Blanche Burden
DeLand,US
Summary
Detail-oriented Compliance Officer dedicated to improving policies and procedures in all business areas. Hardworking and driven with quality-focused and proactive approach. Bringing 10 years of experience in Healthcare industry. Detail-driven Compliance Officer focused on maximizing company compliance with applicable laws and standards. Knowledgeable about internal controls, process evaluations and procedural reviews. Proficient in Veterans Affairs software. Veteran Program Analyst versed in ongoing program evaluations and eager for new professional challenges. Highly effective at reviewing and validating data, conducting complex reviews, and assessing program operations.
Overview
22
22
years of professional experience
1
1
Certification
Work History
Program Analyst
LaWanda Knox
- Atlanta VA Health Care System
- Cell - 205-799-7181
- Lawanda.knox@va.gov
Privacy Officer
Shirley Hobson, VA Medical Center
Utilization Nurse
Sandi Strome
- Retired
- Home: 310-884-8667
Health System Specialist (Compliance Officer)
North Florida/South Georgia VA Health System
11.2020 - Current
- Assisted with internal and external audits to confirm compliance with applicable laws and regulations.
- Conducted thorough risk assessments for identifying potential compliance vulnerabilities and formulated mitigation strategies.
- Audit researching, collecting, and analyzing data; applying qualitative and quantitative techniques of analyzing and measuring the effectiveness, efficiency, and productivity of program management, data analysis and the application of data reporting related programs; audits and/or other evaluation techniques to monitor issue/trends and to assist in the reduction of identified problem area, contract audit and credentialing/privileging audit etc. Advising Facility Director of all data analysis, audits, investigation issues. Manage compliance staff and working through subordinate supervisors to support management operation of business processes.
- Applying analytic principles, theories, and techniques to healthcare management and operational systems with a degree of resourcefulness and ingenuity.
- Collaborate with the VISN Compliance Officer and other Medical Center Compliance Officers/Coordinators and management to review initiatives on regulatory compliance and consistency in application. Provides recommendations for improvements in the overall compliance program.
- Assessing existing policies and procedures, identifying and documenting compliance risks.
- Assist in developing, and drafting written Medical Center policies and procedures, consistent with VISN and VACO CBI directives to ensure local compliance issues are addressed.
- Monitor and respond to Compliance Hotline Complaints regarding allegations of improper/illegal activities and the enforcement of appropriate disciplinary action against employees who have violated internal compliance policies, regulations, or federal health care program requirements.
- Maintain Compliance Hotline Complaints (Compliance/White House) inquiry of received complaints and protect the anonymity of complainants.
- Distribute new/updated policies by Congress that promote commitment to compliance (by including adherence to compliance as an element in evaluating managers and employees) and address specific areas of potential fraud, such as billing, collections, and upcoding.
- Collaborate with VISN Compliance Officer, Facility Director, and other colleagues to review initiatives on regulatory compliance and consistency in application to provide recommendations for improvements in the overall compliance program.
- · Submit Personnel Actions Request (PAR) within the HRMS applicable database (HRSmart), write performance appraisals that accurately depict employees' annual performance, collaborate with local Union personnel, advise Executive Director employee conduct, ethical issues reference to fact-finding/investigations.
Health Systems Specialist (Compliance Officer)
Gainesville Veterans Affairs Health System
11.2020 - Current
- Audit researching, collecting, and analyzing data; applying qualitative and quantitative techniques of analyzing and measuring the effectiveness, efficiency, and productivity of program management, data analysis and the application of data reporting related programs; audits and/or other evaluation techniques to monitor issue/trends and to assist in the reduction of identified problem area, contract audit and credentialing/privileging audit etc. Advising Facility Director of all data analysis, audits, investigation issues. Manage compliance staff and working through subordinate supervisors to support management operation of business processes.
- Monitor and respond to Compliance Hotline Complaints regarding allegations of improper/illegal activities and the enforcement of appropriate disciplinary action against employees who have violated internal compliance policies, regulations, or federal health care program requirements.
- Maintain Compliance Hotline Complaints (Compliance/White House) inquiry of received complaints and protect the anonymity of complainants.
- Assessing existing policies and procedures, identifying and documenting compliance risks.
- Assist in developing, and drafting written Medical Center policies and procedures, consistent with VISN and VACO CBI directives to ensure local compliance issues are addressed.
- Gathering information, identifying, and analyzing concerns of potential non-compliance with VA and VHA directives, and developing recommendations to resolve substantive problems relating to the effectiveness efficiency, and appropriateness of work operations within the CBI program.
- Conducting and coordinates CBI investigations on reported incidents of non-compliance with VHA administrative policies and directives pursuant to VHA Compliance Inquiry Policy.
- Developing appropriate monitoring and auditing processes and corrective action plans to improve the effectiveness, efficiency, and appropriateness of business practices.
- Participates in external reviews of the organization surveys (JCAHO, IG/CAP, GAO) as directed by Medical Center executive leadership.
- Coordinate the investigation and remediation of identified system problems and the development of policies addressing the non-employment or retention of sanctioned individuals.
- Ensures complete and accurate diagnostic and procedural coded data is achieved for the purpose of research management, outcomes and statistical analysis, financial and strategic planning, reimbursement, and quality of care.
- Coordinates efforts to communicate compliance related information which addresses identified compliance risk areas, e.g., results from consultant reviews/internal reviews to those operational areas that would be impacted by any revisions to current processes and procedures.
- Coordinates training and educational programs related to compliance, which ensure operations employees maintain understanding of compliance and the Medical Center’s mission for compliance.
- Ensures a mechanism is utilized for documenting and tracking operational area compliance training and monitors this mechanism to ensure system is used and information is captured timely.
- Maintains awareness of laws and regulations, keeping apprised of current changes that may affect the compliance program, through personal initiative, seminars, training programs.
- Interacts with facility management, government agencies, contractors, Regional Counsel, and employees to ensure an understanding of facilities initiatives towards compliance and to provide consistency of compliance between the divisions and among departments.
- Monitors questions, issues, and reports of possible non-compliance reported through established mechanisms.
- Oversight of inspection, and completion of the required work to be accomplished in assigned contracts. Monitors and inspects all contract deliverable provided within the scope of the contract and reviews and approves invoices using the rates and other fees established in the contract work meets standards of adequacy necessary for authorization of payment.
- Distribute new/updated policies by Congress that promote commitment to Veterans, (by including adherence to compliance as an element in evaluating managers and employees) and address specific areas of potential fraud, such as billing, collections, and upcoding.
- · Collaborate with VISN Compliance Officer, Facility Director, and other colleagues to review initiatives on regulatory compliance and consistency in application to provide recommendations for improvements in the overall medical facility.
- · Submit Personnel Actions Request (PAR) within the HRMS applicable database (HRSmart), write performance appraisals that accurately depict employees' annual performance, collaborate with local Union personnel, advise Executive Director employee conduct, ethical issues reference to fact-finding/investigations.
