Quality Assurance Revenue Integrity

Highlights of Expertise

General Healthcare Compliance Budget Administration

Laboratory Operations & Compliance Quality Assurance Policy and Procedures Development OSHA, HIPAA, and DOH Regulations Product Research & Implementation Team Building and Leadership Project Management

Dept. of Health, CMS, CLIA, CLEP, CLIS Requirements Unionized Labor Contracts

WORK EXPERIENCE

St. Mary’s Hospital, Waterbury CT

Serve as the specialists in matters that have to do with billing, revenue integrity and overall laboratory

compliance

Laboratory Billing/Revenue Integrity and Compliance Specialist ( January 2023-March 2024)

●Responsible for coordinating, monitoring, and facilitating all Quality Assurance (QA) activities related to the clinical lab operations.

●Responsible for promoting compliance through applicable laws, regulations and policies pertaining to and not limited to billing and reimbursement.

●Responsible also for conducting audits and reviewing systems and processes to ensure and/or to identify potential compliance issues.

●Serve as an internal source for billing-related questions, appropriate billing and corrections processes.

●In charge of building and activating CPT Codes and their respective fee schedules.

●Responsible for researching and updating staff with regards to CMS policies, insurance coverage and payout.

●Accountable for determining that SOPs exist for all procedures in the lab and ensuring that all are up-to-date and available to all laboratory sections.

●In charge of reviewing and providing written approval of all standard operating procedures relating to the overall compliance program that include and not limited to billing and revenue integrity.

●Answerable to all compliance-related complaints.

●Assist dept. manager in maintaining, updating all permits and licenses.

●Responsible for making sure the laboratory is meeting contract and regulatory requirements where applicable such as Business Associate Agreements, Stark and Anti-Kickback laws and HIPAA

●Other duties as needed

Brown Point Facilities Management Lincoln, RI

Serving as liaison between governmental agencies, contracted and directly employed staff for a company

dedicated to the provision of service management as it relates to environmental and workplace safety

throughout the continental United States.

Environment, Health and Safety (EHS) Quality and Compliance Manager (May 2022 to August 2022)

●Responsible for establishing guidelines involving health and safety in the workplace as established by OSHA.

●Responsible for establishing guidelines involving The Environmental Protection Agency (EPA).

●Responsible for establishing guidelines and training involving Chemical Hygiene and Biological hazards.

●Responsible for assessing staff knowledge of work-related materials/trainings,

●Responsible for creating policies and procedures reflecting topics involving EHS, EPA, Chemical handling/disposal and Bloodborne Pathogens.

●Serve as the interpreter of legal and regulatory guidelines as it relates to EHS, EPA and OSHA processes and procedures in Spanish and English.

●Serve as the primary contact for issues relating to policies, procedures and emergency situations

●Responsible for conducting audits and providing recommendations with implementations as well as follow-ups.

●Responsible for meeting the expectations of established contractual agreements as they relate to any regulatory agency contracted with.

ProPhase Diagnostics, Inc. Garden City, NY

A laboratory environment specializing in the testing of COVID-19 helped establish and implement regulatory federal and state guidelines for two laboratories with respect to all lab operations utilizing working experience, educational knowledge in medical technology, law healthcare safety and compliance.

LABORATORY OPERATIONS AND COMPLIANCE OFFICER (01/11/21-02/1-/22)

●Accountable for keeping the laboratory abreast of all regulatory guidelines as well as creating and implementing policies and procedures to maintain the laboratory compliant with governmental agencies with regards to OSHA, HIPAA, Privacy, FDA, EEOC, DOT etc.

●Responsible for assessing laboratory risk including and not limited to biological, chemical, labor and legal

●Responsible for performing laboratory audits and pertinent competencies

●Responsible for creating and updating policies and procedures

●Responsible for creating and maintaining the Quality Assurance program and committee

●Responsible for safety education, training, assessments and safety committee

●Responsible for the safeguarding and submission of documents to State with respect to application and maintenance of laboratory licensures

●Responsible for assuring and maintaining the laboratory in compliance regarding quality control and assurance

●Complaint addressing

●Other duties as assigned

Acupath Laboratories, Inc. Anatomic Pathology Specimen Grosser Plainview Long Island, NY

Through acquired knowledge and following regulatory guidelines perform specimen selection, dissection, submission for further analysis and diagnosis by a pathologist.

(10/28/2019 to 01/08/2021)

●Responsible for receiving, examining, dissecting and submission of human tissue specimens for diagnostic and research purposes.

