North Highlands CA 95660
Seeking position as a Hospital Compliance Officer with reputable organization in which my skills and knowledge can help further the development of the organization.
Summary of Qualifications:
- Huge experience in revenue cycle, program development and strategic planning
- Thorough knowledge of Medicare and Medicaid reimbursement and fraud and abuse laws
- Sound knowledge of accreditation and licensing requirements
- Good understanding of both CPT and ICD-9 codes
- Ability to Ability to analyze claims, billing and medical data
- Skilled in auditing, conducting investigations, monitoring standards
- Strong interpersonal and communication skills
- Excellent project management and organizational skills
- Ability to manage a diverse and demanding workload
Hospital Compliance Officer, August 2005 – Present
Central Carolina Hospital, Spokane Valley, WA
- Provided advice on regulatory compliance issues to Hospital’s employees.
- Coordinated and prepared reports for Company’s Compliance Department.
- Maintained Hospital’s compliance program in adherence with applicable federal and state rules and regulations.
- Attended compliance committee meetings and headed them.
- Resolved safety, health and regulatory issues.
Hospital Compliance Officer, May 2000 – July 2005
Tenet Healthcare, Spokane Valley, WA
- Ensured integrity of the regional hotline process & conducted investigations to resolve compliance issues & complaints.
- Overseen medical center responses to external regulatory agencies such as CMS & the Federal Office of Civil Rights.
- Managed identified privacy breaches to ensure and file all reports, performed root cause analysis, & initiated controls to prevent further loss of protected health information.
- Overseen implementation of revenue cycle functions & ensured the remediation of Site of Service, Scope of Practice, & billing and documentation issues.
- Managed risks & assisted local leadership to establish plans to address these risks.
Bachelor’s Degree in Health Administration, Century College, White Bear Lake, MN
Master’s Degree in Health Administration, Immaculata University, Immaculata, PA