EXECUTIVE MANAGEMENT

Renee Krul, RN, BSN, CCS, CCDS

Co-Founder, President and Chief Operating Officer

Renee brings over thirty-five years of nursing and healthcare cost containment experience in varied settings inclusive of hospitals, medical review companies, health plans, third-party administrators and managed care organizations, most recently in Medicare Advantage and Dual Eligible plans. She developed and oversees all clinical services and business operations for DRG Claims Management, which provides DRG Auditing and Recovery services for any health plan that pays inpatient hospital claims based on DRG methodology. Renee’s strong background in compliance and managed care inspired her hallmark program development of risk-free auditing that delivers provider-signed agreements which effectively eliminates provider appeals for health plan clients. Previously, Renee was the President of Compliant DRG for three years, following ten years as a principal and Clinical Director of Total Claims Review & Management, Inc, providing both case management and bill review/auditing products.

Renee has also worked extensively as a consultant to health care plans in all aspects of cost management and has served as an expert witness in litigation related to payor-based case management and clinical documentation standards. Having obtained certifications  as a Clinical Documentation Specialist and as a Case Manager, she is noted for her expertise in Reimbursement and DRG methodology, CMS reimbursement guidelines, clinical documentation standards, utilization management, case management of populations with chronic disabilities, discharge planning, provider contracting and relations, and denials/ appeals, Renee is a Registered Professional Nurse licensed in multiple states.  She graduated from State University of New York School of Health Related Sciences in Syracuse, New York, State University of New York, Albany, New York with a Bachelor’s of Science in Nursing, and attended Rutgers University Graduate School of Nursing in Newark, New Jersey. Renee was the recipient of three national awards, the Nursing Spectrum’s Tri-State Region Nurse of the Year in 2005, Spina Bifida Association of America’s Healthcare Achievement Award in 2003, and the Case Management Society of America’s Case Manager of the Year in 1997.

Karen VanOverberghe

Executive Vice President, Business Development

Karen is an accomplished leader with 25 years in the BioPharma, reimbursement and EMR industry with a unique combination of expertise in access/managed markets, sales and marketing consulting in a broad array of bio-therapeutically focused areas, technologies and reimbursement models.

Her career spans the Biopharmaceutical/Medical Technology Management/Sales, Pharmacy Benefit Management, Health Insurance, Access/ Managed Markets, Public and Private Sector Contract Management and Negotiations, Advocacy Development, and Public Relations.

Karen’s expertise and experience are highlighted by numerous contributions in new business ventures, exceeding sales, maximizing brand positioning and providing strategic organizational direction in increasingly competitive and restrictive environments.

Karen has enjoyed working on new business ventures; starting and developing high performing teams, launching over 20 new products and a variety of key projects. She has worked with new innovative startups and the highest ranked healthcare Fortune 100 companies in the USA.

Abraham Kaufman

Chief Information Officer

Abraham is a proven technology leader with many years of experience leading and defining technology solutions for companies from the retail, telecommunications and health industries. His success is attributable to knowing how to adapt to rapidly changing environments and to building IT organizations that strive for operational excellence and innovative solutions.

As Chief Information Officer of DRG Claims Management, Abraham leads technology strategy development and execution. Abraham is also conducting the programs, policies, and procedures to ensure that we are fully compliant with HIPPA and all federal and state requirements.

Mark Lyons

Director of Software Development

Mark has over 20 years of experience defining and developing software solutions for companies from the consumer, bio-technology, health, and insurance sectors. Mark is savvy at understanding what the company needs, assuring solutions that are technically elegant while stressing simplicity and usability. Mark has worked on many projects in C++ and in .NET technologies. He holds a degree in Computer Science from Loyola University Chicago and is responsible for the development of DRG Claims Management internal claims management and auditing system.

Katie Cancelliere, CCS, RHIT

Auditing Manager and Supervisor of Complex Reviews

Katie Cancelliere RHIT, CCS graduated from Berkeley College in 2000 as valedictorian with an Associate Degree in Health Information Management. She obtained her RHIT and CCS credential in 2000 She has 10 years’ experience in DRG Validation Auditing. Katie is responsible for all new hire assessments and training, and supervision of coding staff. She coordinates all complex coding initiatives and contributes to the data analytic process for ongoing development of our algorithms for audit selection.

Catherine Moriarity, BS, RHIT, CCS, CHC

Auditing Compliance Officer

Cay Moriarity, BS, RHIT, CCS, CHC has thirty years of experience with a focus on training, educating, and the auditing of inpatient records, as well as how coding is related to clinical documentation programs. She has successfully trained coders in inpatient coding and guidelines and has written and delivered educational sessions on a variety of coding topics. She also has educated physicians and other healthcare professionals to understand how documentation impact the assign of MS-DRGs and reimbursement. Cay is also certified in health care compliance and is responsible for our data compliance policies and procedures.

 

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