Gastro Health

Compliance

• Day-to-day management and oversight of Gastro Health’s Corporate Compliance and Privacy Programs
• Support the Chief Compliance & General Counsel in implementing and maintaining a robust compliance framework
• Serve as a trusted advisor to leadership and staff on compliance, privacy, and ethics matters
• Manage the daily operations of the Compliance and Privacy Programs, including monitoring activities, training, auditing, and investigations
• Oversee the administration of compliance policies, procedures, and protocols to ensure effectiveness and alignment with regulatory requirements
• Lead internal compliance monitoring and auditing activities to identify risks, trends, and areas for improvement
• Oversee HIPAA compliance, patient privacy incident investigations, breach response, and privacy-related training
• Conduct and oversee investigations into compliance and privacy concerns, document findings, and recommend corrective actions
• Develop and deliver compliance education and training programs for physicians, staff, and leadership
• Monitor changes in healthcare laws and regulations and assess their impact on company policies and practices
• Support regulatory reporting obligations, including state and federal privacy breach notifications
• Partner with operations, HR, IT, revenue cycle, clinical leadership, and other stakeholders to identify and mitigate compliance risks
• Collaborate with outside counsel, consultants, and regulatory bodies as needed
• Prepare compliance reports and updates for the Compliance Committee and senior leadership
• Promote an ethical culture consistent with Gastro Health’s mission and values

Director of Compliance

General Counsel

• Lead legal support for acquisitions, affiliations, and joint ventures involving physician practices and related entities.
• Draft, review, and negotiate a wide variety of complex healthcare and corporate transaction documents, including purchase agreements, management services agreements, employment agreements, governance documents, and related contracts.
• Provide practical, business-oriented legal advice to the development team and executive leadership regarding deal structure, regulatory risk, and transaction strategy.
• Collaborate cross-functionally with finance, operations, compliance, HR, and integration teams to support successful transaction execution and post-closing integration.
• Manage outside counsel in connection with M&A and other strategic transactions.
• Assist with due diligence processes, including regulatory, corporate, and contractual review.
• Support business stakeholders in negotiating key economic and operational terms.
• Ensure transactions comply with healthcare regulatory requirements, including fraud and abuse, anti-kickback, Stark Law, and HIPAA.
• Contribute to the continuous improvement of legal processes, templates, and playbooks for M&A transactions.
• Assist the General Counsel on complex or enterprise-level legal matters as needed.

Senior Corporate Counsel

Collections

• Provides Liaison between the providers of health care services, the patient, or other responsible persons, and revenue sources, to ensure the correctness of charges, a current record of all transactions, and account resolution Maintains active communications with insurance carriers and third-party carriers until account is paid. Negotiates payment of current and past due accounts by direct telephone and written correspondence. Updates patient account information Monitors and identifies payer denial trends and problem accounts; communicates patterns to supervisor. Runs a monthly aging report based on DOS and current A/R to identify accounts that require follow up. Manage all assigned worklist on a daily basis for assigned insurances. Utilize collection techniques to resolve accounts according to company’s policies and procedures. Report any coding related denial to the Coding Specialist. Performs other duties including but limited to faxing information as required, generating retroactive authorization requests, and verifying medical eligibility. Conducts necessary research to ensure proper reimbursement of claims. Assist with special projects assigned by Billing Manager or Supervisor

Insurance Collections Specialist

Manager

• Plans, directs, and evaluates nursing care and functions in accordance with established philosophy. Maintains documentation and improves services in accordance with written policies and in compliance with various city, state, and federal regulatory and accrediting agencies for the operation of the Endoscopy Center. Provides leadership while demonstrating communication and management skills that assist in the coordination of patient care. Relates effectively with other personnel for continuity of care; maintains satisfactory relations with others, participates in all phases of education, maintenance of records, and upgrading of policies, procedures, and skills of personnel. Translates the company’s policies and procedures to employees, patients, family members, medical partners, vendors, and governmental agencies as necessary. Participates in QA activities and benchmark studies. Serves as liaison between physicians and staff. This includes leading monthly Board Meetings, quarterly CQI meetings, quarterly safety meetings, and meetings as needed. Works in partnership with Human Resources for interviewing, hiring, orientation, and training of clinical staff. Responsible for staff wage and salary administration, motivation, corrective action, and performance appraisal. Evaluates staff performance/competency and provides opportunities for staff development based on results. Develops and produces accurate and timely reports, including reports on statistics, audits, adverse events, patient surveys, patient complaints/grievances. Creates and manages staff and MD schedules. Manages purchasing and maintenance of all equipment in the ASC. Must be competent with all staff roles (pre, intra, post-procedure, scope room) within the Endoscopy Center and be able to move in and out of these roles as needed due to staffing issues. Responsible for reviewing, editing, and writing Policies and Procedures of the Center. Recommends edits to the Board as needed. Direct Supervisory Responsibility: Carries out supervisory responsibilities in accordance with the organization's policies and applicable laws. Responsibilities include interviewing, hiring, and training employees; planning, assigning, and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems.

Endoscopy Nurse Manager

Implementation Specialist

• Participates in EHR implementations involving planning, workflow analysis, configuration design and training of EHR (electronic health record) software application
• Delivers on set deadlines, assigned responsibilities, and monitors and summarizes progress of multiple projects in unison
• Configures database set up to include providers, facilities, users, documentation templates, letters, and any other clients business requirements based on analysis of legacy systems and information provided by stakeholders
• Provides direction to training partners assisting with end user training and on-site go live support
• Delivers exceptional on site and remote support being viewed as a subject matter expert by displaying in depth knowledge of Gastro Health workflows, policies, and system configurations
• Assists with the creation and maintenance of the computer-based learning management system
• Develops training courses, training videos, end user role-based reference manuals and workflow guides and prepares appropriate training and presentation materials and agendas
• Supports end users onsite and remotely during Go-Live of the EHR
• Resolves and monitor concerns raised during implementation and integration and escalates appropriately
• Assists with the creation and maintenance of project-related documentation
• Trains personnel by conducting formal in-classroom trainings, workshops, seminars, and remote webinars
• Edits and updates functional descriptions, system specifications, educational materials, special reports, or any other project deliverable or documents
• Conducts research to ensure the use of proper technical terminology
• Translates technical information into clear, readable documents to be used by technical and non-technical personnel
• Provides on-call coverage and performs other duties that support the project as needed

Director of Compliance

Senior Corporate Counsel

Insurance Collections Specialist

Endoscopy Nurse Manager

Health Informatics Implementation Specialist