About The Instructor
Jessika is an experienced healthcare internal audit manager in the Risk and Advisory practice. Based out of the Tampa office, Jessika has over 9 years of professional experience providing operational, financial, regulatory consulting, and outsourced and co-sourced internal audit services. She has extensive experience in evaluating the effectiveness of compliance programs for various health care organizations, managing the internal audit function (both fully outsourced and co-sourced) for various healthcare organizations, performing revenue cycle audits (including billing, collections, denials and claims review), comprehensive operational reviews, and HIPAA privacy assessments.Jessika has provided healthcare internal audit and other financial support services, which have included the following:
• Operated as the interim VP of Compliance for a health care client. Overseeing the compliance function which included: reviewing compliance policies and procedures, managing the investigation of reported privacy incidences, training management on compliance, and evaluating vendors for HIPAA compliance.
• Managed the internal audit function for multiple health care systems. Responsibilities included, performing the annual risk assessment to identify organizational risks, developing the internal audit plan, executing audit projects, and reporting audit results to the audit committee. Health care clients include:
• An integrated healthcare system comprised of 3 medical centers, long term care facilities, and hospice center with over 900 beds, 6,000 employees and 500 physicians on staff. Managed the Internal Audit department on a fully outsourced basis.
• A non-for-profit health network comprised of 7 hospitals with over 931 acute license beds, 750 physicians, and more than 8,200 employees. Managed various Internal Audit projects on a co-sourced basis and reported monthly to the CFO. Projects included physician compensation review and evaluating cash reconciliation / cash management process.
• A non-for-profit hospital with over 600 beds and 5,500 employees. Managed the internal audit department on a co-sourced basis.
• Led compliance program assessments for several large healthcare systems which focused on evaluating the effectiveness of the compliance program, evaluating the maturity of the program and providing best practices, where applicable, to further advance the program. Specifically, the programs were evaluated using the “Seven Elements of an Effective Compliance Program” as defined by the OIG, based on criteria adopted by the Federal Government under Federal Sentencing Guidelines for Organizations.
• For several major health care systems, evaluated the sufficiency of oversight programs in place for promoting, monitoring, and enforcing compliance with regards to safeguarding Protected Health Information (PHI), specific to the HIPAA/HITECH Privacy regulations as defined by the U.S. Department of Health and Human Services (HHS) and enforced by the Office for Civil Rights (OCR). Specifically, interviewed key departmental personnel responsible for HIPAA/HITECH privacy compliance, identified risks that may occur during the process and identified and evaluated the design effectiveness of existing controls to mitigate these risks, performed testing, as appropriate, to validate compliance with regulatory requirements and internal policies and procedures, and identified process gaps and weaknesses and provide recommendations and alternative solutions for improvement.
Professional Certifications, Affiliations, & Education
• Certified in Healthcare Compliance (CHC)
• Institute of Internal Auditors Member
• HCCA Member
• Bachelor of Science, Accounting, University of South Florida