Self-assured individual trained to be a focused Compliance expert bringing more than 3 years working for Government organization. Determined to exceed expectations and promote developed skills in regulatory standards.
Overview
11
11
years of professional experience
Work History
Compliance Specialist
Department Of Community Health
07.2020 - Current
Monitored compliance with Federal and State enforcement and program integrity laws and regulations
Analyzed contractor performance activities and/or work performance of staff addressing deficient performance findings in order to resolve identified problems
Implemented improvement initiatives and developed compliance testing program to monitor and identify gaps in new and existing practices.
Documented and reported all complaint investigations within a week time frame
Conducted 25-30 monthly on-site inspections at Provider locations, completing 2-3 surveys a day
Proficient in decoding programs (Medicaid, VA, GAPP) requirements that align with or affect State regulations
Guaranteed any language in contracts protect client rights
Success in developing and managing working relationships with Providers to bridge connections
Managed practical action plans to respond to audit discoveries and compliance violations.
Identified, investigated and documented compliance violations and recommended corrective measures.
Collaborated with management to train new hires within 6 months, ensuring employee proficiency in complaint investigations.
Scheduling Dictionary Coordinator
Parallon/HCA
03.2017 - 06.2020
Proactively identified scheduling issues and developed quick solutions to promote efficiency and profitability.
Performed maintenance of Scheduling Dictionaries including meeting with ancillary departments to resolve dictionary issues for initial rollout and on an ongoing basis within the same week of request
Managed project timelines for successful completion, ensuring milestones were met and deadlines were adhered to.
Assisted with development and/or creation of scheduling education materials
Coordinated appointments for multidisciplinary hospital procedures
Collaborated with facility directors/managers to maintain scheduling standards
Conducted employee engagements
Followed up on patient and department director complaints promptly
Patient Access Associate
The Emory Clinic
06.2016 - 02.2017
Cultivated relations between patient and clinical provider to ensure efficient care is distributed
Collected and entered patient demographic and insurance data into computer database to establish patient's medical record.
Secured patient information and confidential medical records in compliance with HIPAA privacy rule standards to protect patient's privacy.
Offered simple, clear explanations to help clients and families understand hospital policies and procedures.
Constructed internal internet portal for employees with daily pertinent information
Safeguarded patients information by verifying customers
Indulged in a team atmosphere to complete daily tasks.
Improved patient satisfaction by efficiently registering and verifying insurance information, leading to a streamlined admission process.
Release of Information Specialist
CioxHealth, formally Healthport, LLC
09.2013 - 05.2016
Exhibited interpersonal skills by responding to patients with appropriate and informative information
Enhanced the efficiency of the release of information process by implementing a streamlined system for handling requests.
Validated appropriate HIPAA-compliant authorizations, subpoenas, and production of documents to protect patients' confidentiality rights and comply with federal regulations
Analyzed medical records for suitable information to safeguard patient security
Scanned correspondence letters, medical records and hospital billing records to third party clients
Maintained database by logging release of information requests from patients and third party clients
Education
Master’s of Health Administration -
Clayton State University
Morrow, GA
05.2017
Bachelor of Science - Health Information Management
Alabama State University
Montgomery, AL
05.2013
Skills
Service Review
Auditing Processes
Field Inspection
Corrective Actions
Regulatory Compliance and Documentation
Regulatory Standards
Compliance Knowledge
State and Federal Regulations
Compliance Reviews
Regulation Enforcement
Inspection Reviews
Employee training and development
Timeline
Compliance Specialist
Department Of Community Health
07.2020 - Current
Scheduling Dictionary Coordinator
Parallon/HCA
03.2017 - 06.2020
Patient Access Associate
The Emory Clinic
06.2016 - 02.2017
Release of Information Specialist
CioxHealth, formally Healthport, LLC
09.2013 - 05.2016
Master’s of Health Administration -
Clayton State University
Bachelor of Science - Health Information Management
Alabama State University
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