Michael Routh Email & Phone Number

San Antonio, Tx, Us

Hunt, Tx

San Antonio, Texas

As compliance auditor, I implemented privacy rounds and perform regular audits of specific privacy records. Report results, potential solutions and action plans to Executive Compliance Committee. Investigate compliance- and HIPAA-related complaints. With Compliance Officer and hospital counsel, create policies and procedures which reflect federal and state compliance. Gatekeeper for all Medicare RAC activities, having tracked 1,200 reviewed claims over a two year period. Create successful appeals at redetermination, reconsideration and Administrative Law Judge levels. I chair both the RAC Team and Chart Audit Committees, and am a member of Compliance Policy, Compliance Work Group, Executive Compliance, Physician Remuneration and Utilization Management/Case Management Committees.

Case Management

Gatekeeper for all Medicare RAC activities, having tracked 1,200 reviewed claims over a two year period. Created successful appeals at redetermination, reconsideration and Administrative Law Judge levels. Researched defense audits and analyzed denial trends.As compliance auditor, I implemented compliance rounds and perform daily audits of records and users. Report results, potential solutions and action plans to Executive Compliance Committee. Investigate compliance- and HIPAA-related complaints. With Compliance Officer and hospital counsel, create policies and procedures which reflect federal and state compliance. Create and present Medicare educational material to physicians and physicians’ staff. Present and explain the concepts of compliance and health information privacy and security in new employee orientation.I chair both the RAC Team and Compliance Audit Committees, and am a member of Compliance Policy, Compliance Work Group, Executive Compliance, Physician Remuneration and Utilization Management/Case Management Committees.Tasks are completed in a networked environment and utilizing multiple revenue cycle and compliance applications. Duties involve daily exposure to confidential and sensitive information.

Ma, Psychology

Ba, Mass Communications

Activities and Societies: Phi Theta Kappa, Odessa College Broadcasting Association, KOCV-FM

Education record

Activities and Societies: Speech & Drama