SUNDAY O. AIGBOBOH, RHIA, CHC

**** ***** **** ******

Bakersfield, CA 93313

661-***-****

r8nt6b@r.postjobfree.com

QUALIFICATION SUMMARY

• Experienced health care professional with proven results in building new business, turning around operational challenges, transitioning “smaller” entities into world class integrated delivery systems in the profit and non-profit sectors. Team focused experience with diverse groups, community minded, and energetic style supports building a successful organization and ensuring mission achievement, while developing major projects, enhancing physician relations, creating cost savings, and maximizing customer service.

• Health information administrator, director of compliance, privacy officer and consultant in both acute care and ambulatory care settings. Domain experience includes system analysis, project management, operations management and revenue cycle management.

• Effective leader of employee teams, setting directions, managing performance improvement, building talent, managing and developing others.

• Extensive knowledge of HIPAA privacy/security, JCAHO, federal /state regulations, principles and guidelines as well as policies pertaining to documentation, coding, billing and reimbursement systems.

• Expertise in coding/auditing relative to the assignment of in ICD-9, CPT, and HCPCS with extensive knowledge of E/M coding, extracts and assignment of codes, sequencing and DRG selection, performance of peer reviews and quality control checks, implementation of new CMS payment guidelines and JCAHO standards including correct coding initiative, monitoring of coding compliance programs, education and training of medical records coders, clinical staff and physicians.

• Experience working with large scale revenue cycle transformation projects for major health care systems with respect to managing the processes of the business office, patient access /registration, coding compliance, charge entry, charge description management (CDM) and health information management, facilitate interdisciplinary teams of patient access, patient financial services, health information management and clinical representatives to improve processes, reduce days in account receivable and achieve revenue cycle compliance remediation

PROFESSIONAL EXPERIENCE

California Department of Corrections and Rehabilitation, Department of Juvenile Justice, Division of Health Care Services

Sacramento, California

Health Information Management Consultant April 2008- Present

Purpose

Under general direction plans, develops and manages a comprehensive health record system within the CDCR Division of Juvenile Justice; manages and direct staff and oversees a health record system that meets medical, administrative, legal, ethical, regulatory agency, and facility requirements.

The Health Record Service has five major responsibilities of file maintenance, release of information, confidential health information, technical record processing, and quality control. Health record service personnel shall ensure that confidential health information is maintained together, so that maximum health information is available to healthcare providers on demand. Health record service personnel shall ensure that each Unified Health Record is in good order, i.e., systematically organized to facilitate prompt retrieval of information. When a policy or procedure is established, revised and approved, health record service personnel shall receive training to be prepared for the multiple complex task of information management,

The initiation, development and timely completion of accurate and complete Unified Health Records involves following policies and procedures that not only influence the management of health record service but influence healthcare providers. The Health Record Services Policies and Procedures include minimum documentation standards necessary to justify the diagnosis and services provided, and the guidelines to achieve accuracy and completeness of information, including the monitoring and control to ensure that information is complete as it is developed.

Objectives

• Work with Medical Directors to develop, edit, amend, and publish the DJJ Health Records Policies and Procedures

• Develop, author and perform data analysis of facility health record systems and procedures

• Produce management level reports including , individual facility program and system wide in relation health records management and clinical guidelines

• Participate in clinical records evaluations that support best practice management directives and guidelines

• Develop an audit tool to monitor field clinical record operations on-site at the institutions

• Assist in the development and training of standardized headquarters clinical records training for improved operations.

• By a date to be set in the Standards and Criteria section, review the current records system to address problems related to redundancy and lack of access to clinical/treatment information

• By date to be set in the Standards and Criteria section, identify or develop an appropriate computerized record system to address problems of redundancy and lack of access identified in the corrective action/remediation plan,

PYRAMID HEALTHCARE SOLUTIONS- Clearwater, FL

Pyramid Healthcare solutions is a leading national healthcare consulting firm delivering a complete suite of best business service solutions, including HIM interim management, onsite and remote coding, HIPAA compliance, clinical documentation standards, revenue cycle assessment, JCAHO preparation, managing transition of paper records to electronic medical records (EMR) and outsourcing of departments and functions.

National Director, Health Information Management Consulting, February 2006 – March 2008

• Management of professional staff, overseeing scheduling, performance monitoring, performance evaluation, recruitment of personnel based on company/divisional/client needs.

• Management of existing client relationships (monthly follow up, performance reporting, and new opportunity development) and promotion of cross selling opportunities.

• Promotion of Quality Assurance and compliance monitoring for the HIM Consulting Division.

