Summary
Overview
Work History
Education
Skills
Certification
Timeline
Generic

Casey Fletcher

Amissville

Summary

Dynamic Compliance Officer with proven expertise at Winchester Neurological Consultants, adept at regulatory compliance and staff development. Skilled in orchestrating effective training programs and optimizing documentation management, excels in fostering team collaboration and ensuring adherence to federal regulations, driving organizational success through strategic problem-solving and attention to detail.

Overview

12
12
years of professional experience
1
1
Certification

Work History

Compliance Officer

Winchester Neurological Consultants
Winchester
04.2024 - Current
  • Monitored compliance with regulations and internal policies across multiple departments.
  • Developed and implemented compliance training programs for staff members.
  • Reviewed and updated compliance documentation to reflect regulatory changes.
  • Provided guidance on compliance issues to management and employees.
  • Maintained records of compliance activities and findings for review purposes.
  • Advised management on best practices in compliance-related matters.
  • Assessed the effectiveness of existing processes and procedures related to compliance.
  • Identified gaps in existing controls and recommended corrective actions as needed.
  • Maintained and revised policy procedures for general operation of compliance program.

Hiring Manager

Winchester Neurological Consultants
Winchester
04.2024 - Current
  • Collaborated with department heads to identify staffing needs and roles.
  • Developed onboarding programs for new hires in a fast-paced medical environment.
  • Conducted interviews and evaluated candidates for clinical and administrative roles.
  • Implemented employee training sessions to enhance team performance and cohesion.
  • Maintained applicant tracking system to streamline hiring processes effectively.
  • Facilitated performance evaluations and feedback sessions for staff development.
  • Organized orientation sessions for new employees to ensure smooth onboarding experience.
  • Coordinated workforce planning to align staffing with patient care demands.
  • Managed the full cycle of recruitment process including sourcing, interviewing, screening and selection of candidates.
  • Received and reviewed candidate resume and job application submissions to approve or deny applicants for initial interviews.
  • Resolved employee queries regarding job descriptions or roles during hiring processes.
  • Conducted new hire orientations to provide company information and establish performance requirements.
  • Conducted background checks and reference checks on potential hires.
  • Advised managers on best practices for interviewing techniques and selection criteria.

Prior Authorization Specialist

Winchester Neurological Consultants
Winchester
08.2022 - Current
  • Reviewed insurance policies and guidelines for prior authorization requests.
  • Submitted and tracked prior authorization requests using electronic systems.
  • Coordinated communication between patients, providers, and insurance companies.
  • Resolved issues related to authorization denials and appeal processes.
  • Collaborated with healthcare providers to gather necessary documentation.
  • Educated patients on the prior authorization process and requirements.
  • Maintained accurate records of all authorization activities and correspondence.
  • Coordinated with other departments to obtain additional information needed for prior authorization.
  • Assisted in training new staff on prior authorization procedures and protocols.
  • Verified patient insurance coverage, including eligibility, benefits and authorizations for medical services.
  • Scheduled peer to peer reviews for physicians to discuss medical necessity with insurance providers.
  • Contacted insurance carriers to obtain authorizations, notifications and pre-certifications for patients.
  • Notified ordering providers of denied authorizations.
  • Performed detailed medical reviews of prior authorization request, following established criteria and protocols.
  • Responded promptly to inquiries from providers, patients and payers regarding status of prior authorization requests.
  • Provided guidance to providers regarding the prior authorization process.
  • Developed relationships with external vendors providing pre-authorization services.
  • Identified reasons behind denied claims and worked closely with insurance carriers to promote resolutions.
  • Assisted with developing policies and procedures related to prior authorizations.
  • Identified areas where improvements can be made within the department by analyzing trends in denials and approvals.
  • Ensured compliance with state and federal regulations pertaining to prior authorizations.
  • Utilized medical coding knowledge to accurately process and document authorization requests.
  • Communicated authorization decisions, including approvals and denials, to healthcare providers and patients.

Medical Collections Specialist

Winchester Neurological Consultants
Winchester
04.2022 - Current
  • Managed patient accounts for timely collections and billing accuracy.
  • Communicated with insurance providers regarding claim status and requirements.
  • Reviewed patient statements for discrepancies and resolved billing issues.
  • Processed payments from patients and recorded transactions in the system.
  • Collaborated with healthcare staff to obtain necessary documentation for claims.
  • Assisted patients in understanding their financial responsibilities and payment plans.
  • Monitored aging accounts to prioritize follow-up actions for collections.
  • Maintained up-to-date knowledge of healthcare regulations affecting billing practices.
  • Negotiated payment plans with patients based on their financial abilities.
  • Compiled statistical reports regarding outstanding debts and past due payments.
  • Utilized available resources such as credit bureaus and legal services, when necessary.
  • Ensured compliance with applicable laws governing debt collection practices.
  • Trained new staff members on proper procedures for collecting payments from customers.
  • Assisted in the resolution of credit balances due to overpayment or incorrect coding issues.
  • Reviewed and processed patient accounts for collections purposes.
  • Developed strategies for improving cash flow through more effective debt collection practices.
  • Contacted patients via telephone, mail, and email to discuss payment options.
  • Protected medical office operations and integrity by keeping patient information confidential.
  • Took billing calls, questions and concerns from patients and third party carriers.
  • Accepted and processed customer payments and applied toward account balances.
  • Spoke with customers to learn reasons for overdue payments and to review terms of credit contract.
  • Notified credit departments and turned over records to attorneys when customers failed to respond to collection attempts.