Health System Specialist (Compliance Business Integrity Officer), Certified Ethics Advisor
GS
11.2020 - Current
- 367-2884
- Department of Veterans Affairs Employer Code: 10208
- Distribute written policies and procedures that promote commitment to compliance (by including adherence to compliance as an element in evaluating managers and employees) and address specific areas of potential fraud, such as billing, collections, and upcoding
- Maintain a process, such as hotline (Compliance/White House) inquiry, to receive complaints, and the adoption of procedures to protect the anonymity of complainants
- Monitor the responses received from the Compliance hotline regarding allegations of improper/illegal activities and the enforcement of appropriate disciplinary action against employees who have violated internal compliance policies, regulations, or federal health care program requirements
- Use of audit researching, collecting, and analyzing data; applying qualitative and quantitative techniques of analyzing and measuring the effectiveness, efficiency, and productivity of program management, data analysis and the application of data reporting related programs; audits and/or other evaluation techniques to monitor issue/trends and to assist in the reduction of identified problem area, contract audit and credentialing/privileging audit etc
- Advising Facility Director of all data analysis, audits, investigation issues
- Manage compliance staff and working through subordinate supervisors to support management operation of business processes
- Applying analytic principles, theories, and techniques to healthcare management and operational systems with a degree of resourcefulness and ingenuity
- Assessing existing policies and procedures, identifying and documenting compliance risks
- Initiating, developing, and drafting written Medical Center policies and procedures, consistent with VISN and VACO CBI directives to ensure local compliance issues are addressed
- Gathering information, identifying, and analyzing concerns of potential non-compliance with VA and VHA directives, and developing recommendations to resolve substantive problems relating to the effectiveness efficiency, and appropriateness of work operations within the CBI program
- Conducting and coordinates CBI investigations on reported incidents of non-compliance with VHA administrative policies and directives pursuant to VHA Compliance Inquiry Policy
- Developing appropriate monitoring and auditing processes and corrective action plans to improve the effectiveness, efficiency, and appropriateness of business practices
- Participates in external reviews of the organization surveys (JCAHO, IG/CAP, GAO) as directed by Medical Center executive leadership
- Coordinate the investigation and remediation of identified system problems and the development of policies addressing the non-employment or retention of sanctioned individuals
- Ensures complete and accurate diagnostic and procedural coded data is achieved for the purpose of research management, outcomes and statistical analysis, financial and strategic planning, reimbursement, and quality of care
- Coordinate efforts of Issue Management, status, date detected, responsible operating unit, detection method and source of deficiency
- Coordinates efforts to communicate compliance related information which addresses identified compliance risk areas, e.g., results from consultant reviews/internal reviews to those operational areas that would be impacted by any revisions to current processes and procedures
- Coordinates training and educational programs related to compliance, which ensure operations employees maintain understanding of compliance and the Medical Center’s mission for compliance
- Ensures a mechanism is utilized for documenting and tracking operational area compliance training and monitors this mechanism to ensure system is used and information is captured timely
- Maintains awareness of laws and regulations, keeping apprised of current changes that may affect the compliance program, through personal initiative, seminars, training programs
- Interacts with facility management, government agencies, contractors, Regional Counsel, and employees to ensure an understanding of facilities initiatives towards compliance and to provide consistency of compliance between the divisions and among departments
- Monitors questions, issues, and reports of possible non-compliance reported through established mechanisms
- Oversight of inspection, and completion of the required work to be accomplished in assigned contracts
- Monitors and inspects all contract deliverable provided within the scope of the contract and reviews and approves invoices using the rates and other fees established in the contract work meets standards of adequacy necessary for authorization of payment
- Interacts with the VISN Compliance Officer and other Medical Center Compliance Officers/Coordinators and management to review initiatives on regulatory compliance and consistency in application
- Provides recommendations for improvements in the overall compliance program
- Provides reports to each healthcare system Director and VISN Compliance Officer on program implementation and ongoing monitoring
- Submit Personnel Actions Request (PAR) within the HRMS applicable database (HRSmart), writing performance appraisals that accurately depict employees' performance, collaborate with local Union personnel, advise Executive Director employee conduct, ethical issues reference to factfinding.
Health System Specialist (Compliance Officer)
Atlanta Veterans Affairs Health System
11.2018 - 11.2020
- Acting VISN 7 Compliance Officer in the absence of VISN 7 Compliance Officer.
- Controlled Substance Inspection Committee Chair, Appointed by Facility Director.
- Applying knowledge of healthcare systems and management to assist in developing and implementing Controlled Substance Inspection safety program.
- Managing documentation, communication, and reporting controlled substance inspection related issues to the Facility Director and Organizational Health Council.
- Monitoring and managing incoming inspection issues/diversion and requests initial receipt to completion and closeout. Analyzing and trending incoming information for distribution to Facility Director and Organizational Health Council.
- Developed and maintained strong relationships with key stakeholders, including local government officials, community organizations, and other healthcare providers.
- Leveraged data analytics tools to identify trends in patient population demographics or disease prevalence that may affect long-term facility capacity planning efforts.
- Evaluated the effectiveness of existing health programs, recommending changes or updates as needed to maintain relevancy and efficacy.
- · Monitors, tracks, and trends questions, issues, and reports of possible non-compliance. Develop, coordinate, conduct and analyze results of audits or other evaluation techniques to monitor compliance.
- Develop performance standards, evaluated subordinate supervisors, and served as the review official on evaluations of non-supervisory employees rated by subordinate supervisory positions.
- Oversight of inspection, and completion of the required work to be accomplished in assigned contracts. Monitors and inspects all contract deliverable provided within the scope of the contract and reviews and approves invoices using the rates and other fees established in the contract work meets standards of adequacy necessary for authorization of payment.
- Exercised final authority for the full range of personnel actions and organization design proposals recommended by subordinated supervisors and supported the affirmative action and patient safety goals with the goals within the Department and was responsible and accountable for fair, equitable, consistent, and correct administration of time and attendance policies and timecard reporting/recording for all employees in their service.
- Worked with Human Resources Specialist as the subject matter expert to prepare vacancy announcements-based Position Description (PD) and/or Functional Statements (FS) and provided analysis of the position, qualifies/disqualifies applicants, and maintains all documentation for the job announcement.
