Kathy Haley

Kathy has more than 28 years of experience. She is experienced in health care policy and reimbursement analysis, managed care organization contract compliance review, and encounter data validation. She performs various analyses of correct coding on health care claims and analyses of health care policy and reimbursement for state Medicaid managed care programs. She also conducts analyses of Medicaid and state CHIP encounter claims to identify overpayments and performs on-site activities at managed care organizations. Kathy implements and manages external quality review protocols related to the validation of encounter data using medical record reviews, trace analyses, and other tools. She generates reports and presentations, provides project management and is skilled in the development of analytical tools.

Kathy is a Certified Fraud Examiner, a Certified Coding Associate, and Certified Outpatient Coder. She also is certified in Healthcare Compliance and is a Master of Planning. She is a member of American Academy of Professional Coders, American Health Information Management Association, Association of Certified Fraud Examiners, and Health Care Compliance Association.