compliance auditor resume example with 17+ years of experience
JessicaClaire
Montgomery Street, San Francisco, CA94105609 Johnson Ave., 49204, Tulsa, OK Home: (555) 432-1000 - Cell: - resumesample@example.com - : - -
Professional Summary
Multi-talented Medical Records Department Mananger with over 16 years of experience in HIPAA compliance, Records management and Release of Information. Experienced in policy development planning and operational improvements to also include staff management procedures positively impacting overall moral and productivity. Eager to contribute to team success through hard work, attention to detail and excellent organizational skills. Great reputation for resolving problems, improving customer satisfaction, and driving overall operational improvements while consistently saving on costs and increasing profits.
Skills
Health Information Management
Medical Records Research, Maintenance & Retrieval
HIPAA Complance
Release of Information
EMR Proficient (Greenway, Nextgen, ECW)
Ability to read medical records
Medical terminology understanding
CMS Guidelines
Podiatry
MS Word, Excel, PowerPoint, and Outlook, Internet Explorer, Mozilla, Firefox)
Contract Negotiation
Vendor Relation
Department Revenue and Budgeting
Work History
01/2013 to Current
MEDICAL RECORDS DEPARTMENT MANAGERAlliance Healthcare Services, Inc. – Toms River, NJ,
Saved over $100,000 by implementing cost-saving initiatives that addressed long-standing problems.
Led the records team in delivery of Risk Adjustment Audit projects, resulting in thousands of dollars in revenue.
Perform a variety of compliance duties that protects the company's assets and ensures that each line of business operates within the policies, procedures and regulations set forth by the company, local, state and federal laws while achieving responsible and effective corporate governance and ethics.Drove operational improvements which resulted in savings and improved profit margins.
Streamlined daily operations by monitoring compliance with laws, regulations, and policies.
Manage and prepare audit control reports by researching material, collecting, analyzing, and summarizing operating information and trends to ensure each department remains in accordance with corporate best practice, as well as local, state and federal laws.
Preform risk assessments, determine the level of risk, and audit the highest risk areas.
Performed physcian audits for documentation compliance in accordance with CMS guidlines.
Documents all positive and negative information discovered and formulate plans of action.
Schedule future audits to monitor a department's progress and escalates non- compliance issues to senior management when needed.
Reports functionally to the organization's compliance committee.
Reports administratively to the organization's Chief Medical and Operating Officer and Director of Operations.
Ensured adherence with organization regulations by establishing internal control and procedures, examining records, reports, operating practices and documentation for compliance.
Manage internal control systems by updating audit programs and implementing new policies and procedures while ensure all are in compliance with HIPAA, OSHA, state and federal laws.
Re-educate staff on regulations and issues identified in the audit process.
Enforces any new or updated best practices or legal regulations that have been established.
Manage productivity, quality and identify work process improvements..
Managed and maintained storage records and companywide shredding services.
01/2007 to 01/2012
FRONT OFFICE ASSISTANTMinnesota Urology, Pa – Woodbury, MN,
Performed a variety of non-clinical duties in support of a fast-paced physicians' practice following established methods and procedures.
Streamlined daily operations by checking in patients, verifying and/or updating demographic, insurance, and registration information in accordance with established policies and procedures.
Often checked out patients once services are rendered and collected appropriate payments in accordance with patient's medical plan coverage and provided receipts for service.
Reviewed and edited patient bills generated by providers through the electronic medical record and/or entered charges and payments from fee tickets.
Maintained balances and reconciled assigned cash drawer at the end of each day.
Facilitated the scheduling, canceling, and rescheduling of patient appointments and communicated changes to staff as needed.
Referred calls regarding prescription drug medications, treatments, etc., to appropriate clinical staff.
Immediately advised physicians and/or other licensed staff of patients requiring emergence assistance.
Coordinated referrals and/or hospital admission arrangements as directed.
Acquired knowledge of managed care plans, CPT, and ICD-9coding.
Received and routed business correspondence to correct departments and staff members.
Ensured adherence with organization regulations by maintaining compliance with all HIPAA policies specifically relating to patient confidentiality and release of information.
Maintained strict confidentiality on all patient information and practice matters.
Remained current on HIPAA, OSHA, Infection Control, patient safety, and other mandatory regulations, standards, and organizational policies and procedures.
Provided clerical support to company employees by copying, faxing and filing documents.
Kept physical files and digitized records organized for easy updating and retrieval by authorized team members.
Kept reception area clean and neat to give visitors positive first impression.
Coordinated master schedule by booking and rescheduling appointments
Enhanced clinic operational success through efficient records coordination, supply management and document processing.
01/2002 to 01/2006
MEDICAL RECORDS TECHNICIANMEDSOUTH RECORD MANAGEMENT, LSU Medical Center – City, STATE,
Provided administrative support services in the management of health information in the healthcare setting.
Streamlined daily operations by working under the direction of the Director of HIM Operations while ensuring the proper release of health information.
Ensured that all request for health information followed all guidelines of the state and federal privacy law that regulates confidentiality in health care therefore, all request for health information were carefully reviewed and validated for HIPAA Compliance daily.
Assisted in daily operations by working in a centralized release of information operation at LSU Medical Center that supported the confidential copying and release of requested medical information to third party payers in support of revenue cycle operations.
Performed the duties related, but not limited to, the systematic retrieval, reproduction and distribution of medical record information requested by third party payers.
Released patient health information appropriately to requestors according to state, federal and HIPAA (Health Insurance Portability and Accountability Act) regulatory guidelines.
Ensured adherence with facility regulations by providing extensive customer service skills due to continuous interactions with and providing service to revenue cycle staff, HIM staff at LSU facilities, staff and third party payer requestors.
Maintained responsibility for receipt, monitoring, and tracking of release of information request until completed and meeting a reasonable turnaround time to ensure no negative impact on revenue cycle operations.
Education
Expected in to to
Bachelors: Business Management COLORADO UNIVERSITY - COLORADO SPRINGS, CO GPA:
Expected in to to
: Healthcare GRETNA CAREER COLLEGE - GRETNA, LOUISIANA GPA:
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