Health System Specialist (Compliance Business Integrity Officer)
Atlanta VA Health System
11.2018 - 11.2020
- GS-13
- Employment Verification/Salary, 800-367-2884
- Department of Veterans Affairs Employer Code: 10208
- Acting VISN 7 Compliance Officer in the absence of VISN 7 Compliance Business Integrity Officer
- Controlled Substance Inspection Committee Chair, Appointed by Atlanta Health Care System Director
- Applying knowledge of healthcare systems and management to assist in developing and implementing Controlled Substance Inspection safety program
- Managing documentation, communication, and reporting controlled substance inspection related issues to the Director and Organizational Health Council
- Monitoring and managing incoming inspection issues/diversion and requests initial receipt to completion and closeout
- Analyzing and trending incoming information for distribution to Director and Organizational Health Council
- Develops, implements, and maintains the compliance program throughout the facility
- Performs an annual system wide prioritized risk assessment
- Conduct investigations and remediation of system problems identified through the helpline
- Provide Community Care Consult Audit and defining and analyzing, resolving complex problems with appropriate solutions
- Communicate VHA new and/or amended policies and conducts or directs studies to resolve administrator problems
- Develop policies addressing the non-employment or retention of sanctioned individuals
- Respond and take appropriate action to allegations of improper/illegal activities and regulations
- Interacts with facility, VISN, VACO Compliance and Business Integrity (CBI) Management
- Monitors, tracks, and trends questions, issues, and reports of possible non-compliance
- Develop, coordinate, conduct and analyze results of audits or other evaluation techniques to monitor compliance
- Enters and updates the Compliance Inquiry Reporting and Tracking Systems (CIRTS)
- Provide written reports and recommendation of corrective action plan to the Medical Center Director and VISN Compliance Officer
- Prepares for and leads investigation of the facility by the center for Medicare and Medicaid Services (CMS) or third-party payers, performance standards
- Participates in Board of Investigation when relevant to compliance
- Develop performance standards, evaluated subordinate supervisors, and served as the review official on evaluations of non-supervisory employees rated by subordinate supervisory positions
- Made selections for non-supervisory positions and supervisory positions and interviewed candidates for position in the unit, recommended appointment, promotion, or reassignment to such position
- Collaborate and resolved group grievances or serious employee complaints
- Reviewed and approved serious disciplinary actions involving non-supervisory subordinates
- Made decisions on nonroutine, costly and/or controversial training needs, and training requested related to the employees in the unit
- Recommended awards or bonuses for non-supervisory personnel and changes in position classification, which was subject to approval by high level officials, supervisors, or others
- Approved/disapproved leave requests from subordinate supervisors and developed and established an effective, efficient, and economical position structure which will best serve mission
- Oversight of inspection, and completion of the required work to be accomplished in assigned contracts
- Monitors and inspects all contract deliverable provided within the scope of the contract and reviews and approves invoices using the rates and other fees established in the contract work meets standards of adequacy necessary for authorization of payment
- Approved expenses comparable to within-grade increases, extensive overtime, and employee travel
- Exercised final authority for the full range of personnel actions and organization design proposals recommended by subordinated supervisors and supported the affirmative action and patient safety goals with the goals within the Department and was responsible and accountable for fair, equitable, consistent, and correct administration of time and attendance policies and timecard reporting/recording for all employees in their service
- Worked with Human Resources Specialist as the subject matter expert to prepare vacancy announcements-based Position Description (PD) and/or Functional Statements (FS) and provided analysis of the position, qualifies/disqualifies applicants, and maintains all documentation for the job announcement
- Reviewed and consulted, in conjunction with the Human Resources Specialist, on job analysis and/or rating and ranking panels when needed
- Researched qualifications and skills needed and ensures the job analysis is properly formulated with subject matter experts to garner highly qualified applicants.
Health Systems Specialist (Compliance Specialist)
Memphis Veterans Affairs Health System
11.2016 - 11.2018
- Developed comprehensive data analysis reports to inform decision-making processes for improved healthcare outcomes.
- Mentored junior staff members in their professional development through regular feedback sessions focused on skill-building opportunities within the organization''s health system efforts.
- Coordinated activities with Program managers (Service Chiefs) to align planning processes with targeted project outcomes.
- Improved patient care quality by implementing efficient health systems and streamlining processes.
- Provides educational assistance to the facility staff under the direction of Chief Compliance Officer and in conjunction with Chief Health Information Management Services. Comprehensive and in-depth knowledge and understanding of hospital administration, and the VA and VHA healthcare missions, programs, procedures, and requirements.
- Assists the Chief Compliance Officer ensuring that the facility is compliant with billing, medical record documentation, and coding guidelines required by VA and VHA regulations, contract audits for Community Base Outpatient Clinics (CBOCs) which includes Health Care Services Contract, Sharing Agreement, University Academic Affiliate.
- Monitors contractor performance for compliance with applicable laws, delivery schedules, payment provisions, contract data reporting requirements, systems, policies, and procedures are monitored and evaluated in accordance with contract requirements.
- Attend meeting of committees providing input and recommendations, which represent the VA Medical Center. Broad general knowledge of Veterans Administration operating manuals and local directives.
- Performs quality review audits and monitoring on financial, medical and reimbursement data to ensure that facility reimbursement is appropriate, and the facility profile is accurate and reliable. Applies management qualitative and quantitative tools to improve the operations of the organization.
- Works closely and in coordination with the Business Office, Health Information Management Section (HIMS), Mid-South Consolidated Patient Account Center (MSCPAC), Community Based Outpatient Clinics (CBOCS) and Executive Management Officials.
- Responsible for providing evaluation of documentation of medical services provided by VHA providers to ensure that all services documented in compliance with established guidelines for reimbursement and to meet VHA regulations, OIG, CMS, and TJC standards.
- Audit and analyze data in VistA including, but not limited to Computer Patient Record System (CPRS), VHA Support Service Center (VSSC), Insurance Capture Buffer (ICB) Cube, Decision Support System (DSS), Non-VA Community Care (NVCC), Data Validation, Nuance (encounters), progress notes and other patient care reports, Healthcare Contracts, Provider Agreements, workload capture data and Community Based Outpatient Clinics (CBOCS) related performance measure sufficient to provide guidance to others as well as improvement recommendations.
- Provide support to the Chief Compliance Officer by developing and reviewing quality control procedures and methodologies to ensure accuracy of reimbursement and medical record documentation; providing technical assistance to the Chief Compliance Officer in the selection of focused audits, contract audits, criteria development, data retrieval, compilation of findings, and follow-up audits oriented toward improving utilization of resources including quality of care and cost effectiveness to improve the operational performance of the organization.
- Ability to establish and maintain effective relationships with managers, supervisors, co-workers and gain the cooperation on complex and/or controversial issues. Tactfully negotiate in persuading others effectively with management to accept and implement recommendations in changing procedures for the good of the organization.
- Ability to work both independently and in a team environment in a proactive manner to plan, prioritize, organize, delegate, and monitor the work being performed.
