Jennifer Westfall
Ashville
Summary
Experienced compliance leader skilled in critical analysis and fostering team collaboration. Adept at identifying data trends to reduce compliance risks and facilitate strategic decision-making. Focused on creating effective compliance frameworks that align with organizational goals..
Overview
32
32
years of professional experience
1
1
Certification
Work History
Manager, Ethics & Compliance
OhioHealth
Columbus
02.2017 - Current
- Analyze data trends to identify compliance risks and potential issues, informing strategic decisions.
- Prepare comprehensive reports on investigation findings for management review, facilitating informed decision-making.
- Analyze data from multiple sources to identify potential areas of non-compliance or risk.
- Draft reports summarizing the findings of investigations.
- Investigate policy violations by conducting interviews with employees and witnesses, gathering evidence to support compliance actions.
- Create corrective action plans based on investigation findings.
- Pursue continuous learning opportunities regarding latest compliance and procedural changes.
- Participate in industry forums and workshops to stay informed on compliance best practices and emerging trends.
- Analyze data to identify potential areas of compliance risk and recommend improvements.
- Collaborate with legal and operational teams to address compliance issues and implement corrective actions.
- Monitor and report on compliance metrics and performance indicators.
- Lead complex investigations into fraud and misconduct cases.
- Develop and implement investigation protocols and procedures.
- Train and mentor junior investigators on investigative techniques.
- Analyze evidence to determine the nature of violations and identify potential suspects.
- Delegate work to staff, setting priorities and goals.
- Provide leadership, insight and mentoring to newly hired employees to supply knowledge of various company aspects of the investigator position.
- Review associate performance and provide ongoing feedback and coaching.
Compliance Research Analyst
OhioHealth
Columbus
08.2010 - 02.2016
- Reviewed and monitored compliance with laws, regulations, and policies to ensure adherence to regulatory requirements.
- Analyzed compliance data to identify potential regulatory risks and gaps.
- Collaborated with cross-functional teams to implement compliance policies and procedures.
- Analyzed potential areas of risk and developed strategies to mitigate such risks.
- Maintained an up-to-date knowledge base of all relevant laws, regulations, guidelines, and industry standards.
- Collaborated with departments to create effective solutions for maintaining ongoing compliance.
- Conducted training sessions for staff on compliance regulations and best practices.
- Developed and executed corrective action plans to address identified non-compliance issues.
- Investigated any suspected violations of the organization's compliance policies.
- Drafted reports outlining findings from investigations into non-compliance incidents.
- Collaborated with legal and operational teams to address compliance issues and implement corrective actions.
- Helped to investigate fraud and identify risks in collaboration with risk management staff.
- Analyzed data to identify potential areas of compliance risk and recommend improvements.
- Performed regular compliance audits and presented findings to management.
Coding Education Sr. Analyst
Holzer Clinic
Gallipolis
05.2005 - 08.2010
- Collaborated with healthcare providers to identify and resolve coding discrepancies, enhancing billing accuracy.
- Researched and assigned appropriate ICD-10 codes based on documentation in the patient's medical record.
- Coded diagnosis and procedures according to established guidelines.
- Reviewed patient medical records for accuracy and completeness, ensuring reliable data for coding.
- Coordinated with clinical staff to clarify documentation and determine appropriate code assignments.
- Maintained up-to-date knowledge of current coding rules, regulations, and best practices.
- Assisted in training new staff on coding and billing procedures.
- Evaluated new technologies available for use in the organization's coding process.
Manager
Internal Medicine Associates
Jackson
09.1996 - 05.2005
- Managed staff scheduling and set patient scheduling policy.
- Oversaw day-to-day operations of the front desk area to ensure efficient flow of patients through check-in and checkout processes.
- Oversaw medical billing processes and maintained accurate patient records to support efficient operations.
- Managed accounts receivable, ensuring timely payments from insurance companies and patients to maintain cash flow.
- Participated in budgeting activities by analyzing cost trends to inform financial planning for the practice.
- Planned and controlled budgets for contracts, equipment and supplies.
- Maintained compliance with healthcare regulations and ensured adherence to policies.
- Developed and implemented office policies and procedures while adhering to HIPAA and OSHA regulations.
- Coordinated scheduling for multiple providers and handled patient appointments effectively.
- Communicated with insurance companies regarding claims and patient coverage inquiries.
- Coordinated with insurance companies to verify coverage of services rendered.
- Maintained accurate patient data, including medical history, laboratory results, billing information and other relevant documents.
- Determined staffing requirements, interviewing, hiring and training new employees.
Director Medical Records
Oak Hill Hospital
Oak Hill
05.1994 - 09.1996
- Led a team of 10 employees, ensuring high productivity and excellent customer service.
- Developed and enforced policies and procedures to ensure effective management of health information.
- Ensured compliance with all applicable laws, regulations, industry standards.
- Coached and mentored team members, enhancing their skills and job performance.
- Monitored staff performance and addressed issues.
- Conducted performance evaluations, providing feedback and coaching for team development.
- Assigned tasks to associates to fit skill levels and maximize team performance.
- Facilitated cross-departmental communication to improve collaboration on health information management.
- Participated in interdisciplinary teams focused on improving quality outcomes through better documentation practices.
- Collaborated with physicians, nurses, coders and other healthcare professionals on documentation issues.
- Worked with physicians and nurses to find methods to improve quality of patient health documents and records.
- Served as a resource for coding staff regarding complex coding scenarios.
- Coordinated the release of confidential patient information according to applicable laws and regulations.
- Maintained up-to-date knowledge about changes in federal regulations governing the collection and use of protected health information.
- Performed quality assurance reviews of medical records for completeness, accuracy and compliance with regulatory standards.
- Created, maintained and updated patient medical records in accordance with HIPAA regulations.
- Researched and recommended software solutions for improved data management.
- Developed and implemented standard operating procedures for efficiency.
- Established solid relations with leadership and staff by attending board meetings and coordinating interdepartmental information exchanges.
Education
Associate of Applied Science -
Marshall University
Huntington, WV05-1994
Skills
- Regulatory compliance
- Investigation techniques
- Risk management
- Data analysis
- Complex Problem-solving
- Leadership skills
- Team leadership
- Staff management
- Staff development
- Communication skills
- Team collaboration
- Partnership development
- Coaching skills
- Relationship building
- Customer support
- Critical thinking
- Risk management
Accomplishments
- Phi Theta Kappa - Inducted in 1992
Certification
- RHIT 1994
- CPC 2007
- CPMA 2013
- CGSC 2008
- CFE 2019
Timeline
Manager, Ethics & Compliance
OhioHealth
02.2017 - Current
Compliance Research Analyst
OhioHealth
08.2010 - 02.2016
Coding Education Sr. Analyst
Holzer Clinic
05.2005 - 08.2010
Manager
Internal Medicine Associates
09.1996 - 05.2005
Director Medical Records
Oak Hill Hospital
05.1994 - 09.1996
Associate of Applied Science -
Marshall University