication between patients, families, and healthcare providers to promote continuity of care across settings.
• Improved patient outcomes by administering medications, monitoring vital signs, and documenting relevant information.
• Adapted quickly to changing patient needs, adjusting care plans accordingly to ensure optimal outcomes in diverse clinical scenarios.
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