Health Systems Specialist (Compliance Business Integrity Specialist/Program Analyst)
Memphis
11.2016 - 11.2018
- Hours per week: 40, 11
- Employment Verification/Salary: 800-367-2884
- Department of Veterans Affairs Employer Code: 10208
- Provides educational assistance to the facility staff under the direction of Chief CBI Officer and in conjunction with Chief Health Information Management Services
- Comprehensive and in-depth knowledge and understanding of hospital administration, and the VA and VHA healthcare missions, programs, procedures, and requirements
- Assists the Chief Compliance and Business Integrity Officer ensuring that the facility is compliant with billing, medical record documentation, and coding guidelines required by VA and VHA regulations, contract audits for Community Base Outpatient Clinics (CBOCs) which includes Health Care Services Contract, Sharing Agreement, University Academic Affiliate
- Monitors contractor performance for compliance with applicable laws, delivery schedules, payment provisions, contract data reporting requirements, systems, policies, and procedures are monitored and evaluated in accordance with contract requirements
- Attend meeting of committees providing input and recommendations, which represent the VA Medical Center
- Broad general knowledge of Veterans Administration operating manuals and local directives
- Performs quality review audits and monitoring on financial, medical and reimbursement data to ensure that facility reimbursement is appropriate, and the facility profile is accurate and reliable
- Applies management qualitative and quantitative tools to improve the operations of the organization
- Works closely and in coordination with the Business Office, Health Information Management Section (HIMS), Mid-South Consolidated Patient Account Center (MSCPAC), Community Based Outpatient Clinics (CBOCS) and Executive Management Officials
- Responsible for providing evaluation of documentation of medical services provided by VHA providers to ensure that all services documented in compliance with established guidelines for reimbursement and to meet VHA regulations, OIG, CMS, and TJC standards
- Audit and analyze data in VistA including, but not limited to Computer Patient Record System (CPRS), VHA Support Service Center (VSSC), Insurance Capture Buffer (ICB) Cube, Decision Support System (DSS), Non-VA Community Care (NVCC), Data Validation, Nuance (encounters), progress notes and other patient care reports, Healthcare Contracts, Provider Agreements, workload capture data and Community Based Outpatient Clinics (CBOCS) related performance measure sufficient to provide guidance to others as well as improvement recommendations
- Provide support to the Chief CBI Officer by developing and reviewing quality control procedures and methodologies to ensure accuracy of reimbursement and medical record documentation; providing technical assistance to the CBI Officer in the selection of focused audits, contract audits, criteria development, data retrieval, compilation of findings, and follow-up audits oriented toward improving utilization of resources including quality of care and cost effectiveness to improve the operational performance of the organization.
- Ability to establish and maintain effective relationships with managers, supervisors, co-workers and gain the cooperation on complex and/or controversial issues
- Tactfully negotiate in persuading others effectively with management to accept and implement recommendations in changing procedures for the good of the organization
- Ability to work both independently and in a team environment in a proactive manner to plan, prioritize, organize, delegate, and monitor the work being performed.
Supervisor Financial Management Specialist
Los Angeles Veterans Affairs Health Systems
12.2011 - 11.2016
- Oversaw daily operations of the department, ensuring smooth workflow and timely completion of tasks.
- Applied strong leadership talents and problem-solving skills to maintain team efficiency and organize workflows.
- Increased team productivity by implementing efficient workflows and setting clear expectations for staff members.
- Enhanced communication within the team by holding regular meetings and encouraging open dialogue among all members.
- Enhance revenue operations throughout the Veterans Healthcare Administration (VHA) network by standardization and consolidation of billing and collection activity supported by medical center-based utilization review, data validation and customer service, pharmacy; National Provider Identification (NPI) functions, insurance capture, and Internal Control Audit that are organizationally aligned with the consolidated center. As well as Automated Data Processing Application Coordinator (ADPAC) for service line.
- Provides managerial guidance and direction to the full range of activities involved in health care revenue processes. Identifies problems, recommends corrective actions, and tracks changes to maintain accuracy.
- Coordinates day-to-day revenue functions for the support of health care operations such as: collections, registration, admissions, scheduling, insurance verification, pre-registration, data validation, review of services/claims for first- and third-party billing, customer service, review of eligibility, pre-certification, clinical appeals and continued stay review, pharmacy; national provider identification, utilization review and financial reporting for each activity. Assist Office of General Counsel Attorney with Tort Claims.
- Analysis/presents complex financial data and information to audiences of senior managers, executives, subordinate staff, and veterans’ groups.
- Plans work to be accomplished by subordinate staff; establishes priorities and deadlines. Resolves discrepancies between billings and collections and advises staff and management of determinations made.
- Develop performance standards, evaluated subordinate supervisors, and served as the review official on evaluations of non-supervisory employees rated by subordinate supervisory positions.
- Exercised final authority for the full range of personnel actions and organization design proposals recommended by subordinated supervisors and supported the affirmative action and patient safety goals with the goals within the Department and was responsible and accountable for fair, equitable, consistent, and correct administration of time and attendance policies and timecard reporting/recording for all employees in their service.
- Worked with Human Resources Specialist as the subject matter expert to prepare vacancy announcements-based Position Description (PD) and/or Functional Statements (FS) and provided analysis of the position, qualifies/disqualifies applicants, and maintains all documentation for the job announcement.
Supervisor Financial Management Specialist (Facility Revenue Manager)
Consolidate Patient Account Center, NECPAC
08.2012 - 11.2016
- GS-12
- Employment Verification/, : 800-367-2884
- Department of Veterans Affairs Employer Code: 10208
- I serve as Facility Revenue Manager for a Greater Los Angeles VA Medical Healthcare within the West Consolidated Patient Account Center (WCPAC)
- The WCPAC is a regionally consolidated business entity established to enhance revenue operations throughout the Veterans Healthcare Administration (VHA) network by standardization and consolidation of billing and collection activity supported by medical center-based utilization review, data validation and customer service, pharmacy; National Provider Identification (NPI) functions, insurance capture, and Internal Control Audit that are organizationally aligned with the consolidated center
- As well as Automated Data Processing Application Coordinator (ADPAC) for service line
- Provides managerial guidance and direction to the full range of activities involved in health care revenue processes
- Identifies problems, recommends corrective actions, and tracks changes to maintain accuracy
- Coordinates day-to-day revenue functions for the support of health care operations such as: collections, registration, admissions, scheduling, insurance verification, pre-registration, data validation, review of services/claims for first- and third-party billing, customer service, review of eligibility, pre-certification, clinical appeals and continued stay review, pharmacy; national provider identification, utilization review and financial reporting for each activity
- Assist Office of General Counsel Attorney with Tort Claims
- Analysis/presents complex financial data and information to audiences of senior managers, executives, subordinate staff, and veterans’ groups
- Plans work to be accomplished by subordinate staff; establishes priorities and deadlines
- Resolves discrepancies between billings and collections and advises staff and management of determinations made
- Performs audit duties for either financial or operational programs
- Serves as the Greater Los Angeles VA Medical Healthcare Manager for healthcare revenue-related issues from both WCPAC and Medical Staff
- Participation in all revenue initiatives related to the complete revenue cycle
- Ensures maximum collections and compliance with revenue activities
- Analyzes potential revenue sources
- Ensures all billing and collections guidelines are followed
- Develop performance standards, evaluated subordinate supervisors, and served as the review official on evaluations of non-supervisory employees rated by subordinate supervisory positions
- Made selections for non-supervisory positions and supervisory positions and interviewed candidates for position in the unit, recommended appointment, promotion, or reassignment to such position
- Collaborate and resolved group grievances or serious employee complaints
- Reviewed and approved serious disciplinary actions involving non-supervisory subordinates
- Made decisions on nonroutine, costly and/or controversial training needs, and training requested related to the employees in the unit
- Recommended awards or bonuses for non-supervisory personnel and changes in position classification, which was subject to approval by high level officials, supervisors, or others
- Approved/disapproved leave requests from subordinate supervisors and developed and established an effective, efficient, and economical position structure which will best serve mission
- Determined whether contractor performed work meets standards of adequacy necessary for authorization of payment
- Approved expenses comparable to within-grade increases, extensive overtime, and employee travel
- Exercised final authority for the full range of personnel actions and organization design proposals recommended by subordinated supervisors and supported the affirmative action and patient safety goals with the goals within the Department and was responsible and accountable for fair, equitable, consistent, and correct administration of time and attendance policies and timecard reporting/recording for all employees in their service
- Worked with Human Resources Specialist as the subject matter expert to prepare vacancy announcements-based Position Description (PD) and/or Functional Statements (FS) and provided analysis of the position, qualifies/disqualifies applicants, and maintains all documentation for the job announcement
- Reviewed and consulted, in conjunction with the Human Resources Specialist, on job analysis and/or rating and ranking panels when needed
- Researched qualifications and skills needed and ensures the job analysis is properly formulated with subject matter experts to garner highly qualified applicants.
