Open to opportunities

Kristine Moore

@kristinemoore

Message

I am an experienced home infusion RCM specialist improving revenue and reducing denials.

United States

Message

What I'm looking for

I seek a role leveraging home-infusion RCM and clinical experience to reduce denials, standardize SOPs, mentor teams, and drive measurable revenue recovery in a collaborative environment.

I am an experienced healthcare professional specializing in home infusion revenue cycle management with over five years of proven results. I improve revenue capture through claims auditing, denial management and full-cycle billing for IVIG, TPN and oncology therapies.

I have led quality audits and trained offshore billing teams, developed SOPs, and analyzed payer denial trends to reduce denials and resolve high-impact discrepancies. I’m proficient with Brightree, CPR+, Change Healthcare, Availity, CMS-1500, ICD-10 and EOB interpretation. I maintain compliance with Medicare Part B, Medicaid and commercial payer requirements.

Currently a Pre-Operative Testing Nurse and a licensed LPN pursuing an ASN, I bring clinical judgment alongside billing expertise to bridge clinical and financial operations. I seek to join a team where I can standardize processes, mentor staff and drive measurable revenue improvements.

Experience

Work history, roles, and key accomplishments

Current

Pre-Operative Testing Nurse

Current

Winter Garden Surgery Center

May 2024 - Present (1 year 4 months)

Conduct pre-op assessments and medical history interviews to determine surgical clearance; review test results with anesthesia and participate in onboarding and training of new nursing staff.

Patient Education Onboarding EHR Vitals Assessment

Payor Analyst - Home Infusion RCM

Brightree

May 2022 - Jun 2023 (1 year 1 month)

Led quality audits on home infusion claims prior to submission to minimize denials and developed SOPs to standardize revenue processes while managing and training offshore billing analysts.

Denial Management SOP Development Brightree

Reimbursement Analyst, Home Infusion

Professional Reimbursement Inc.

Oct 2018 - May 2022 (3 years 7 months)

Managed full-cycle billing for home infusion therapies including TPN, IVIG, and oncology; maintained prior authorizations, submitted appeals, and reconciled payments to ensure accurate reimbursement.

Full Cycle Billing TPN Oncology Billing CPR Authorization ICD 10

Pharmacy Nurse Support Specialist

Prime Therapeutics Specialty Pharmacy

May 2015 - Dec 2016 (1 year 7 months)

Monitored adverse drug event reports with high accuracy, coordinated with pharma partners, and managed task delegation and inbox workflows to support specialty pharmacy operations.

Adverse Events Clinical Coordination Data Reporting Inbox Management

Financial Assistance Specialist

Advanced Care Scripts

May 2014 - Jan 2015 (8 months)

Reviewed and corrected billing account errors, interpreted EOBs and J-codes for high-cost specialty medications, and collaborated with pharmacies, payers, and manufacturers to resolve benefit issues.

EOB Interpretation J Codes