• Monitoring and approval of expenditures and resource use (expense reports, timesheets, and education requests) in accordance with budgetary guidelines.

• Management of appropriate and profitable project and divisional budgets. Monitor and ensure fiscally responsible use of resources.

• Provision of consultative services/expertise in support of training and staff development of HIM Consultants and related areas.

• Promote company expertise through speaking and professional association activities.

• Participation in Manager/Director weekly and HIM or Coding Staff monthly conference calls.

• Conduct HIM assessments, projects (e.g. JCAHO, HIPAA, clerical oversight, etc.),

• Interim management at outsourcing sites, and interim department management nation-wide.

Consulting/ Director of Health Information 11/2001 – 2/2006

Locations:

KAISER PERMANENTE, Fremont California

Interim Director of Compliance/ Project Management,

BARTON HEATHCARE SYSTEM (BHS) South Lake Tahoe, CA

Interim Director of HIM and Privacy Officer

COMMUNITY MEDICAL CENTER, Missoula Montana

Interim Director of HIM and Privacy Officer

PLAINS REGIONAL MEDICAL CENTER, Clovis New Mexico

Interim Director of Health Information Services and Privacy Officer

• Developed and recommended a Fremont/Hayward compliance program in accordance with regional and national leadership and compliance goals, (DHHS) and Office of Inspector General (OIG) guidance issued for the establishment of effective compliance programs, and regulatory requirement for Centers for Medicare and Medicaid Services (CMS)

• Established goals and priorities for implementation and evaluation of the Fremont/Hayward compliance program.

• Completed HIPAA physical/ security and gap analysis and recommended mitigation strategies.

• Trained 4,171 employees (100%) on HIPAA Privacy and Security, 1800 employees (100%) on Conflict of Interest.

• Implemented Revenue Cycle Compliance remediation based on accurate identification of key compliance issues, including site of service, entity, default coding, provider enrollment and other deficiencies identified by Price Waterhouse Coopers (PwC) billing compliance assessment.

• Developed Revenue Cycle Compliance Continuum based on accurate registration/admitting, clinical source systems, medical records and coding.

• Developed and implemented documentation standards based on medical necessity related to Medicare coverage rules and other payer requirements.

• Chaired the Compliance Steering Committee

• Accountable for all assembly, analysis, filing, coding, correspondence, and transcription function

• Established and led department directors in assessment and revision of the charge description master (CDM), automated the review process to facilitate billing and achieve 100% compliance.

• Successfully developed/implemented a chart completion/suspension policy / procedure which reduced medical record delinquency from 57 % to 10% in 6 months

• Successfully coordinated the install of the 3M Encoder interfaced to the mainframe computer.

• Successfully planned and coordinated the conversion of a character based Chart Tracking/Deficiency system to a Windows based product.

• Managed 40 medical records employees in multiple sections including technical services abstracting and coding , file management, health information reporting, clerical functions and physician chart completion

• Reduced accounts receivable (DNFB) from 9 million dollars per week to 500,000 dollars

• Outsourced overflow transcription reducing transcription turn around time from 5 days to 1 day

• Implemented electronic medical records to replace microfilm storage improving retrieval from 80 -100 %.

• Hired and trained 3 outpatient coders for E&M coding to replace outsourced vendor contract cost of $500,000 to salary compensation of $95,000 per year.

• Organized HIPAA Compliance Committee and, as chairperson, conducted security assessment, determined necessary policy and procedures for reaching and maintaining privacy compliance with covered entities as required by HIPAA privacy regulation addressed in handling protected health information, analyzed and interpreted legal and regulatory privacy requirements.

• Recruited a registered health information administrator (RHIA) for the hospital Privacy Officer position.

• Trained all staff groups on HIPAA privacy regulation including physicians, leadership team, nursing, registration/admitting, patient accounting and other employee groups in the organization.

• Provided leadership and collaboration on improving management systems and updating Health Information Management policies/procedures including JCAHO standards, Medical Staff Rules and Regulations to reflect higher level of adherence to both corporate and state mandates.

KAWEAH HEALTH CARE DISTRICT HOSPITALS, Visalia, CA

580 acute, 46 sub-acute, 48 SNF, 24 Rehabilitation facility 30 Psychiatric facility, 3 satellite clinics and 260,000 emergency room visits, with over 80 FTEs.

Director of Health Information Management and Privacy Officer, 5/ 1999- 11/2001

• Implementation of electronic medical record (EMR) in a district-wide multi and integrated hospital system,

• Documented migration path from paper records to full functionality of a comprehensive EMR.

