Sharmil McKee, J.D., M.B.A

Sharmil McKee is a dynamic and results-driven compliance officer bringing over 15 years of experience focused on the healthcare industry, federal contracts, and grants.  She partners with business leaders to hit goals in an ethical and legal way. She is a skilled former attorney who can create and nurture a compliance-driven culture while maintaining company profits.  She has extensive knowledge of CMS regulations, HIPAA, HITECH, False Claims Act, the U.S. Sentencing Commission Guidelines, FAR, and DFARS.  She is an expert in creating and implementing policies, training, procedures, and controls to mitigate compliance risks.
 
Key Successes: 
 
·         Drafted written compliance policies and/or procedures to comply with DOJ’s Sentencing Commission and passed an OIG Audit. This allowed the hospital to retain millions of dollars of medical claims paid over the past 7 years.
·         Contested and reversed a denied claim of $100K from a health insurer which resulted in saving the hospital $75K
·         Developed a comprehensive training program that individually catered to all hospital staff and their role in compliance. This training program boosted compliance training participation from 30% to 85%.
·         Devised and implemented a systemic training campaign to teach all staff how to document evidence of medical necessity.
·         Developed and operationalized an auditing procedure with controls to prevent submitting claims that lacked complete documentation, which resulted in payor rejections rates dropping from 60% to 30%.