Advize
Jeanmarie Loria, MBA, PMP, CPC, has a diverse and extensive work experience. Starting in 2005, they held various internships, including positions at CrossLites, Crummer Graduate School of Business, and Schenck Co., gaining valuable experience in business and project management. In 2007, they founded Jeanmarie Loria Consulting and served as the Principal until 2014, providing consulting services. From 2007 to the present, they have been actively involved in various nonprofits, holding positions such as Board Member and VP of Membership at the National Contract Management Association. In 2007, they joined the Orlando Utilities Commission as a Senior Financial Analyst, where they played a key role in financial forecasting, capital improvement optimization, and training employees. In 2011, they joined KPMG Advisory as a Senior Associate IT Advisory, focusing on IT processes, risks, and internal controls for clients in various industries. Currently, they are the CEO of Advize, a company that offers consulting and project management services that enhance clients' ROI and satisfaction. Overall, Jeanmarie Loria's work experience showcases their expertise in consulting, project management, financial analysis, and IT advisory.
Jeanmarie Loria, MBA, PMP, CPC, has embarked on a progressive educational journey that has contributed to their diverse skill set. Beginning in 2003, they enrolled at Rollins College, where they pursued a Bachelor of Arts degree in Computer Science, which they completed in 2005. After this successful endeavor, Jeanmarie aspired to gain further business acumen and specialization. Consequently, they attended the Crummer Graduate School of Business at Rollins College from 2006 to 2008, earning a Master of Business Administration (MBA) with a specialization in Finance. With this educational foundation, Jeanmarie Loria's expertise encompasses both computer science and finance, allowing their to excel in diverse professional environments.
Advize
After nearly two decades of auditing large data sets and performing extrapolation for increased ROI for payers, Advize has shifted focus to building relationships with providers based on data and best practices. Our team has expanded our model of coding and billing audits focused on waste and abuse to examine fraud through Big-4 Data Analytics and OIG best practices. Audit and Support Services – Record Retrieval, Storage, Purge – Onsite record retrieval – Send request letters and other communications with providers – Secure file upload (SFU) – Records are stored securely and discarded in accordance with HIPAA recommendations and requirements – Minimum necessary PHI accessed – Record files are securely returned with audit result delivery – Corporate Integrity Agreements – Statistically valid sampling – Medical necessity and proper coding/documentation review – Audit Management and Quality Assurance Support – QA Review – Reporting and Results Delivery – Overpayment Recovery and Overpayment Support – Legal Support – Case building, expert witness, audit, reporting and testimony Review and Reporting – Reviews performed by highly experienced and credentialed auditors – Audit personnel work with a variety of healthcare personnel and patients. They should always conduct themselves in an acceptable, professional manner and adhere to ethical standards, confidentiality requirements, and objectivity. Auditors trained to completely document their findings and problems. – Perform verification of charges – What citations are important, and what policies are important? – Citation guidebook creation – Review of claims – Generation of preliminary audit results – Results delivery and collaboration with client – Report generation – Final Audit Results: – Contain final audit reporting, this reporting will have included the overpayment amount. – Review the next steps for the provider who was audited.