Helen Shakespeare
Fort Washakie,Wyoming
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 24 years of experience in healthcare.
Overview
24
24
years of professional experience
1
1
Certification
Work History
Compliance Officer
Wind River Family And Community Health Care
08.2022 - Current
- Developed and maintained new compliance program, tracking all compliance activities and documents.
- Assisted with internal and external audits to confirm compliance with applicable laws and regulations.
- Promoted a culture of continuous improvement through ongoing evaluation and refinement of compliance program elements.
- Enhanced regulatory compliance by developing and implementing comprehensive policies and procedures.
- Evaluated new regulations for potential impact on business operations, taking proactive measures to ensure readiness for implementation.
- Provided expert guidance on complex regulatory matters, enabling informed decision-making within the organization.
- Spearheaded investigations into potential violations, promptly addressing issues to maintain company reputation and avoid sanctions.
- Streamlined reporting processes for improved efficiency in submitting data to regulatory agencies.
- Collaborated with internal and external stakeholders, auditors and legal counsel to confirm compliance with applicable laws and regulations.
- Advised senior management on strategic planning initiatives, incorporating compliance considerations into decision-making processes.
- Designed risk assessment frameworks to evaluate organizational vulnerabilities and prioritize areas requiring attention.
- Oversaw and monitored violation tracking system for accuracy, reducing non-compliance issues.
- Conducted periodic compliance audits and reviews to identify areas of improvement.
- Developed and implemented corrective action plans for non-compliance issues.
- Maintained up-to-date knowledge of applicable laws and regulations.
- Developed risk assessment models to identify potential compliance risks.
- Identified, investigated and documented compliance violations and recommended corrective measures.
Health Information Management Director
Wind River Family And Community Health Care
12.2016 - 02.2024
- Collaborated closely with physicians and nursing staff to improve quality of patient records documentation.
- Participated in committees to discuss electronic health records and methods to improve overall workflows.
- Recruited and hired top-performing individuals bringing undeniable experience and wealth of skills to organization.
- Ensured timely access to accurate health information for healthcare providers by maintaining a well-organized records system.
- Conducted regular audits on health information systems to ensure data integrity, accuracy, and compliance with regulations.
- Collaborated with interdisciplinary teams to optimize workflow processes and enhance overall efficiency.
- Streamlined data collection and analysis for improved decision-making in healthcare delivery.
- Ensured regulatory compliance with state, federal, and industry standards through meticulous record-keeping practices.
- Oversee all aspects of medical coding operations for accurate billing practices leading to reduced financial risk.
- Enhanced patient care by implementing efficient health information management systems and processes.
- Established and maintained effective communication with staff, physicians and community organizations to promote high quality patient care.
- Communicated with patients, ensuring that medical information was kept private.
- Conducted routine facility inspections, identifying areas needing improvement and eliminating hazards posed to staff and residents for continued compliance with associated regulations.
- Developed and updated policies and procedures, maintaining compliance with guidelines relating to HIPAA, benefits administration and general liability.
- Monitored and inspected staff processes to eliminate hazards posed for both residents and staff while ensuring continuous compliance with regulations.
- Facilitated seamless communication between various departments, resulting in better coordination of patient care activities.
- Monitored performance metrics for continuous process improvements within the Health Information Management Department.
- Championed patient privacy and security by establishing stringent policies and procedures for handling sensitive information.
Medical Records Technician/Coder
Indian Health Service
08.2000 - 11.2016
- Demonstrated strong attention to detail while cross-referencing medical records for completeness and consistency, identifying potential errors and facilitating prompt resolution.
- Maintained strict confidentiality of sensitive patient information in compliance with HIPAA regulations.
- Conducted thorough research on complex medical coding issues when necessary, ensuring accuracy and compliance with insurance reimbursement guidelines.
- Maintained patient records in compliance with security regulations.
- Reduced billing errors by accurately assigning ICD-10 codes to diagnoses and procedures in accordance with official guidelines.
- Supported administrative staff in maintaining current knowledge of billing requirements and regulatory changes through regular training sessions.
- Reviewed charts and flagged incomplete or inaccurate information.
- Maintained confidentiality of all medical records and sensitive information to comply with HIPAA regulations.
- Used classification manuals to gain additional knowledge of disease and diagnoses processes.
- Generated and maintained statistical data related to medical records.
- Maintained high coding standards by adhering to industry best practices and staying current with emerging technologies.
- Resourcefully used various coding books, procedure manuals, and on-line encoders.
- Applied official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services to assign diagnostic codes.
- Facilitated knowledge sharing within the team by conducting regular code reviews, training sessions, and workshops on relevant topics.
- Reviewed, analyzed, and managed coding of diagnostic and treatment procedures contained in outpatient medical records.
- Monitored changes in coding regulations to provide recommendations for compliance.
- Performed on-site coding audits to determine accuracy and compliance with coding guidelines.
- Trained and mentored junior coders to support growth and development and apply high-quality coding practices.
- Followed up with medical staff regarding missing information in patient records.
- Communicated effectively with staff, patients, and insurance companies by email and telephone.
- Contributed to a team-oriented work environment by collaborating closely with colleagues on various projects related to medical records management.
Education
Health Information Technology
National American University - Rapid City
Rapid City, SDHigh School Diploma -
Mandaree High School
Mandaree, ND05.1993
Skills
- Compliance Monitoring
- Document Review
- Auditing processes
- Internal Audits
- Regulatory knowledge
- Compliance reviews
- Policy analysis
- Risk Management
- Regulations enforcement
- Audit management
- Corporate Governance
- Data privacy
- Sanctions compliance
- Investigations skills
- Reporting Requirements
- Deficiency documentation
- Federal and state regulations
- Documentation Review
- Records Management
- Compliance Reporting
- Critical Thinking
- Auditing experience
- Compliance Training
- Report Preparation
- Audit Documentation
- Policy Enforcement
- Leadership Techniques
- Activity monitoring
- Internal Policy Implementation
- Investigative reporting
- Violation Reporting
- Risk Mitigation
- Risk Assessment
- Safety Compliance
- Data Analysis
- Quality Control
- Violations and Infractions
- CPR Certified
Accomplishments
- Supervised team of 28 staff members.
- Collaborated with team of 10 in the development of new clinic services for 638 program.
Affiliations
- Health Care Compliance Academy
- American Academy of Professional Coders
Certification
- Certified Professional Coder, AAPC
Timeline
Compliance Officer
Wind River Family And Community Health Care
08.2022 - Current
Health Information Management Director
Wind River Family And Community Health Care
12.2016 - 02.2024
Medical Records Technician/Coder
Indian Health Service
08.2000 - 11.2016
Health Information Technology
National American University - Rapid City
High School Diploma -
Mandaree High School
- Certified Professional Coder, AAPC
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