Compliance Healthcare
Resume:
OBJECTIVE
To obtain a challenging
position at an organization
where my experience in
Healthcare Compliance,
critical thinking skills,
communication,
and dedication
to promoting an ethical culture
can be utilized to enhance all team members’ experiences and drive business objectives.
Kathleen DiGregorio
HEALTHCARE COMPLIANCE AND ETHICS
My mission is to promote an ethical and compliant culture and reduce risks within a revenue cycle management, hospitals, dental and physician practices.
I have over nineteen years (19) of experience in developing and implementing ethics and compliance programs for healthcare organizations, in accord with the OIG's seven elements of compliance and best practices. I earned the required CEUs in compliance training and am a Certified Healthcare Compliance CHC professional - 2024.
I have demonstrated my expertise in conducting investigations, audits, compliance training, and annual risk assessments, as well as publishing an article in Compliance Today – April 2021, a leading industry publication. I have also enhanced my skills and knowledge by completing Lean Six Sigma, Agile Project Management, and Cascade Leadership course.
CONTACT
*********@*****.***
linkedin.com/in/
Kathleen. digregorio
Summerlin, NV
EDUCATION
RIO HONDO COLLEGE
AA, Paralegal – Business Management
HCCA – CEU Courses
SKILLS
Healthcare Compliance
Auditing
Risk Assessment
Compliance Training
Project Management
EXPERIENCE
SENIOR ASSOCIATE - GUIDEHOUSE
May 2018 – Current - Remote
- CHC Certified in Healthcare Compliance ~ 2024
- Ethics & Compliance for Guidehouse Managed Services - promotion of The Seven Elements of Compliance within a revenue cycle management organization.
- Respond to reported HIPAA - PHI incidents in a timely manner in collaboration with Compliance Officer. Conduct internal investigations to determine root cause and draft effective corrective action plans with Legal and Employee Relations.
- Write monthly micro-training and touchpoints for over 1,600 Revenue Cycle Management team members.
- Track regulatory changes for hospitals and physician practices through daily reviews of government and industry sites.
- Develop and complete audits for email encryption, cash posting, Medicare Credit Balance and Billers - government and commercial, in multiple hospital claim scrubbers.
- Develop and present quarterly ethics and compliance check-ins and tip sheets for processing centers, coders and US onsite hospital team members.
- Project manage revision of Internal Quality Control process for patient access representatives - Insurance Verifiers, Billers and Self Pay, and design dashboard reports in slide decks for operations Senior Leadership, and Executive Compliance Committee.
- Lean Six Sigma Yellow Belt for Healthcare Certification – 2020
- Lean Six Sigma Green Belt completed coursework – 2021
- CAPM Project Management - 30 hours of coursework completed – 2024
- Cascade Leadership Training - spring 2023
QC AUDITOR – TWO CONTRACTS - FQHC + COMMERCIAL
March 2017 – April 2017 - Hybrid
COMPLIANCE AUDITOR - SCAN HEALTH PLAN
April 2014 - January 2017 - Hybrid
- Compliance auditor for delegation network of providers – hospitals, vision care, DME, dental network, and physician practices inside delegated counties in California and Arizona.
COMPLIANCE AUDITOR – CONTRACT - KAISER
August 2013 – February 2014 - Onsite
- SOX Compliance Audits - cash handling - cash, credit/debit card and refunds processing.
- Training, coaching team members and monthly presentations.
- Audit co-pay reports and validate co-pay waives and other revenue cycle management reports in accord with Kaiser policy and procedures.
CAREER BREAK – FAMILY
June 2012 – July 2013
Contact this candidate