Natalie Warf
Spring Lake,NC
Summary
Experienced professional with an extensive background in medical terminology, CMS 1500 and UB 92 billing, ICD 10/CPT HCPCS coding, regulatory compliance, and HIPAA, with a strong focus on quality and exceptional customer service.
Overview
30
30
years of professional experience
Work History
Care Advocate
Imagine360
03.2024 - Current
- Deliver specialized service over multiple channels by acting as a single point of contact, maintaining ownership of member resolution and navigating optimal care.
- Manage and coordinate elevated member and provider issue resolution (IE: access to care, provider selection and outreach, surprise billing, claims, balance billing) with confidence and a sense of urgency.
- Provide concierge-level guidance for members involving their benefit plans throughout their healthcare journey. Empowered to advocate for members by providing knowledge, expertise, and innovative problem solving to proactively identify solutions that elevate the member experience.
- Take ownership of the member experience from beginning to end, minimizing handoffs to ensure service continuity and reduced effort for the member.
- An expert in benefit administration and healthcare solutions with a focus on employer self-insured reference-based pricing plans.
Director of Information Protection, Strategy and Risk Management
HCA
Nashville, TN
08.2005 - 03.2018
- Led the company’s Information Protection Strategy & Risk Management team
- Responsible for the enterprise-wide company information protection risk management program
- Senior leader of HCA’s information protection program reporting directly to the Vice President/Chief Information Security Officer
- Implemented programs to identify, calculate, evaluate, and mitigate risk to the enterprise from an information protection perspective
- Drove HIPAA, HITECH, and OIG audit readiness, compliance with regulatory and company requirements, and HITECH Meaningful Use security attestation requirements
- Formulated a complete strategic governance plan and process to effectively plan and prioritize work from an information protection perspective
- Advised and worked with Senior company leadership, internal and external legal counsel, law enforcement, internal and external audit, and ethics and compliance, and finance and administration
- Manager responsibilities include planning, budgeting, recruitment, staff development, research, design, engineering, implementation, and operations for the department
- Previous Responsibilities as Associate Chief Privacy Officer:
- Provided support for the company Privacy Program and consultative services to HCA Facility Privacy Officials, Ethics and Compliance Officers (ECOs), Zone Facility Information Security Officials, Division Directors of Information Security Assurance, Division ECOs, and other customers
- Provided direction in defining and the development of strategic initiatives and managing risk
- Provided oversight of the HCA corporate privacy reportable issues submitted in accordance with company policy to include identifying, investigating and resolving privacy violations involving a breach of unsecured protected health information and/or egregious in nature
- Led OCR and OIG audit and investigative inquiry responses
- Monitored for regulatory updates pertaining to patient privacy (e.g., HIPAA and HITECH) to include providing comment on relative proposed rules
- Created content and provides subject matter expertise for web based training courses, toolkits, policies, procedures, communications and other educational materials for the Privacy Program
- Provided oversight of three generic mailboxes pertaining to patient privacy to include the review of responses prior to deployment
- Performed due diligence activities with regard to potential acquisitions as it pertains to privacy
- Served on interdepartmental work groups and teams for the Privacy Program (e.g., Regional Health Information Organizations, Health Information Exchanges, Patient Portals, User Activity Monitoring)
- Provided educational support for internal and external customers through public speaking engagements (e.g., seminars, webcasts, teleconferences)
- Previous Regulatory Compliance Support Responsibilities:
- Assisted in implementation and supports company wide projects and initiatives based on government mandates (e.g., Medicare Administrative Contractors (MACs), Recovery Audit Contractors (RACs), HIPAA Privacy)
- Created content and provided subject matter expertise for web based training courses, toolkits, policies, procedures, communications and other educational materials for RACs and MACs
- Provided educational support for internal and external customers through public speaking engagements (e.g., seminars, webcasts, teleconferences)
- Triaged and responded to helpline questions (e.g., RACs, MACs, HIPAA Privacy)
- Served as the lead for interdepartmental work groups for RACs and MACs and as a member of other committee and task forces
- Performed extensive regulatory research
- Provided reports and summaries for management on a regular and ad hoc basis
- Provided regulatory billing support for the Outpatient Services Group (OSG)
- Assisted in the development of OSG coding and billing policies
- Beta tested edit software
- Provided feedback on proposed edits
- Performed billing compliance audits
Specialty Accounts & Electronic Billing Supervisor
Cape Fear Valley Health System
Fayetteville, NC
02.2004 - 07.2005
- Oversaw all physician billing aspects of the following health system owned clinics: Psychology, Obstetrics/Gynecology, Sleep Center, Neurology, Lifeline, Anesthesia and Pain Management
- Maintained multi-million dollar receivables
- Enforced compliance of all billing functions, including HIPAA
- Developed and established new procedures for practice groups
- Monitored daily operations and employee performance
- Ensured communication with management team
- Troubleshot software/hardware problems associated with claims processing
- Educated and trained physicians, office managers and other staff of billing and collection issues, process improvement initiatives, and regulatory requirements
- Served on directed committees
Business Manager
Cape Fear Orthopaedic Clinic, PA
Fayetteville, NC
10.1995 - 02.2004
- Oversaw A/R and A/P functions
- Maintained correct coding guidelines for practice
- Responsible for medical information/protected health information releases from the practice
- Implemented the HIPAA Privacy rule according to the original requirements and compliance dates
- Filed all claims through electronic resources
- Oversaw collection efforts by in-house staff and negotiate contracts with outside agencies
- Created financial reports for practice
- Ensured timely and accurate data entry
- Maintained good customer relations with area employers for workers compensation contracts
- Reviewed managed care contracts and enforced contracts
- Researched new carriers for potential business
- Maintained correct insurance processing and posting
- Reviewed procedures and policies
- Trained physicians and staff on billing and collection issues and other regulatory requirements
- Researched supply vendors for comparison pricing/purchasing
- Managed patient concerns and complaints
Education
BS - Business Administration with a Healthcare Administration focus
Methodist College
Fayetteville, NCSkills
Professional boundaries
Self-awareness
Cultural history
Healthcare
Customer service
Problem-solving
Friendly and outgoing
Multitasking and organization
Team collaboration
Team leadership
HIPAA compliance
Customer follow-up
Verbal and written communication
Patient education
Registration and admissions
Electronic health records
Relationship building
Phone and email etiquette
Flexible schedule
Patient registration
Data entry
Insurance verification
Medical terminology
Conflict resolution
Appointment scheduling
Policy understanding
Insurance billing
Payment processing
Quality assurance
Eligibility determination
Training coordination
Medical billing
Work quality evaluation
Regulatory compliance
Medical coding
Insurance company billing
Complaint processing
Teamwork
Problem-solving abilities
Calm and effective under pressure
Timeline
Care Advocate
Imagine360
03.2024 - Current
Director of Information Protection, Strategy and Risk Management
HCA
08.2005 - 03.2018
Specialty Accounts & Electronic Billing Supervisor
Cape Fear Valley Health System
02.2004 - 07.2005
Business Manager
Cape Fear Orthopaedic Clinic, PA
10.1995 - 02.2004
BS - Business Administration with a Healthcare Administration focus
Methodist College