Teri Smith
Healthcare Compliance
Aurora,CO
Summary
Focused Compliance Officer bringing 14 years of expertise in regulatory compliance, audit procedures, project oversight, and risk management. Excellent history of delivering effective leadership and training to support staff development. Driven and strategic with an aptitude for program management. Advanced knowledge of audit methodologies, functions, and compliance teams.
Overview
14
14
years of professional experience
4
4
Certification
Work History
Associate Director – Audit, Compliance & Education
University of Colorado Medicine
Aurora , Colorado
2018.09 - Current
- Remain current with federal and state healthcare regulations, coding changes, and the general healthcare environment by accessing available materials and resources
- Remain current on external audit activity to include federal, state, and commercial payers to ensure the organization is below acceptable risk measures.
- Identified opportunities for improvement in processes, procedures, systems and services.
- Analyzed data collected from various sources in order to identify trends or areas requiring further investigation or action.
- Maintained positive relationships with stakeholders by responding promptly to inquiries, requests and complaints.
- Created effective communication channels between different departments in order to facilitate collaboration.
- Assisted senior leadership team in developing long-term strategic plans for the organization.
- Actively participated in external events such as conferences and seminars related to the company's field of activity.
- Participated actively in decision making processes at a high level within the organization.
- Established key performance indicators which were tracked regularly against set targets.
- Maintained positive relationships with vendors and external partners to support business resilience efforts.
- Prepare annual audit schedule for the School of Medicine providers. Highly experienced in directing project performance, team success, budget management, and strategic alliances.
- Well-versed in tactics and processes to increase staff collaboration and productivity, enhance customer service, and improve cash flow, to positively and significantly impact operating profits.
- Ensured compliance with all applicable laws, regulations and policies related to the organization's operations.
Manager – QCAE
University Physicians Inc., dba CU Medicine
2016.03 - 2018.07
- Provide direction and leadership to a team of 19 on a day-to-day basis
- Includes responding to specific questions regarding systems, processing and policy
- Provide analytical expertise including research, accurate interpretation, documentation, and training for Audit & Education staff
- Maintain project plan and priority status for all projects to ensure that project timelines are met
- Assist in drafting departmental standards, guidelines, procedures, flow-charting, according to the Audit & Education Procedure Manual outline.
Compliance Auditor – QCAE
University Physicians Inc.
2013.09 - 2016.03
- Perform formal Division Audits for SME-specific divisions utilizing a random-focus audit platform to encompass the complete book of business.
- Prepare and present the formal audit report to the Division Chair, Division Finance Administrator, and all providers.
- Subject Matter Expert (SME) for the following specialties: General Surgery, Endocrinology, Renal/Dialysis and the full scope of Evaluation and Management codes
- Prepare and present educational tools and PowerPoint presentations for both coders and providers.
Manager – Coding Hub
Centura Health
Aurora , CO
2011.09 - 2013.10
- Supervise 25 coders to include education, hiring, coaching, and termination
- Educate physicians and build collaborative working relationships
- Organized and facilitated specialty coding roundtables to include physicians, coders, edit and denial teams, facility directors, and related stakeholders
- On board new clinics and providers by integrating Centura coding guidelines and expectations
- Supervise and manage contract coders; forecast the need for additional help based on the addition of new clinics and providers
- Coding department was outsourced.
- Provided training and support to coding staff on current industry standards.
- Resolved coding issues in a timely manner, including discrepancies between codes used by different departments.
- Implemented new technologies and processes for improving the efficiency of coding operations.
- Prepared reports outlining overall performance of the coding department and identified areas needing improvement.
Oncology and Orthopedic coder
Centura Health
2010.05 - 2011.09
- Code oncology and orthopedic charts in compliance with ICD-9 and CPT guidelines; combination of 3 clinics
- Created department processes and procedures for coding infusions to include chart review and auditing
- Educate the physicians on correct coding guidelines, build strong collaborative relationships with the physicians and coders.
Emergency Department Coder
Beacon Medical Services, Aurora, CO
Aurora , CO
2009.05 - 2010.05
- Code emergency department charts in compliance with ICD-9 and CPT guidelines for 10 facilities.
Vice President/Controller
LASTING IMPRESSIONS SIDING &WINDOWS, Aurora, CO
Aurora , CO
2002.06 - 2009.05
- Direct and implement strategies for complete revenue cycle operations for this locally owned and operated home improvement company
- Fiscal responsibilities to include financial statement preparation; maintain a steady cash flow process throughout the year by utilizing effective budgeting and forecasting models
- Strategize with the owner on areas of growth and current market trends to capture market share
- Monitored all sub-contractors for overall work ethics, customer satisfaction and insurance requirements
- Established and implemented an employee on-boarding process to include the hiring process, benefits package, payroll addition and company policies and procedures
- Company was sold; changed careers.
Education
Executive Juris Doctorate - Health Law
Purdue Global Law School
05.2023
Healthcare Information Management Program -
New Horizons Learning Centers, Englewood, CO
01.2009
Bachelor of Science, Sociology with Criminal Justice Emphasis, Minor Accounting and Business -
North Dakota State University, Fargo, ND
01.1997
Skills
- Critical Thinking
- Analytical Thinking
- Decision-Making
- Verbal and Written Communication
- Work Planning and Prioritization
- Relationship Building
- Key Relationship Development
- Team Collaboration and Leadership
- Professional Networking
- Reporting and Documentation
- Coaching and Mentoring
- Budget Development
Certification
- Certified Professional Medical Auditor, 12/2014
- Certified Emergency Department Coder, 12/2010
- Certified Professional Coder, 02/2009
- Certified Billing and Coding Specialist, 03/2009
Accomplishments
- President AAPC (American Association of Professional Coders, Englewood, CO), 2011-2012
- Secretary AAPC (American Association of Professional Coders, Englewood, CO), 2010-2011
Technology Skills
- Advanced Legal Writing
- Legal Analysis
- Healthcare Law
- Tort Law
- Ethics
- Administrative Law
Timeline
Associate Director – Audit, Compliance & Education
University of Colorado Medicine
2018.09 - Current
Manager – QCAE
University Physicians Inc., dba CU Medicine
2016.03 - 2018.07
Compliance Auditor – QCAE
University Physicians Inc.
2013.09 - 2016.03
Manager – Coding Hub
Centura Health
2011.09 - 2013.10
Oncology and Orthopedic coder
Centura Health
2010.05 - 2011.09
Emergency Department Coder
Beacon Medical Services, Aurora, CO
2009.05 - 2010.05
Vice President/Controller
LASTING IMPRESSIONS SIDING &WINDOWS, Aurora, CO
2002.06 - 2009.05
- Certified Professional Medical Auditor, 12/2014
- Certified Emergency Department Coder, 12/2010
- Certified Professional Coder, 02/2009
- Certified Billing and Coding Specialist, 03/2009
Executive Juris Doctorate - Health Law
Purdue Global Law School
Healthcare Information Management Program -
New Horizons Learning Centers, Englewood, CO
Bachelor of Science, Sociology with Criminal Justice Emphasis, Minor Accounting and Business -
North Dakota State University, Fargo, ND
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