Sarra Mcleod Email & Phone Number

Springdale, Ar, Us

United States

Remote

Develop and implement an effective organizational compliance program. Act as Privacy Officer and HIPAA subject matter expert regarding all privacy concerns and issues. Conduct investigations and develop corrective action plans (CAP), monitored CAPs for effectiveness, and adjusted solutions to maximize outcomes. Analyze internal business systems to ensure compliance with industry regulations and ethical standards. Assist the Chief Compliance Officer in the development of risk management strategies and design control systems to address cases of violations of internal business policies. • Built, developed, and monitored the compliance and privacy program to effectively detect signs of fraud, waste and abuse, HIPAA violations, and misconduct.• Created and utilized breach assessment and notification tool, working closely with legal counsel.• Conducted compliance risk assessment and developed compliance plan based on identified risk and analysis of areas of opportunity. Collaborated with core leadership to mitigate high risk gaps and implement meaningful processes.• Collaborated with Information Security Officer on ISO 27001 standards and secure framework.

Phoenix, Arizona, United States

Within this role, I review and ensure that all internal activities and vendor services adhere to compliance standards and policies. Lead companywide risk assessments in collaboration with various departments and stakeholders. Conduct regular analysis of FDR compliance process, auditing programs, and Corrective Action Plans (CAPs). Support Chief Compliance Officer with specialized investigations and projects. Some key achievements for this role include:• Created and delivered compliance education program (which included new hire orientation and events such as corporate compliance and ethics week) which boosted engagement and fostered culture of compliance.• Developed and orchestrated audit program to ensure organizational compliance with Centers for Medicare and Medicaid Services Diabetes Prevention Program and Office of Inspector General exclusion verification.• Assisted in HITRUST and SOC II certification.

Support Chief Compliance Officer by responding to various health plan audits and performing risk assessment analysis on all on-boarding providers entering the organizational network. Act as point of contact for compliance related issues and concerns. Create and conduct Compliance training for new hire orientation and on-going training for distribution throughout the organization.• Track corrective action plans resulting from the risk assessment process while providing guidance to providers for mitigating risk.• Prepare reports by collecting, analyzing, and summarizing information for review and presentation to the Compliance Committee and Board of Directors.• Research regulations by reviewing regulatory bulletins and other sources of information and report on regulatory or legislative changes affecting organizational operations.• Maintain professional and technical knowledge by attending educational workshops; reviewing professional publications; establishing personal networks; benchmarking state-of-the-art practices; participating in professional societies.

Phoenix, Arizona

Strategically performed targeted internal audits to identify areas of opportunity and shortcomings, recommended actionable solutions, and facilitated changes to policies, procedures, and education programs. Updated and enhanced the effectiveness of audit activities/objectives and compliance metrics. Proposed future audit projects to Compliance Audit Program Director. Assisted compliance leadership during government investigations. Some key achievements for this role include:• Streamlined internal audit processes by eliminating redundancies and increasing communication between auditors and area compliance directors.• Maintained awareness of existing and changing laws and regulations to ensure that Banner had an effective, robust, and evolving compliance program.• Contributed to annual audit work-plan development.

Phoenix, Arizona Area

I acted as the subject matter expert, advising and educating senior management on numerous disciplines and functionalities. Investigated compliance and HIPAA privacy issues and instances of potential fraud. Held quarterly Compliance Committee and Performance Improvement Committee meetings to evaluate and address organizational performance (35+ branches) and verify that compliance standards were met. Aided in the design and development of corrective action plans for a wide range of areas.Some key achievements for this role include:• Facilitated the accreditation certification process.• Developed and led organizational training on multiple topics: HIPAA, Stark, Anti-kickback laws, and accreditation.• Crafted tools, templates, and reports that aided in tracking performance at branch level.

Phoenix, Az

Some key achievements for this role include:• Maintained hospital and committee bylaws and regulations to ensure physician compliance.• Built case review processes for OB/GYN peer review committee which included case creation, processing, evaluation, tracking, and reporting - cases involved patient care and hospital bylaws and regulations.• Provided assistance to physicians on all aspects of credentialing, hospital committees, peer review, and hospital privileges.

Phoenix, Az

• Reviewed and verified customer demographic information and insurance coverage; interfaced with insurers to secure pre-authorizations, investigate denials, and facilitate claims payment.• Monitored and maintained contract portal to verify contractual agreements with managed care providers.• Processed weekly billing and daily / monthly claims statistics.

Phoenix, Az

• Developed process standards and policies / procedures for insurance verification resulting in a 20% increase in data accuracy and 50% decrease in paper usage.• Reviewed and maintained 150+ billing accounts daily for registration accuracy; performed daily analytical review of registration / eligibility reports for trends and accuracy, increasing claim payment probability.

Phoenix, Arizona

• Gathered and verified customer demographic and insurance information; processed weekly billing and collaborated with Hearing Screen Coordinators to resolve billing issues.

Glendale, Az

o Review billing sheets, and ensure accurate billing for 4 physicians in the practiceo Responsible for patient check-in/check-outo Front office inventory of all supplies, scheduling, and answering multiline phoneo Follow up with insurance companies regarding denials and requests for additional informationo Ensure HIPAA compliance for all medical record requestso Maintained patient recordso Interfile various patient data into patient charts

Master'S Degree, Legal Studies, Corporate And Healthcare Compliance

Bachelors Of Science, Healthcare Administration

Associates Degree, Health Information Technology