●Responsible for performing embedding of the specimens already grossed for micro-sectioning.

●Other duties as assigned

North Shore-LIJ Health System - Northwell Health, Long Island, New York

Provided leadership and accountability for; Lab Operations, Laboratory Safety, and Regulatory/Compliance at the Long Island Jewish Valley Stream and Long Island Jewish Forest Hills Hospitals

ANATOMIC PATHOLOGY OPERATIONS MANAGER/LABORATORY SAFETY COMPLIANCE OFFICER (03/2012 to 10/2018)

●Accountable for a staff of more than 500 employees including; hiring, time and attendance, organization and direction, disciplinary actions, coaching, training, payroll, paid time off and quality control and assurance observing both hospital and 1199 union contract rules; ensured safety in the workplace, educating staff, conducting risk assessments biological and otherwise on a monthly and yearly basis. Managed specimen receipt and processing, lab expenditures (financial reporting), including new equipment research, justification and purchase.

●Ensured standards for the Clinical Laboratory Evaluation Program, Centers for Medicare & Medicaid Services, Department of Health, The College of American Pathologists, The Department of Environmental Protection and the Joint Commission on Accreditation of Healthcare Organization were met.

●Successfully obtained new instrumentation that improved quality of the work and turnaround time; resulting in renovation project achievement without hindrance to work.

●Managed legal requests from law firms, doctors’ offices, and hospitals, ensuring laboratory and staff adhered to laboratory policies and procedures with respect to patient privacy and confidentiality.

●Served as liaison among department staff including; staff pathologists and system legal team when litigation or possible litigation arose.

●Introduced strategic and tactical policies; relating to laboratory procedures and safety.

●Facilitated the education of prospective medical personnel on; laboratory and hospital procedures.

●Member of the Environment of Care (EOC) Committee.

CBL Path Westchester, New York

Set the direction and managed the overnight operations of the laboratory including; specimen receipt and processing.

OVERNIGHT LAB OPERATIONS MANAGER (08/2011 to 03/2012)

●Accountable for staff with respect to time and attendance, organization and direction, disciplinary actions, payroll, paid time off and quality control and assurance.

●Evaluated procedures and techniques for tests used in the analysis of specimens.

●Organized and performed quality control auditing and documentation.

Clinical Laboratory Partners at Hartford Hospital, Hartford, Connecticut

Collaborated with system leadership and developed three pathology laboratory operational strategies in alignment with the Hartford Hospital Healthcare system.

ANATOMIC PATHOLOGY MANAGER (09/2009 to 08/2011)

●Responsible for more than 30 employees including the development and submission of operating and capital equipment expense budget; accountable for sustaining and advancing the quality assurance program in pathology according to healthcare regulations, departmental goals, and objectives; performed monthly meetings with section leaders.

●Key contributor to the operational transition of the Histology Laboratory operations including; specimen delivery, processing and registration; ownership was transferred over to Clinical Laboratory Partners from Hartford Hospital.

●Contributed to expansion and execution of hospital/department policies and procedures including; healthcare regulations.

●Researched and analyzed new instrumentation; resulting in improved quality of work and turnaround time.

Additional Experience

Anatomic Pathology Supervisor (2007 to 2009) Cape Cod Hospital, Hyannis, Massachusetts

Research Associate (2005 to 2007) Aureon Biosciences, Yonkers, New York

Histology Supervisor (2001 to 2004) New York Methodist Medical Center, Brookly, New York

Education & Credentials

Juris Doctorate, William Howard Taft Law School, Santa Ana, CA, 2017

Master of Business Administration in Finance, Western International University, Tempe, AZ, 2008

Master of Arts in Biology, City University of New York, H.H. Lehman College Campus, Bronx, NY, 2001 Bachelor of Arts in Biology/Psychology, City University of New York, H.H. Lehman College Campus, Bronx, NY, 1991

Certifications

● Certified Clinical Laboratory Technologist, New York State University, Albany, NY, 2007

● New York State Fire Department Certification –C14, Chemical Laboratory Handling

● Certified Safety Healthcare Professional (CSHP)

● Certified in Healthcare Compliance (CHC)

Affiliations

● Healthcare Compliance Association

Academic/Research

Technical Contributor: “Paraffin-resistant Antigens Detectable by Antibodies L26 and Polyclonal CD3 Predict the B-T Cell Lineage of 95% of Diffuse Aggressive Non-Hodgkin’s Lymphomas.” American Journal of Pathology, September 1994, Volume 3

References

Available upon request

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