Supervisor Financial Management Specialist
Pittsburg Veterans Affairs Health System
12.2011 - 11.2012
- Applied strong leadership talents and problem-solving skills to maintain team efficiency and organize workflows.
- Oversaw daily operations of the department, ensuring smooth workflow and timely completion of tasks.
- Enhance revenue operations throughout the Veterans Health (VHA) network by standardization and consolidation of billing and collection activity supported by medical center-based utilization review, data validation and customer service, pharmacy, Internal Control Audits, functions that are organizationally aligned with the consolidated center.
- Overseeing daily operations, including the full range of management and supervisory activities of 2 Utilization Revenue Nurse, 5 Facility Revenue Technicians and responsibilities of all facility revenue functions such as data validation, review of services/claims for first- and third-party billing, customer service, review of eligibility, pre-certification, clinical appeals and continued stay review, etc.
- Ensures integration of sound business practices with the hospital's primary functions, such as, private insurance payer authorization, review of clinical information, obtaining authorization for continued stays, and patient authorization for release of medical information.
- Serves as the liaison with NECPAC, requesting ad-hoc reports on behalf of the medical facility, reconciling data, resolving facility specific issues related to accounts receivable, and otherwise interfacing with NECPAC and medical facility organizations.
- Develop performance standards, evaluated subordinate supervisors, and served as the review official on evaluations of non-supervisory employees rated by subordinate supervisory positions.
- Exercised final authority for the full range of personnel actions and organization design proposals recommended by subordinated supervisors and supported the affirmative action and patient safety goals with the goals within the Department and was responsible and accountable for fair, equitable, consistent, and correct administration of time and attendance policies and timecard reporting/recording for all employees in their service.
- Worked with Human Resources Specialist as the subject matter expert to prepare vacancy announcements-based Position Description (PD) and/or Functional Statements (FS) and provided analysis of the position, qualifies/disqualifies applicants, and maintains all documentation for the job announcement.
Human Resource Manager
West Consolidate Patient Account Center, WCPAC
12.2011 - 08.2012
- Hours per week: 40., for approximately 150 employees and Account Payable Clerk
- Impeccably managed approximately 150 employee’s payroll accounts, including employee time adjustments daily basis, receives and reviews employee 90-day, yearly, employee appraisal reviews, and bonuses, benefits
- Performed new employee orientation and responsible establishing all new employee personnel file in which ensured all necessary documents were obtained and completed in a timely manner
- Ensure background check and all Nursing personnel licenses were checked through healthcare registry
- Document and maintain personnel action forms, including reviewing benefit eligibility, retirement eligibility, creditable service, salary dates, employment date, employee position, and leave eligibility
- Determined personnel action codes required for each action
- Responsible for all documents necessary to support the transaction and ensures that all documents are obtained, completed by Supervisors and in proper order
- In addition, to correcting any errors for accuracy
- Responsible for all employees’ personnel records were maintained in confidentiality and update every 6 months for auditing
- Regulated formal orientation sessions when any changes to benefits, open enrollment, etc
- When notified by the Corporate Office
- Performed garnishment attachments ordered by the courts
- Maintain approximately 122 patients’ trust fund accounts
- Reconciled bank statement to three checking accounts with no discrepancies
- Accurately maintained current aging of accounts payable
- Maintain petty cash fund with zero discrepancies
- Accurately maintained current aging of accounts payable
- Prepared weekly, monthly cash flow reports
- Encourage families of Medicaid patients to set up a patient trust fund at the center so all income comes to the center for Medicaid eligible residents, mailing of Patient Liabilities (2362’s or 552’s) ad Approval letters
- Collaborated in resolve issues with employees’, patients, and vendors with obtaining documents, records and ensuring all parties involved is available meeting resolution
- Responsible for changing the default “with bed hold” to without bed hold when that decision is made
- Ensure admissions enter Available Payment Source, as well as hospital stays and UR notices.