Medical Records Specialist

Winchester Neurological Consultants
Winchester
03.2022 - Current
  • Managed patient records using electronic health systems
  • Obtained information by contacting appropriate personnel or patients.
  • Tracked and processed release of information requests.
  • Managed release of information requests and identified requestors as patient, relation or provider.
  • Processed and invoiced records requests from patients, providers and third parties.
  • Ensured compliance with privacy regulations in record handling
  • Trained new staff on record-keeping procedures
  • Streamlined processes for efficient database management
  • Adhered to HIPAA guidelines when handling protected health information.
  • Collected, filed, scanned, and retrieved confidential patient information.
  • Answered inquiries regarding the status of patient records or their availability.
  • Reviewed medical records to ensure accuracy and completeness.
  • Resolved any issues relating to incomplete documentation or coding errors.
  • Provided training on the use of electronic health record systems to staff members.
  • Conducted quality assurance audits of medical records for compliance with state regulations.
  • Scanned documents into electronic health record system according to established procedures.
  • Safeguarded patient records, managing data transfers in compliance with HIPAA standards and organizational regulations.

Medical Receptionist

Winchester Neurological Consultants
Winchester
10.2021 - Current
  • Greeted patients and answered inquiries to ensure a welcoming environment.
  • Managed appointment scheduling and maintained accurate patient records efficiently.
  • Verified insurance information and processed patient registrations promptly.
  • Coordinated communication between patients and healthcare providers effectively.
  • Handled incoming calls and directed them to appropriate departments as needed.
  • Ensured compliance with privacy regulations while handling sensitive patient information.
  • Trained new reception staff on office procedures and customer service best practices.
  • Answered incoming calls, responding to inquiries from patients and other medical offices.
  • Checked patients in and out for appointments and collected co-payments.
  • Managed office phone lines by checking voicemail, returning calls and directing messages to team members.
  • Scheduled and followed up on patient appointments, collected and processed patient payments and maintained patient files.
  • Greeted and checked in patients, updating patient information in computer system.
  • Retrieved faxes and uploaded documents to patient charts to assist clinical staff.
  • Entered insurance, demographics and health history into patient database.
  • Took messages from patients and promptly relayed to appropriate staff.
  • Protected patients by observing strict HIPAA guidelines.

Assistant Manager

Sherbyn’s Lawn and Landscape
Culpeper
07.2017 - 08.2020
  • Managed daily operations, including proposal preparation, payroll processing, and billing oversight.
  • Scheduled and organized employee appointments to enhance operational efficiency.
  • Maintained high standards for production, productivity, quality, and customer service.
  • Achieved revenue targets while ensuring consistent quality goal attainment.

Assistant Manager

Moseley & Associates, LLC
Winchester
06.2013 - 07.2017
  • Oversaw daily operations of three franchise restaurants, ensuring efficiency and profitability.
  • Managed schedules and training for over 30 employees to optimize workforce performance.
  • Maintained rigorous standards for quality control, cleanliness, and safety compliance.

Education

Certified Professional Compliance Officer -

AAPC
03-2024

High School Diploma -

Rappahannock High School
Rappahannock, VA
06.2013

Skills

  • Ability to delegate
  • Effective communication
  • Organizational skills
  • Interpersonal skills
  • Ability to handle pressure
  • Coordination
  • Microsoft Word
  • Microsoft Excel
  • Documentation management
  • Compliance training
  • Record keeping
  • Regulatory compliance
  • Employee onboarding
  • Problem solving
  • Staff development
  • Influencing skills
  • Documentation review
  • Compliance monitoring
  • Compliance procedures
  • Background review
  • Decision-making
  • Legal terminology
  • Training and development
  • Business intelligence
  • Federal and state regulations
  • Policy analysis
  • Attention to detail
  • Team collaboration
  • Policy writing

Certification

  • HIPAA
  • Certified Professional Compliance Officer (CPCO)

Timeline

Compliance Officer

Winchester Neurological Consultants
04.2024 - Current

Hiring Manager

Winchester Neurological Consultants
04.2024 - Current

Prior Authorization Specialist

Winchester Neurological Consultants
08.2022 - Current

Medical Collections Specialist

Winchester Neurological Consultants
04.2022 - Current

Medical Records Specialist

Winchester Neurological Consultants
03.2022 - Current

Medical Receptionist

Winchester Neurological Consultants
10.2021 - Current

Assistant Manager

Sherbyn’s Lawn and Landscape
07.2017 - 08.2020

Assistant Manager

Moseley & Associates, LLC
06.2013 - 07.2017

Certified Professional Compliance Officer -

AAPC

High School Diploma -

Rappahannock High School

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Casey Fletcher