Customer Service Project Manager

SURAJ AGBOKE

**** ******* ****** **, *********** New Mexico 87121

505-***-****, e-mail: *******@*****.***

SUMMARY

Healthcare executive with substantial, progressive revenue cycle management

experience for hospitals, ambulatory clinics and multi-specialty physicians

practices in the areas of Patient Access, Business Office, charge capture,

CDM maintenance, health information system, HIPAA regulations,

credentialing, managed care contracting, financial management, budgeting

and business development.

Major strengths include:

1. Organization start up, turn around, system conversion, updates and

implementations.

2. Process improvement techniques using Lean, Six Sigma and other

approaches.

3. Financial Operations: G/L reconciliation to BAR module, A/P, payroll,

and auditing.

4. Accounts receivable management/financial analysis reporting and

budgeting.

5. Staff development, conflict resolution, problem-solving, listening,

training, mentoring, delegation, patient, vendor and fiscal

intermediaries' interactions.

6. Medicaid, Medicare reimbursement, regulatory and compliance issues;

e.g., RAC. Familiarity with acute care, sub acute care, Critical Access

Hospital (CAH), Rural Health Clinic (RHC), Indian Health Services (IHS),

Long-term Acute Care (LTAC), Behavioral Health, Psychiatric, and Dental

facilities.

7. Cost reporting compilations, coding, charge master maintenance, rates

modeling, charge capture and verifying medical necessity with case

management.

8. Coordinating denial management team with all stakeholders.

PROFESSIONAL EXPERIENCE

PRESBYTERIAN HEALTHCARE SERVICES, (PMG CLINIC), Tucumcari, New Mexico.

Practice Administrator, November, 2011 - Present.

Responsible and accountable for all administrative aspects, customer

services and financial performance of Family practice, Surgery, Behavioral

health, Diabetes education, Rehabilitative clinics, and Employees health.

Leads strategic, tactical, CQI planning and all revenue cycle operations.

Oversees implementation and ongoing measure of same. Directs clinical and

non-clinical staff to include: providers' recruitment, contracts, and

compensation. Collaborates with hospital administrative, ancillaries, and

clinical directors to ensure clinics provide high quality, cost-effective

care. Responsible for the business development, strategies and community

outreach programs.

Responsible for both operation and capital budgets. Reviews and analyzes

daily, weekly, monthly and yearly financial analysis reports, provider's

monthly productivity by RVUs, other dashboard or key performances

indicators and other assigned duties or special projects. System Used: EPIC

Prof- Billing &Cadence Enterprise Scheduling, 3M Code Finder, Ingenix,

Caremedic, and HPF.

SOA HEALTHCARE FINANCIAL MGMT. SERVICES, Albuquerque, New Mexico.

Revenue Cycle/Patient Financial Services Consultant, January 2011 -

October, 2011.

Independent contract work for various Hospitals, Clinics and, Physician

groups providers.

I am currently assisting hospitals to get ready for HIPAA 5010 EDI

transactions codes and ICD-10, CM and PCS. Other engagements involved

renegotiating managed care contracts and evaluating entire revenue cycle

processes for physician groups.

MINERS' COLFAX MEDICAL CENTER, Raton, New Mexico

Chief Revenue Cycle Officer, February 2010 to January 2011.

Responsible for the daily directing, planning, and evaluation of this

State owned hospital and long-term acute care entire operations of Patient

access, Business office, Charge capturing, Chargemaster, Medical records

(HIM), Information technology (IT), Managed care contracting, vendors and

payers interactions, process improvement and implementations. Initiate

special projects and management. Coach and develop staff as needed to

enhance the revenue cycle initiatives. Demonstrate consistent standard of

excellence based on establishing and maintaining constancy of purpose,

focus on continuous improvement, collaborating with all stakeholders, and

delivering the highest degree of quality service possible. Achieve annual

and periodic statistical goals of revenue cycle performance indicators and

overall financial performance of the organization. Report to the CEO and

CFO. System Used: Healthland, SSI and Caremedic.

SOUTH TEXAS SURGICAL HOSPITAL, Corpus Christi, Texas

Director of Patient Financial Services, August 2009 to January 2010

As a start-up operation, I was responsible for the Patient Access, Business

Office and Medical Records departments operations. I worked closely with

the Meditech Project Manager and with the Vendor (Meditech) to set up all

parameters, tables and dictionaries for BAR, ADM, HIM, and ABSTRACT

modules. I also worked closely and assisted with Pharmacy and Materials

Management modules as well. I created the new chargemaster, for all

departments, charge capture processing, working with other revenue-

producing directors, like nursing, OP, pharmacy, materials management to

establish charging processes. Worked closely with the CFO and the then CEO.

I developed policies and procedures for the Admission, Business office and

Medical Records departments. I hired and trained new staff for these three

areas of revenue cycle. Assisted in getting ready for JCHAO survey and

passed within three months of preparations. Assisted with getting new

Managed Care contracts and worked on other assigned special projects.

System Used: Meditech- ADM, ARM, BAR, GL, MM, ABS and HIM Modules.

SOA HEALTHCARE FINANCIAL MGMT. SERVICES Albuquerque, New Mexico.

Revenue Cycle/Patient Financial Services Consultant, May 2007 - July

2009.