• Provided leadership for the planning, and managing EMR system acquisition and implementation.

• Documented standards of a benefits portfolio that ensured appropriate return on EMR investment.

• Addressed the legal and regulatory aspects of EMR and other forms of health care documentation.

• Implemented hospital/corporate compliance for HIPAA privacy and security regulations

• Performed ongoing virtual privacy and security surveillance to detect inappropriate access to protected health information (PHI) within the electronic medical records.

• Provided information management expertise in the area of data interface across various platforms, data manipulation, database structuring for online data reporting to senior leadership and OSHPD.

• Provided 24/7 online access to EMR to physicians for chart completion, obtaining copies of their patients records for billing and follow-up care in private practices

• Reduced account receivable from 25 million to $500,000 in 6 months

• Conducted on going records/ clinical pertinence review online on EMR system

• Organized and chaired HIPAA Compliance Committee, conducted privacy/security assessment, determined necessary policy and procedures for reaching and maintaining privacy compliance with covered entities as required by HIPAA privacy regulation addressed in handling protected health information, analyzed and interpreted legal and regulatory privacy requirements.

STRATEGIC HEALTH INFORMATION CONSULTING, Bakersfield, CA

Management Consultant / Director and Manager 1996- 1999

• Coding compliance and account receivable management

• JCAHO Accreditation preparation.

• Participated in the development and implementation of QI hospital-wide programs.

• Ongoing records review training

• Record deficiency management

• Coordinated with Finance in maintaining an A/R at an acceptable level.

• Supported administration in search and recruitment of qualified HIM directors.

KERN MEDICAL CENTER, Bakersfield, CA

450 bed acute care County owned level II trauma care teaching hospital serving a community of 650,000. KMC is affiliated with UCLA, UCSD, and UCI Schools of Medicine, giving nearly 1,000 visiting doctors/ researchers. The hospital provides care for over 16,000 inpatients annually, while the clinics provide care and services for over 100,000 patients

Director of Health Information Department, 1990- 1996

• Accountable for all assembly, analysis, filing, coding, correspondence, tumor registry, birth certificate and transcription functions

• Reengineered department, reducing FTE from 55 to 50 and maintained industry best practices.

• Implementation of HBOC McKesson HIM applications relative to chart deficiency, analysis, chart locator and 3M encoder and Clintrac.

• Led multidisciplinary team for the implementation of clinical pertinence review for meeting JCAHO standards.

• Continually assessed the HIM operations and service to ensure that appropriate integration and coordination of services are provided to other departments and customers while meeting financial and compliance goals.

• Served on the Revenue Cycle Management Team and provided regular reports to the CFO.

• Maintained a positive budget variance consistently for six (6) years.

• Reduced accounts receivable (DNFB) from 7 million to 0 balance in 9 months.

SANTA BARBARA MEDICAL FOUNDATION, Santa Barbara, CA

150 physician group practice, 12 locations, 400,000 visits.

Director of Health Information and Transcription and PBX, 1988- 1990

• Managed 56 medical records employees in the 12 clinics, including technical services abstracting and coding, file management, health information reporting, clerical functions and physician chart completion.

• Led multidisciplinary team in the implementation of Meditech HIM applications

• Reduced department staff by 15 in two years while maintaining performance standards.

• Managed the conversion of medical records from alphabetical to terminal digit filing system resulting in saving of $100,000 in two years.

TECHNOLOGY/ELECTRONIC MEDICAL RECORD IMPLEMENTATION

Microsoft Project Management, Excel, Visio, Word, Power Point. Quardramed, Softmed –Clintrac, ChartFact, Chart Locator, Chart Reserve CharScipt, HBOC (WIS/SAI), IMNET- McKesson, STAR AS400 SIEMENS CLS –Incorporate the Lifetime Clinical Records, Invision Implementation, Patient Management, Patient Accounting & ADT, MPI Conversion and Meditech HIM applications

EDUCATION / CREDENTIALS

MBA, Health Care Administration, 1983, Northeastern University, Boston, MA

BS, Health Information Administration, 1980, Northeastern University, Boston, MA

CHC/Certification in Healthcare Compliance, Security and Privacy, 2005, Healthcare Compliance Association

RHIA, 1981, American Health Information Management Association

PROFESSIONAL ACTIVITIES

American Health Information Management Association, Performance Improvement Committee

California Health Information Association Legislative Liaison

Sierra Health Information Management, President, 1998–1999

Healthcare Compliance Association membership

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