Marjorie Wilkins
Godley,TX
Summary
Collaborative leader with dedication to partnering with coworkers to promote engaged, empowering work culture. Documented strengths in building and maintaining relationships with diverse range of stakeholders in dynamic, fast-paced settings. Develop and implement compliance policies and procedures. Monitor and review compliance activities to ensure adherence to established policies and procedures.
Overview
14
14
years of professional experience
1
1
Certification
Work History
Director Compliance & Ethics
McKesson
09.2017 - Current
- Responsible for audit and monitoring billing and coding activities in support of the US Oncology Network
- Ensures staff keeps abreast of regulatory guidance, regulations and other industry guidelines and changes
- Manage identified backlogs to determine priorities to resolve them to mitigate potential risks to a practice or the organization
- Work collaboratively with stakeholders to resolve identified risks found during the auditing process
- Create policies and procedures for various processes and projects the team will work on
- Improve compliance audit & monitoring work processes to emphasize a more automated process
- Develop and execute work plans for compliance initiatives, in conjunction with leadership and subject matter experts in appropriate areas
- Consults with the VP of Compliance Practice Management to ensure key compliance program responsibilities are met
- Collaborates and provide oversight to vendors contracted for audit and monitoring projects
- Report on auditing and monitoring activities to the executive compliance committee
- Strategically developed a new auditing process to ensure auditing was being conducted in a timely manner
- Aid in mentoring and developing staff to exceed their yearly goals
- Identify areas of improvement within the workflows for each specialty audit group
- Collaborate with the education team to ensure provider feedback to reviews and audits are provided timely.
Healthcare Consultant
Nolij Consulting
07.2016 - 05.2017
- Created audit and monitoring policies and instructions for staff
- Reviewed current policies and advise on updates and changes
- Assist client with regulatory guidance as needed
- Collaborated with cross functional teams and vendors to ensure the success of the Navy Medical Service Corp objectives
- Assisted with the review of data within the Navy’s EMR for the conversion to the DOD’s proposed new EMR MHS Genesis.
Director Audit/Monitoring/Practice Transformation
Providence Health Services
10.2014 - 06.2016
- Worked with finance to ensure month end and departmental budgets were completed timely
- Oversaw physician compliance reviews to prevent future incidents of risks
- Identified compliance vulnerabilities and risk
- Maintained an effective compliance communication program for the organization, including promoting use of the compliance hotline, and the understanding of new and existing compliance issues and related policies and procedures
- Advised and worked with clinical departments, physicians, and Senior leadership on resolving internal control, compliance, and other operational issues
- Developed and recommended corrective action plans for resolution of problematic issues identified with audits
- Responsible for ensuring compliance with established coding guidelines, third party reimbursement policies and procedures
- Created strategies and actions that sustained an environment that promoted change within the department
- Responsible for developing a Quality Assurance program and auditing periodically to ensure adherence to appropriate billing and collection protocols
- Performed compliance analysis and kept senior leadership informed of the operation and progress of compliance efforts
- Lead the organization with the implementation of Athena EMR and practice management system
- Ensured appropriate testing and results were identified and mitigated prior to the implementation of the new EMR and practice management system
- Trained and supported the organizations training efforts to ensure physicians, nurse practitioners, physician assistants and staff were sufficient in using the new EMR.
Senior Analyst
Altarum Institute
07.2010 - 10.2014
- Subject Matter Expert (SME) for the Uniform Business Office (UBO) for coding and billing concerns
- Ensured inpatient and outpatient rates were accurate per Tricare and/or Medicare requirements for the chargemaster components
- Participated and contributed to all TMA (Tricare Management Activity) meetings for transitioning to ICD-10 for the MHS (Military Health System)
- Reviewed and audited medical records for coding and billing accuracy for The Defense Health Agency (DHA)
- Responded to billing concerns to verify and correct the billing & charging solutions
- Responsible for writing and contributing to billing policy and guidance for the UBO billing personnel
- Created and provided monthly training opportunities for all billing and coding personnel within the MHS
- Supported the Deputy Director of HIM for all Coding and HIM related projects.
Education
BA - Healthcare Management
Purdue Global
AA - Business Administration
St. Philips College
Master of Science - Healthcare Administration
Texas Tech University
03.2025
Skills
- Strategic Planning
- Verbal and written communication
- People Management
- Operations Management
- Strategies and goals
- Budget Management
- Staff Development
- Contract and Vendor Management
- Financial Reporting
- Rules and regulations
- Legal and Regulatory Compliance
Certification
- CPC
- COC
- ICD-10 Certified
- CHC
Affiliations
- Health Care Compliance Association (HCCA)
- American Academy of Professional Coders (APC)
Timeline
Director Compliance & Ethics
McKesson
09.2017 - Current
Healthcare Consultant
Nolij Consulting
07.2016 - 05.2017
Director Audit/Monitoring/Practice Transformation
Providence Health Services
10.2014 - 06.2016
Senior Analyst
Altarum Institute
07.2010 - 10.2014
BA - Healthcare Management
Purdue Global
AA - Business Administration
St. Philips College
Master of Science - Healthcare Administration
Texas Tech University