Supervisor Financial Management Specialist (Facility Revenue Manager)
Florida Caribbean Consolidate Patient Account Center, FCPAC
- 01.2012
- Employment Verification/Salary: 800-367-2884
- Department of Veterans Affairs Employer Code: 10208
- Enhance revenue operations throughout the Veterans Health Administration (VHA) network by standardization and consolidation of billing and collection activity supported by medical center-based utilization review, data validation and customer service, pharmacy, Internal Control Audits, functions that are organizationally aligned with the consolidated center
- Overseeing daily operations, including the full range of management and supervisory activities of 2 Utilization Revenue Nurse, 5 Facility Revenue Technicians and responsibilities of all facility revenue functions such as data validation, review of services/claims for first- and third-party billing, customer service, review of eligibility, pre-certification, clinical appeals and continued stay review, etc
- Ensures integration of sound business practices with the hospital's primary functions, such as, private insurance payer authorization, review of clinical information, obtaining authorization for continued stays, and patient authorization for release of medical information
- Develops and implements local medical center policies and procedures based on NECPAC guidance
- Assures "front-end" patient and facility satisfaction with services by continually monitoring and enhancing services, revising operating procedures, and recommending policy changes
- Creates and monitors accounts receivable action plans resulting from Management Operational Reviews
- Serves as the liaison with NECPAC, requesting ad-hoc reports on behalf of the medical facility, reconciling data, resolving facility specific issues related to accounts receivable, and otherwise interfacing with NECPAC and medical facility organizations
- Develop performance standards, evaluated subordinate supervisors, and served as the review official on evaluations of non-supervisory employees rated by subordinate supervisory positions
- Made selections for non-supervisory positions and supervisory positions and interviewed candidates for position in the unit, recommended appointment, promotion, or reassignment to such position
- Collaborate and resolved group grievances or serious employee complaints
- Reviewed and approved serious disciplinary actions involving non-supervisory subordinates
- Made decisions on nonroutine, costly and/or controversial training need and training requested related to the employees in the unit
- Recommended awards or bonuses for non-supervisory personnel and changes in position classification, which was subject to approval by high level officials, supervisors, or others
- Approved/disapproved leave requests from subordinate supervisors and developed and established an effective, efficient, and economical position structure which will best serve mission
- Determined whether contractor performed work meets standards of adequacy necessary for authorization of payment
- Approved expenses comparable to within-grade increases, extensive overtime, and employee travel
- Exercised final authority for the full range of personnel actions and organization design proposals recommended by subordinated supervisors and supported the affirmative action and patient safety goals with the goals within the Department and was responsible and accountable for fair, equitable, consistent, and correct administration of time and attendance policies and timecard reporting/recording for all employees in their service
- Worked with Human Resources Specialist as the subject matter expert to prepare vacancy announcements-based Position Description (PD) and/or Functional Statements (FS) and provided analysis of the position, qualifies/disqualifies applicants, and maintains all documentation for the job announcement
- Reviewed and consulted, in conjunction with the Human Resources Specialist, on job analysis and/or rating and ranking panels when needed
- Researched qualifications and skills needed and ensures the job analysis is properly formulated with subject matter experts to garner highly qualified applicants.
Financial Administrative Specialist
Orlando Veterans Affairs Health System
11.2010 - 12.2011
- Boosted employee morale by planning team-building activities and corporate events.
- Facilitated communication between departments, organizing meetings and distributing essential information.
- Enhance revenue operations throughout the Veterans Healthcare Administration (VHA) network by standardization and consolidation of billing and collection activity supported by medical center-based utilization review, data validation and customer service, pharmacy; National Provider Identification (NPI) functions that are organizationally aligned with the consolidated center.
- Performing precise and timely follow-up on outstanding third-party accounts, by contacting insurance companies to expedite collections, or referring on the more difficult cases to Regional Counsel for further action.
- Act as Lead Financial Administrative Specialist in communicating assignments to team members with deadlines and time frame for completion.
- Train Lead Financial Administrative Specialist, co-workers on Payer Analysis functions, Regional Counsel, Financial Management Report.
- Train co-workers on correction of cash posting of insurance payment error.
- Research to determine if refund request is warranted and documenting findings in Third-Party Joint Inquiry Menu. Refund through correct appropriation funds 3875 and 528704 and maintain records of all refunds with detailed documentation.
- Excellent research skills for resolving refund and claim conflicts. Excellent customer service and consistently communicating in a courteous, tactful, and respectful manner.
- Detailed documentation concerning issues and actions taken to resolve claims, updating account as needed, while adjusting accounts on a regular basis and ensure appropriate audit.
- Knowledge in Electronic Health Record, Accounting, Laboratory, Radiology, Dietetics, Progress Notes, Health Summary and Administrative Options.
- Work independently to implement account receivable guidelines and resolve problems.
Financial Administrative Specialist
Department of Veterans
11.2010 - 12.2011
- Hours per week: 40 plus, GS-09
- Employment Verification/Salary: 800-367-2884
- Department of Veterans Affairs Employer Code: 10208
- Enhance revenue operations throughout the Veterans Healthcare Administration (VHA) network by standardization and consolidation of billing and collection activity supported by medical center-based utilization review, data validation and customer service, pharmacy; National Provider Identification (NPI) functions that are organizationally aligned with the consolidated center
- Performing precise and timely follow-up on outstanding third-party accounts, by contacting insurance companies to expedite collections, or referring on the more difficult cases to Regional Counsel for further action
- Act as Lead Financial Administrative Specialist in communicating assignments to team members with deadlines and time frame for completion
- Train Lead Financial Administrative Specialist, co-workers on Payer Analysis functions, Regional Counsel, Financial Management Report
- Payment analysis of prescription, healthcare remittance and Electronic Explanation of Benefits (EOB’s)
- Train co-workers on correction of cash posting of insurance payment error
- Detailed documentation concerning issues and actions taken to resolve claims, updating account as needed, while adjusting accounts on a regular basis and ensure appropriate audit
- Work independently to implement account receivable guidelines and resolve problems
- Research to determine if refund request is warranted and documenting findings in Third-Party Joint Inquiry Menu
- Refund through correct appropriation funds 3875 and 528704 and maintain records of all refunds with detailed documentation
- Knowledge in CPRS, Accounting, Laboratory, Radiology, Dietetics, Progress Notes, Health Summary and Administrative Options
- Excellent research skills for resolving refund and claim conflicts
- Excellent customer service and consistently communicating in a courteous, tactful, and respectful manner.
Program Specialist (Quality/Internal Control)
Tennessee Veterans Affairs Health System
08.2008 - 11.2010
- Ensured compliance with relevant regulations throughout all stages of program implementation by closely monitoring adherence to established guidelines.
- Designed and implemented monitoring and evaluation systems to track progress towards desired outcomes.
- Perform a wide range of function involving the review, analysis, and evaluation of the full range of health services provided at 23 medical facilities. The purpose is to provide professional support in the analysis, evaluation and presentation of information and data pertaining to the delivery of health care services and revenue. Duties includes identify trends, patterns and other characteristics in data that may provide opportunities for enhancements in policies, procedures, practices, and financial activities to improve the delivery of health care services and prepare formalized assessment reports to the Facility Director, Assistance Director, Managers, Supervisors and Compliance Officers.
- Focus on office program operations, analyzes, and evaluate on quantitative or qualitative basis, managing communications, data collection and tracking to enhance processes to meet various established goals and objectives.
- Analyze and investigate adverse quality trends or conditions and initiating corrective action. Identifying organizational risk and communicating findings and provide recommendations to management and staff of program issues for refinement and improvement.
- Working knowledge of organization including accounts receivable, pharmacy, income verification match, pre-registration, customer service and Fee Basis claims. Knowledge and understanding of ICD-9, CPT, HCPCS, and other coding principles.
- Working knowledge of CMS reimbursement guidelines, federal rules and regulation as published in the Federal Register, Trailblazer, and other insurance carrier publications, along with VA regulations.
- Working knowledge of VISTA computer applications and other computer applications, including Microsoft Excel, graphic applications, Claimtrust (electronic denials), ProClarity, and Microsoft word, Nuance, Document Imaging, Electronic Health Record, and Administrative options.
