Shannon Walker
Buford,GA
Summary
Healthcare professional with over 15 years of hands on experience in a fast-paced healthcare environment. Well-organized and diligent Compliance Specialist adept at coordinating and tracking regulatory-related actions. Highly successful at keeping on top of changes in requirements to maintain flawless compliance. Very motivated and compassionate about my work and job duties. Skilled at preparing and submitting regulatory documentation, including reviewing materials, technical data and accuracy of filings. Articulate and personable with exceptional data analysis, report writing and recordkeeping abilities. Healthcare is a strong focus which I am very responsible and accountable for. Highly- professional and organized Healthcare Industry with a solid experience in managing and overseeing daily office operations in healthcare as well as coordinating medical and administrative staff to deliver high-quality Healthcare services. Possess excellent communication, leadership, and multi-tasking skills along with the basic knowledge of Medical principles, terminology, laws, and ethics to ensure smooth running of medical practice. Well organized and detail-oriented with the skill to grasp complex situations. Experienced in HEDIS, NCQA and CMS guidelines
Overview
18
18
years of professional experience
Work History
Regulatory Compliance Specialist(Part-time)
Healthcare Consultants
Cumming, GA
12.2021 - Current
- Performed and documented quality control checks to maintain compliance with company initiatives.
- Prepared and maintained document inventory for core dossier preparation.
- Worked with governance committees to make and evaluate plans.
- Received, researched and resolved consumer inquiries.
- Recommended improvements to processes.
- Prioritized project-related tasks to efficiently complete essential tasks.
- Provided pre-, ongoing, and post-inspection follow-up assistance to governmental inspectors.
- Wrote or updated standard operating procedures, work instructions or policies.
- Completed and reported on CMS impact assessments.
HEDIS Quality Improvement Specialist(contract End)
Zing Health (Contract Successfully Ended)
Chicago, IL
03.2021 - 10.2021
- Documented and reported issues with compliance, standards of care and quality assurance requirements.
- Supports quality improvement HEDIS and program studies as needed,
requesting records from providers, maintaining databases, and researching
to identify members' provider encounter history - Collects, summarizes, and trends provider performance data to identify and strategize opportunities for provider improvement
- Delivers provider specific metrics and coach providers on gap closing
opportunities - Ensures that documentation produced and/or processed complies with
state regulations and/or accrediting body requirements - Abstracting medical records and overread HEDIS data entry of even
- Advises and educates Provider practices and IPAs in appropriate HEDIS
measures, medical record documentation guidelines and HEDIS in accordance with NCQA requirements - Develops, enhances, and maintains provider clinical relationship.
Document Control Specialist
UHC (Equity Staffing)
Remote( Project Successfully Ended), GA
11.2020 - 03.2021
- Modified and maintained tools to support operations and business process creation using Adobe Acrobat, SharePoint, Excel and Access capabilities.
- Prepared digital files, physical documents and work requests in compliance with company guidelines.
- Provided support for document controls and worked with contract documents.
- Proofread filenames, titles and submittal details to streamline submittal and avoid rejection.
- Transmitted documents, organized revisions and tracked changes.
- Maintained document control system including work instructions, procedures and associated databases.
- Performed document reproduction, printing documents from electronic sources such as email attachments, PDF files and cloud storage.
- Oversaw creation, routing and data input of bills of materials, ECOs, ECRs and ISO documents.
- Converted documents from one application to another, including cleaning, formatting and applying styles as needed.
- Manipulated and converted documents to meet needs for projects.
Legal Quality Assurance Specialist
BD Medical Inc
Covington, GA
09.2017 - 03.2020
- Evaluated accuracy and quality of data entered into agency management system.
- Perform complaint and quality investigations related to manufacturing, design or clinical use issues.
- Review and approve investigations performed by OEM supplier. Managed large volume of medical claims on daily basis.
- Ensure consistency to detail in performing and documenting complaint investigations
- Evaluates complaints for determining MDR/Vigilance events and document rationale for not filing MDRs
- Determine whether a product malfunction or serious injury reports needs to be filed with the FDA.
- Determine whether a 30 day or 5-day MDR report is required. Maintain the records of all MDRs and document rationale for not filing MDRs.
- Perform final review for closure of complaint files to ensure accuracy, completeness and attention to detail.
- Generates results letters to customers and maintain all required records for the complaint.
