Hailey Wares, Bs, Cpc, Cdeo, Cpma Email & Phone Number

New York, Ny, Us

- Conduct physician practice coding reviews to ensure the accuracy of E/M, ICD-10, and CPT procedure codes, including the appropriateness of supporting documentation.- Deliver education to physicians and non-physician practitioners on proper documentation, coding, and billing practices.- Provide subject matter expertise on physician practice coding, including evaluation and management (E/M) coding under CMS 95/97 guidelines and 2021 updates, as well as ICD-10 and CPT procedure codes.- Maintain a strong understanding of federal and state laws, regulations, and guidelines, particularly those related to Federal Health Care Program payment and reimbursement requirements. Monitor changes that may impact the organization, inform relevant teams of regulatory updates, and contribute to the development and implementation of ethical business practices.- Monitor, assess, and prioritize key compliance risk areas, proactively identifying significant enterprise-wide risks.- Assist portfolio compliance and revenue cycle teams in minimizing denials by identifying billing trends and areas of improvement.- Support portfolio compliance teams in developing annual internal coding audit plans to ensure ongoing accuracy and compliance.- Provide expert advice on creating post-close integration plans for portfolio companies’ compliance and revenue cycle teams, tailored to findings from due diligence.- Plan and coordinate Waud Capital Partners' Annual Compliance Symposium: - Secure sponsors for the event - Curate key topics and identify expert speakers to present - Manage all logistics for the 3-day event- Assist in annual data collection related to responsible investing for the Firm and Portfolio.- Stay current on federal and state ESG regulations and provide relevant updates.

Delray Beach, Fl

-Conduct chart audits on a daily basis in areas such as: Evaluation and Management, Critical Care, Radiology, Gastroenterology, Physical/Occupational Therapy, etc.-Conduct due diligence audits on third party practices. -Draft reports of findings for clinical and billing staff based on coding accuracy results.-Provide coding and compliance consult education to physicians and non-physician practitioners.-Provide compliance and HIPAA education to physicians and medical staff.-Develop and create visual aids and supplemental tools to compliment 2021 Evaluation and Management physician education.-Conduct research and provide expert subject matter responses to physician inquiries base on up to date coding rules and regulations.-MIPS expert-Incident-to billing expert-Modifier 25 expert

New Brunswick, Nj

-Continuously performed Evaluation & Management audits on coding and documentation for procedures and all services performed by providers.-Performed Wound Care Audits.-Performed O.R. Supply Audits (specifically on mesh and skin substitute products).-Performed Ultrasound Authorization Audits.-Performed Pediatric Neurology Audits.-Performed internal compliance department audits.-Assisted in educating SPHS providers on how to compliantly code procedures and services they provided.-Responsible for monthly sanction & exclusion screenings of all providers, employees, and vendors.-Assisted with monthly updates of vendor contact information and Business Associate Agreements (BAA) using a contract management software (MediTract).-Reported monthly to the Executive Compliance Committee on all findings.

New Brunswick, Nj

Saved the organization from a $100k+ loss by identifying and investigating an abnormal result during a routine Sanction Screening. - Assisted with the investigation, auditing, review and analysis of general compliance, billing, HIPAA Privacy, and other matters to ensure compliance with governmental regulations and internal policies.- Responsible for monthly exclusion/sanction screenings of Vendors, Employees and Physicians.- Under supervision, conducted periodic audits of coding and documentation of procedures and services performed by SPUH physicians. - Assisted compliance auditors and analysts in the completion of specific projects.- Assisted in the roll-out of the 2018-2019 Conflict of Interest survey distribution.

Health Administration, Health/Health Care Administration/Management

High School Deploma, Criminal Justice And Corrections

Activities and Societies: Varsity Swimming Team, Baseball Team Manager