Ahead of the healthXchange Revenue Integrity: Optimizing Compliant Reimbursement meeting taking place March 26th, we had the chance to sit down with Heather Harris, CPC, CGSC, CHONC, CPMA to discuss details of her career journey and current priorities at Sarasota Memorial Hospital.
Tell us about your professional background; what motivated you to start working in the healthcare industry, and what are some of the roles you’ve enjoyed in your career thus far?
I come from a family involved with medicine; my mother was a geriatric nurse, and my father an EMT. I aspired to be a pediatrician, but in college, found that I had a greater interest in psychology.
For 5 years, I worked with at risk youth, and when a front-desk position opened up with a medical oncologist, I joined the team and learned about coding, finding a real passion for it.
From there, I moved to code professionally for 3 medical oncologists and a surgical oncologist, as well as obtaining all authorizations for both medical and radiation oncology, including my CPC, CGSC, and CHONC certifications.
I was then promoted to a coding and training manager position where I was introduced to auditing medical charts for compliance audits. While in that position, I obtained my CPMA in order to assist with my duties. I then became a regional director for the 5 hospitals and led a team of coders and assisted with audits for our providers. The coding and auditing team evolved under a corporate structure where I then oversaw a team of 17 auditors supporting nearly 3,000 providers.
We auditing and assisted with new provider review, pre-bill audits, and worked closely with compliance for the various regions.
I then moved to the hospital side, working with revenue integrity and entering charges for ECC visits as well as resolving billing and coding edits and procedures.
In your current position as a Senior Revenue Integrity Analyst at Sarasota Memorial Hospital, what are your main goals or priorities for you and your team as you look towards the year ahead?
As a department, we are working to ensure documentation is appropriate for our high dollar and highly utilized departments. We also make sure that medical necessity is met and any prior authorization is obtained prior to the procedure date. Reviewing accounts that appear on our RAC reviews to identify any preventative measure that can be put into place, or where additional documentation can be provided is also a priority as we look to mitigate future risk. Recently, we have also implemented a new work group consisting of various revenue cycle leaders reviewing upcoming CMS guidelines.
We are looking forward to having you join us during our Revenue Integrity meeting on a panel that will address Internal Claims Auditing. Can you share one issue that you’re looking forward to discussing with the panelists and audience during the session?
Collaboration with various revenue cycle departments to ensure CMS and other payer regulations are met.
Thank you so much Heather, for sharing your professional background, more details on your current work, and what you’re looking forward to discussing during the upcoming meeting. We appreciate your support of this meeting and look forward to the panel on Internal Claims Auditing on March 26th, 2024.