- Excellent interpersonal skills with the capability of working closely with medical and administrative personnel in both structured and unstructured setting.
Program Specialist
South Consolidated Patient
06.2008 - 11.2010
- Quality Assurance/Internal Control) GS-09
- Employment Verification/Salary: 800-367-2884
- Department of Veterans Affairs Employer Code: 10208
- Perform a wide range of function involving the review, analysis, and evaluation of the full range of health services provided at 23 medical facilities
- The purpose is to provide professional support in the analysis, evaluation and presentation of information and data pertaining to the delivery of health care services and revenue
- Duties includes identify trends, patterns and other characteristics in data that may provide opportunities for enhancements in policies, procedures, practices, and financial activities to improve the delivery of health care services and prepare formalized assessment reports to the Director of the medical facility, Assistance Director, Managers, Supervisors and Compliance Officers
- Focus on office program operations, analyzes, and evaluate on quantitative or qualitative basis, managing communications, data collection and tracking to enhance processes to meet various established goals and objectives
- Analyze and investigate adverse quality trends or conditions and initiating corrective action
- Identifying organizational risk and communicating findings and provide recommendations to management and staff of program issues for refinement and improvement
- Working knowledge of organization including accounts receivable, pharmacy, income verification match, pre-registration, customer service and Fee Basis claims
- Knowledge and understanding of ICD-9, CPT, HCPCS, and other coding principles
- Working knowledge of CMS reimbursement guidelines, federal rules and regulation as published in the Federal Register, Trailblazer, and other insurance carrier publications, along with VA regulations
- Working knowledge of VISTA computer applications and other computer applications, including Microsoft Excel, graphic applications, Claimtrust (electronic denials), ProClarity, and Microsoft word, Nuance, Document Imaging, CPRS, Administrative options
- Excellent interpersonal skills with the capability of working closely with medical and administrative personnel in both structured and unstructured setting.
Financial Management Specialist (Account Receivabl
Tennessee Veterans Affairs Health System
01.2007 - 06.2008
- Enhanced the accuracy of financial reporting through regular data analysis and reconciliation efforts.
- Recorded, interpreted and communicated financial data and plans using VA software.
- Handled payments and disbursements for Third Party Insurance, and Veterans.
- Thoroughly review the refund request from insurance carrier. This involves their review of veterans’ eligibility, the claim that was submitted, the covered services under the insurance policy, amount (s) billed to and paid by the insurance carrier and veteran, and the Explanation of Benefits (EOB), interest, and administrative fees. If a refund is determined to be appropriate, documentation must be completed to record the actions that were taken to justify the refund. Similar actions are taken if a refund is determined not to be due. This also includes Financial Management System (FMS), where money is placed in suspense.
- Responsible of Nashville VA Health System, Memphis VA Health System and Mountain Home VA Health System, paper refunds and suspense report. Work closely with accounting department to ensure proper allocation of suspense refunds. Refund through correct appropriation funds 3875 and 528704 of VHA directives, 2005-038 and 2005-039.
- Knowledge in Computerized Patient Record System (CPRS), Accounting, Laboratory, Radiology, Dietetics, Progress Notes, Health Summary, and Administrative Options.
- Excellent research skills for resolving refund conflicts.
Financial Management Specialist (Account Receivable Refund Analyst)
Department of Veterans, South Consolidated Patient, CPAC
01.2007 - 06.2008
- Hours per week: 40 plus, GS-07
- Employment Verification/Salary: 800-367-2884
- Department of Veterans Affairs Employer Code: 10208
- Thoroughly review the refund request from insurance carrier
- This involves their review of veterans’ eligibility, the claim that was submitted, the covered services under the insurance policy, amount (s) billed to and paid by the insurance carrier and veteran, and the explanation of benefits (EOB), interest, and administrative fees
- If a refund is determined to be appropriate, documentation must be completed to record the actions that were taken to justify the refund
- Similar actions are taken if a refund is determined not to be due
- This also includes Financial Management System (FMS), where money is placed in suspense
- Daily use of codes implemented by the Compliance and Business Integrity (CBI) Refund Oversight Implementation Training
- Work daily in conjunction with Account Receivable Supervisor or VISN 9 MID-SOUTH CPAC Deputy Program Director before refunds are issued
- Utilize daily use of VISN 9 Standard Operating Procedure for Third Party Refunds
- Responsible of Nashville, Memphis and Mountain Home paper refunds and suspense report
- Work closely with accounting department to ensure proper allocation of suspense refunds
- Refund through correct appropriation funds 3875 and 528704 of VHA directives, 2005-038 and 2005-039
- Knowledge in Computerized Patient Record System (CPRS), Accounting, Laboratory, Radiology, Dietetics, Progress Notes, Health Summary, and Administrative Options
- Excellent research skills for resolving refund conflicts.
Financial Management Specialist (Account Receivabl
Tennessee Veterans Affairs Health Systerm
08.2006 - 12.2006
- Drove process improvements within the finance department, increasing overall efficiency.
- Working independently with the ability to determine reimbursement accuracy based on insurance policy provision. In many cases interpret and post payments, review bulk check payments which are applied to multiple claim billings as well as processing deductions taken by insurance carrier on prior reimbursement accounts. Further, review insurance payments linking with crediting veteran copayments if appropriate. Also, analyzes, plans, initiates, coordinates, and implements actions required in maximize collections of account receivable.
- Performing precise and timely follow-up on outstanding third-party accounts.
- Receiving and placing phone calls to insurance carriers to obtain information concerning patient’s open balance accounts.
- Placing calls to the Veteran’s in obtaining accurate insurance and demographic information that is then updated in the patient insurance information.
- Cash posting of insurance payments.
- · Detailed documentation concerning issues and actions taken to resolve claims. Documenting veteran account and insurance carrier request on appropriate accounts and resolving issues via fax, mail, or telephone in accordance with MP-4, Part VIII, the VA DHCP Accounts Receivable v4.5 User Manual, VHA Directives as well as established Standard Operating Procedures.
- Utilize daily knowledge of VA Handbook 4800.14-Medical Care Debts and fully fluent in HIPPA guidelines.
Financial Management Specialist (Account Receivable Analyst)
Consolidated Patient, CPC
08.2006 - 12.2006
- GS-07
- Employment Verification/Salary: 800-367-2884
- Department of Veterans Affairs Employer Code: 10208
- This involves working independently and the ability to determine reimbursement accuracy based on insurance policy provision
- In many cases interpret and post payments, review bulk check payments which are applied to multiple claim billings as well as processing deductions taken by insurance carrier on prior reimbursement accounts
- Further, review insurance payments linking with crediting veteran copayments if appropriate
- Also, analyzes, plans, initiates, coordinates, and implements actions required in maximize collections of account receivable
- Performing precise and timely follow-up on outstanding third-party accounts
- Receiving and placing phone calls to insurance carriers to obtain information concerning patient’s open balance accounts
- Placing calls to the Veteran’s in obtaining accurate insurance and demographic information that is then updated in the patient insurance information
- Cash posting of insurance payments
- Detailed documentation concerning issues and actions taken to resolve claims
- Documenting veteran account and insurance carrier request on appropriate accounts and resolving issues via fax, mail, or telephone in accordance with MP-4, Part VIII, the VA DHCP Accounts Receivable v4.5 User Manual, VHA Directives as well as established Standard Operating Procedures
- Utilize daily knowledge of VA Handbook 4800.14-Medical Care Debts and fully fluent in HIPPA guidelines.