- Approve decision trees for vigilance reports/international competent authority.
- Handle competent authority inquiries of complaints and other duties as assigned
Compliance Specialist
Healthcare Consultant
Cumming, GA
02.2008 - 09.2017
- Prepared and submitted regulatory file applications and supporting documentation.
- Investigate and examined guidance in connection with government health plans
- Trained new and current employee's on company's policies and procedures.
- Regularly conducted medical records audits for completeness and accuracy in conformance of HIPAA standards
- Monitor projects timeline and resources along with overseeing and finalizing the completion of correction action plan tasks
- Assist the compliance risk assessment process used for the development of the yearly compliance work plan
- Respond to CMS inquires regarding audit activities
- Work with a variety of government and outside vendors
- Maintain knowledge of applicable rules, regulatory polices, laws and guidelines
Medical Records Director
Liberty Nursing& Rehab
Charlotte, NC
05.2003 - 01.2008
- Maintained accuracy, completeness and security for medical records and health information.
- Interacted and communicated easily with department personnel and public.
- Adhered to all confidentiality requirements at all times.
- Demonstrate initiative by organizing and closing out all charts of residents in a 281 bed facility.
- Research all current and closed charts for appropriate forms and signatures.
- Manage a team of Ward clerks, and assist in their daily routines of maintenance of the medical records.
- Take on weekends duties, helped mealtime preparation, and perform hall monitoring.
- Create a functioning file method of filing medical records within compliance of the State of North Carolina.
Education
Bachelor of Science - Health Administration
Columbia Southern University
Orange Beach, ALCertificate - Advanced Medical Coding
Kennesaw State University
Kennesaw, GABachelor of Arts - Paralegal Studies/current
Indiana University - Purdue University Indianapolis
Indianapolis, INCertificate - HEDIS/ STARR Certified
Next Level Training
Atlanta, GA11.2020
Skills
- Computer: HEDIS, NCQA, CMS, E-clinical Work, Medtech, NextGen, Cairo, STNA, Advance Med, Allscripts, Athena Health, Cerner, Practice Fusion, Advance-MD, ChartLogic, Greenway and Microsoft Office Suite
- HEDIS Review,HEDIS Abstraction, NCQA, EMR, Diagnosis code, Microsoft word, Excel, Power point DARTH, Health-EC, QSHR,Optum, Care-Analyzer, SAP, Cognos EPM, Axiom Software
- Documentation abilities
- Scrupulous records management
- Operational improvement
- Problem resolution
Timeline
Regulatory Compliance Specialist(Part-time)
Healthcare Consultants
12.2021 - Current
HEDIS Quality Improvement Specialist(contract End)
Zing Health (Contract Successfully Ended)
03.2021 - 10.2021
Document Control Specialist
UHC (Equity Staffing)
11.2020 - 03.2021
Legal Quality Assurance Specialist
BD Medical Inc
09.2017 - 03.2020
Compliance Specialist
Healthcare Consultant
02.2008 - 09.2017
Medical Records Director
Liberty Nursing& Rehab
05.2003 - 01.2008
Bachelor of Science - Health Administration
Columbia Southern University
Certificate - Advanced Medical Coding
Kennesaw State University
Bachelor of Arts - Paralegal Studies/current
Indiana University - Purdue University Indianapolis
Certificate - HEDIS/ STARR Certified
Next Level Training
Similar Profiles
Kenyana WootenKenyana Wooten
Patient Care Coordinator Remotely at Healthcare ConsultantsPatient Care Coordinator Remotely at Healthcare Consultants
JADE JOHNSTONJADE JOHNSTON
REMOTE PROVIDER DATA AND ENROLLMENT SPECIALIST I at Healthcare ConsultantsREMOTE PROVIDER DATA AND ENROLLMENT SPECIALIST I at Healthcare Consultants
Sarika KannanSarika Kannan
Registered Nurse at Nexim Healthcare ConsultantsRegistered Nurse at Nexim Healthcare Consultants
Cody HarshCody Harsh
Used Car Foreman / Lean Coordinator at Hendrick Mall of Georgia MiniUsed Car Foreman / Lean Coordinator at Hendrick Mall of Georgia Mini
Jason PerezJason Perez
Flight Attendant at Delta Air Lines, IncFlight Attendant at Delta Air Lines, Inc