Management Manager

Cynthia Borders

**** *. **** **. • Los Angeles, CA 90043 • **********@***.*** • (323) - 632-1486

TARGET: Director, Billing and Collections

CAREER PROFILE

• • •

Claims Processing Compliance HIPPA Practice Management

• • •

Account Receivable HMO / PPO / POS Claims Auditing /Quality Assurance

• • •

Physician Credentialing Data Entry/Coding Account Reconciliation

• • •

Credit & Collection Medical Terminology CMS – Medicare Regulations

• • •

Oncology Medical/Radiation Customer Services/Call Center Credentialing – Acquisitions

SUMMARY OF QUALIFICATIONS

• Developed corporate protocol for work allocation, to ensure policies and procedures were in compliant with,

state, or federal agency.

• Results-driven in supporting complex, strategic strategies which are implemented at the functional level.

• Promoted to management from within including A/R and MD Credentialing.

• Designed and implemented monthly billing and collections reports critical for month end financial reporting.

• Orchestrated claims procedures including, claims adjudication, check reimbursement, EOB’S, remittance

processing, daily, weekly and monthly insurance communications relating to benefit and pricing.

• Credited with implementing innovative strategies and procedures that are organization specific.

• Responsive to demanding environments that lead to improved business strategies and accomplishments.

• Proficient at healthcare accounting: cost reporting, reimbursement, general accounting, budgets and forecasts.

• In-depth knowledge of state and federal regulations pertaining to healthcare reimbursement.

CAREER ACHIEVEMENTS

• Supervised comprehensive marketing and business development campaign to revitalize existing client

relationships recapturing more than 60% of lost business within four months.

• Designed and implemented a strategy which consistently surpassed all credit and collection targets, minimizing

DSO from 125 to 60 days or less and sustained the levels.

• Managed an administrative program which reduce redundancy, streamline processes, and improve operations.

• Reduced personnel turnover by 60% through improved internal training efforts and improved relationship with

Human Resource.

• Reorganized customers service call center and improved customers service from 70% to 95%.

• Phenomenal performance results due to changed Internal Audit’s, perception from historical “police” function

into a business partner, working cooperatively with management teams to achieve financial, regulatory and

operating goals.

PROFESSIONAL EXPERIENCE

MANAGER, PATIENT ACCOUNT SERVICES & PHYSICIANS CREDENTIALING 2008 -

PRESENT

VANTAGE ONCOLOGY, MANHATTAN BEACH, CA

• Provide strategic direction in support of facility revenue related initiatives and goals. Provide leadership,

coordination and subject matter expertise across all components of the revenue cycle.

• Responsible for overseeing activities of the (CBO) Central Billing Office of (45) forty-five employees.

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• Direct and manage all aspects of physician revenue billing cycle, including the development and maintenance of

internal and external client relationship.

• Provided administrative oversight and guidance for the effective operation of the revenue cycle which provided

(10) ten-million dollars to ensure adherence to governmental and other third-party contract guidelines.

• Acts as a liaison between (CBO) Central Billing Office, Center Mangers, Directors and Vice President for (29)

twenty nine centers throughout the nation.

• Responsible for the timely submission of credentialing applications for (242) two hundred forty-two physicians.

• Manage corporate and branch offices, nationwide, credentialing staff.

• Improved tracking and quality processes.

• Conducted research, analysis, and submission of applications for new group acquisitions in multiple states.

• Working with business office staff and management to identify issues or trends with regards to billing/appeals

DIRECTOR, PATIENT BUSINESS SERVICES 1991 -

2008

AMERICAN MEDICAL RESPONSE (EMS), TORRANCE, CA

• Established 360 annual review process and skill assessment testing which yielded teams that consistently

exceeded goals for productivity, efficiency, and quality of operations.

• Created an intricate and detailed scope month-end closing budgets and schedules as well as insure adherence to

project schedules while aggressively monitoring projects and reallocate resources to avoid budget or schedule

variances.

• Established continuous improvement and quality management program, amid at the billing office and all

operating locations producing results of a 35% increase in daily production yields, 25% reduction in missing

Patient Care Reports monthly, and 52% in customer’s satisfaction.

• Effectively supervise activities for more than 150 personnel members amid 6-service department.

• Minimized company credit balance from $6 million to $2.5 million with-in 6 months, reorganized and tightened

the company’s cash management policy to ensure cash requirements.

• Restructured customer services operations and designed/implemented policies procedures and processed that

improved internal and external customer services, reduced outstanding debt and strengthened bottom-line

profitability.

• Demonstrated success in diminishing costs 25% while maintaining high quality via resolving long-standing

issues impacting employee retention and interaction

• Restructured patients accounting operations and designed/implemented policies, procedures and processes that

improved collections reduced outstanding debt and strengthened bottom-line profitability.

MANAGER, BUSINESS OFFICE, EATING DISORDER UNIT 1987 - 1991

MEDICAL CENTER OF NO. HOLLYWOOD, HOLLYWOOD, CA

• Manage all operations within the Accounts Receivables Management Division, sets overall goals, and monitors

adherence to all accounting procedures, practices, and compliance regulations to ensure the highest quality

efficiency of workflow.

• Experienced in hospital patient account system, calculating managed care reimbursement contracts, working

knowledge of electronic billing media and date elements including UB92 and HCFA 1500 forms.

• Review and approves proposed work plans, system strategy, project staffing and initial assignments processing

for all new (clients) patients.

• Established and maintains ongoing, effective client relations, Work in coordination with the Management team,

and President in the sales and public relations of potential clients.

• Recommends policies and procedures, guidelines and operating standards as needed and appraises monthly status

on projects and operations to the corporate office.

• Manage financial planning operation for the eating disorders units, in-patients, and outpatients.

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EDUCATION AND TRAINING

BACHELOR OF ARTS

University of Chicago IL. 1976

Major: Business/History 3.0 GPA in field of concentration

TRAINING, CERTIFICATIONS, LICENSES, AND ACCOMPLISHMENTS

• HBMA – Healthcare Billing and Management Association

• AMA - American Management Association

• EARMA – Educational Accounts Receivable Management Association

• Employee and Management Communications Training – Franklin Covey 2006-2007

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