Assistant Business Office Manager
National Healthcare Corporation
03.2003 - 08.2006
- Updated reports, managed accounts, and generated reports for company database.
- Impeccably managed approximately 150 employee’s payroll accounts, including employee time adjustments daily basis, receives and reviews employee 90-day, yearly, employee appraisal reviews, and bonuses, benefits.
- Performed new employee orientation and responsible establishing all new employee personnel file in which ensured all necessary documents were obtained and completed in a timely manner.
- Ensure background check and all Nursing personnel licenses were checked through healthcare registry.
- Document and maintain personnel action forms, including reviewing benefit eligibility, retirement eligibility, creditable service, salary dates, employment date, employee position, and leave eligibility. Determined personnel action codes required for each action.
- Responsible for all documents necessary to support the transaction and ensures that all documents are obtained, completed by Supervisors and in proper order. In addition, to correcting any errors for accuracy.
- Responsible for all employees’ personnel records were maintained in confidentiality and update every 6 months for auditing.
- Regulated formal orientation sessions when any changes to benefits, open enrollment, etc. when notified by the Corporate Office.
- Performed garnishment attachments ordered by the courts. Maintain approximately 122 patients’ trust fund accounts.
- Reconciled bank statement to three checking accounts with no discrepancies. Accurately maintained current aging of accounts payable. Maintain petty cash fund with zero discrepancies. Accurately maintained current aging of accounts payable. Prepared weekly, monthly cash flow reports.
- Encourage families of Medicaid patients to set up a patient trust fund at the center so all income comes to the center for Medicaid eligible residents, mailing of Patient Liabilities (2362’s or 552’s) and Approval letters
- Collaborated in resolve issues with employees’, patients, and vendors with obtaining documents, records and ensuring all parties involved is available meeting resolution.
- Responsible for changing the default “with bed hold” to without bed hold when that decision is made. Ensure admissions enter Available Payment Source, as well as hospital stays and UR notices.
Business Office Manager Assistant / Account Payable Supervisor
National HealthCare Corporation
03.2003 - 08.2006
- Salary: 25,000 USD Per Year
- Hours per week: 40, HUMAN RESOURCES (615-890
Education
Bachelor Degree - Business Management
Bethel College
Nashville, TNAssociate Degree - Business Management
Draughons Junior College
Murfreesboro, TN08.2005
Skills
- Risk Assessments
- Strategic Planning
- Policy analysis
- Innovation and Creativity
- Business Intelligence
- Organizational Development
- Customer Service
- Problem-solving abilities
- Critical Thinking
- Microsoft Excel
- Healthcare industry understanding
- Patient confidentiality
- Claims Processing
Certification
Training Certification
Contracting Officer Training Certificate Level-I
Contract Price Analysis and Contract Types
Automated Data Processing Application Coordinator (ADPAC)
VA Lean Yellow/Bronze Belt Certification
Ethics Advisor-Certification
Law Enforcement Training Center – Fact Finding Certification
Health Informatic 101 - Certification
Affiliations
- AFGE Local 559 – Union Steward, Orlando, FL Volunteer Services – Orlando VA Medical Center AFGE Local 1844 – Union Steward, Murfreesboro, TN Control Substance Inspector – Los Angeles VA Medical Center Control Substance Inspection Committee Chair – Atlanta VA Medical Center Compliance Committee, Resident Supervision Committee, Records Mgmt. Committee – Atlanta &Gainesville VA Medical Center Atlanta VA Health Care System Facility Flow Committee Health Care Contract Auditor, Sharing Agreement, University Academic Affiliate – Atlanta VA & Memphis VA
Timeline
Health System Specialist (Compliance Officer)
North Florida/South Georgia VA Health System
11.2020 - Current
Health Systems Specialist (Compliance Officer)
Gainesville Veterans Affairs Health System
11.2020 - Current
Health System Specialist (Compliance Business Integrity Officer), Certified Ethics Advisor
GS
11.2020 - Current
Health System Specialist (Compliance Officer)
Atlanta Veterans Affairs Health System
11.2018 - 11.2020
Health System Specialist (Compliance Business Integrity Officer)
Atlanta VA Health System
11.2018 - 11.2020
Health Systems Specialist (Compliance Specialist)
Memphis Veterans Affairs Health System
11.2016 - 11.2018
Health Systems Specialist (Compliance Business Integrity Specialist/Program Analyst)
Memphis
11.2016 - 11.2018
Supervisor Financial Management Specialist (Facility Revenue Manager)
Consolidate Patient Account Center, NECPAC
08.2012 - 11.2016
Supervisor Financial Management Specialist
Los Angeles Veterans Affairs Health Systems
12.2011 - 11.2016
Supervisor Financial Management Specialist
Pittsburg Veterans Affairs Health System
12.2011 - 11.2012
Human Resource Manager
West Consolidate Patient Account Center, WCPAC
12.2011 - 08.2012
Financial Administrative Specialist
Orlando Veterans Affairs Health System
11.2010 - 12.2011
Financial Administrative Specialist
Department of Veterans
11.2010 - 12.2011
Program Specialist (Quality/Internal Control)
Tennessee Veterans Affairs Health System
08.2008 - 11.2010
Program Specialist
South Consolidated Patient
06.2008 - 11.2010
Financial Management Specialist (Account Receivabl
Tennessee Veterans Affairs Health System
01.2007 - 06.2008
Financial Management Specialist (Account Receivable Refund Analyst)
Department of Veterans, South Consolidated Patient, CPAC
01.2007 - 06.2008
Financial Management Specialist (Account Receivabl
Tennessee Veterans Affairs Health Systerm
08.2006 - 12.2006
Financial Management Specialist (Account Receivable Analyst)
Consolidated Patient, CPC
08.2006 - 12.2006
Assistant Business Office Manager
National Healthcare Corporation
03.2003 - 08.2006
Business Office Manager Assistant / Account Payable Supervisor
National HealthCare Corporation
03.2003 - 08.2006
Program Analyst
LaWanda Knox
Privacy Officer
Shirley Hobson, VA Medical Center
Utilization Nurse
Sandi Strome
Supervisor Financial Management Specialist (Facility Revenue Manager)
Florida Caribbean Consolidate Patient Account Center, FCPAC
- 01.2012
Bachelor Degree - Business Management
Bethel College
Associate Degree - Business Management
Draughons Junior College
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