Independent contracted work for various hospitals, physician groups,

clinics, and dental services, DME, HME, laboratory & imaging center,

nursing home and home health agency providers. Performed education and

training in patient registration, admission, pre-certification, upfront

cash collections, billing, collections, appeals, regulations & compliance

issues and cash posting. I resolved delinquent or denied claims from

various payers such as Medicare, Medicaid, indemnity, managed care,

workers' compensation, auto-accident, victims of violent crimes and self-

pay. I prepared monthly and annual financial analysis reports. Charge

master reviews for accuracy. Brought the A/R days down from 108 days to 57

days, resulting in additional revenue on several occasions. Developed

policies, procedures and revised employees' job descriptions.

Recommended and coordinated system conversion, implementation and training

with IS department. Analyzed monthly estimates of contractual allowances,

bad debt and other billing auditing projects. System used: Meditech, LSS,

McKesson HBOC, PCON, IDX, SMS, HMS, EPIC (Spring07), SIEMENS Med Series 4,

SSI, E-Premis, Medifast, and Med Mgr.

REHOBOTH MCKINLEY CHRISTIAN HEALTHCARE SERVICES Gallup, New Mexico.

Director of Patient Financial Services, September 2006 - May 2007.

I was responsible for the hospital, physicians and clinics Patient Pre-

Registration, Verifications, and Admissions processes. I implemented

process improvement initiatives teaching how to collect all patients'

portions upfront and financial counseling. I oversaw charge capture,

coding, chargemaster, rate modeling, credentialing, billing, collections,

cashiering & cash posting, managed care contracting, negotiations,

implementations, and monitoring. I worked closely with payers Utilization

Review. I coordinated denial management team, system updates. I coached,

mentored, and resolved conflict. Responsible for counseling, hiring, firing

and several other special projects to enhance bottom-line. I presented

monthly revenue cycle dashboard and report cards to senior management and

finance committee. I stayed abreast with all compliances and regulations

affecting the entire revenue cycle and made appropriate changes as

necessary. Assisted patients with concerns and complaints and promoted good

customer service with patients and staff. Increased upfront cash

collections within three months of hire by 147%. Overall monthly cash goals

were met on several occasions. System used: Meditech, LSS and SSI (all

applicable modules)

CHRISTUS SCHUMPERT HEALTH SYSTEM, Shreveport, Louisiana.

Patient Access System Director, February 2006 - September 2006.

Responsible for the entire operations of three hospitals and physicians'

patient access functions. I oversaw Patient Pre-Registration, Pre-

Verification, Pre-Authorization, Admissions, financial counseling, and

upfront cash collections and appeals on delinquent accounts. I worked

closely with the Business Office, Medical Records, Case Management and

other revenue-producing department heads. I implemented several revenue

cycle enhancement initiatives, like collecting from Inpatients before they

are actually discharged. I worked with several payers, like Medicare,

Medicaid and managed care companies to resolve denied claims. Supported and

utilized Six-Sigma process improvement in place. I maintained several

scripts to improve upfront cash collections and customer service

satisfaction goals. I mentored, coached, listened, resolved conflicts and

acted as resource to employees. Assisted patients with concerns and

complaints and promoted good customer service. System used: McKesson.

SOA HEALTHCARE FINANCIAL MGMT. SERVICES, Houston, Texas.

Revenue Cycle/Patient Financial Services Consultant June 2001 - January

2006

Served as interim Director of PFS, Business Office and Patient Accounts for

several hospitals. Responsible for the entire operations of the hospital,

physicians, dental services and clinics' scheduling, patient access,

business office and charge master maintenance. Worked closely with medical

records and the medical staff to ensure charges capturing, coding and

reimbursement are accurate. Coordinated implementations and training of

electronic claims submissions between staff, vendor (SSI) and all types of

payers. Maintained new providers' information, credentialing, charges, and

claims dictionaries input into the system. I increased cash collections by

$300,000 within three months. Worked rigorously to get hospital in

compliance with new CMS HIPAA standardized transactions code setting.

System used: Meditech and SSI

BEAUFORT MEMORIAL HOSPITAL, Beaufort, South Carolina.

Director of Patient Financial Services, August 2000 - May 2001

Responsible for managing the entire operations of patient access and

business office, for the hospital and the ER physicians. These included:

accounts receivable management, reimbursement, regulations and compliance

issues, charge master maintenance, monitoring and implementing managed care

contracts and assuring patient satisfaction with billing process. Audited

and monitored all DRG and APC reimbursements. Mentored, coached, provided

resources to employees as needed. I presented financial analysis reports on

a monthly basis to the Finance Committee. On several occasions, I had

demonstrated exceptional skills in reducing A/R days and bad debt.

Implemented new improvement process of ensuring accurate demographic

information collected at time of registration and improved up-front cash

collection resulting in an increment of 250% of money collected at time of

admission. Negotiated and able to recover full payments from several third-

party insurance re-pricing carriers. Prepared department budget, modified

policies and procedures as needed. Assisted patients with concerns and

complaints and promoted good customer service with patients and staff.

System used: Meditech.

CENTRAL GULF MENTAL HEALTH/MENTAL RETARDATION COMMUNITY SERVICES, Richmond,

Texas.

Reimbursement Director, March 1998 - July 2000

Responsible for all operational functions of the accounts receivables and

reimbursement for six counties to include: billings, collections, and

managed care contracting. Supervised the implementations and training

during system conversion. Monthly, quarterly and annual financial analysis

reports preparation and fiscal revenue forecast, projection and budget.

Supervised coding, master charge entry, regulations & compliance issues and

setting fees. Developed and modified department policies and procedures.

Conducted employees' annual reviews and other performance measures.

Responsible for the performance of credentialing processes of physicians

and other providers with various Managed Care payers. System used:

Anasazi.

SOA Healthcare Financial Services, Houston, Texas.

Reimbursement Consultant/Financial Analyst, June 1990 - February 1998

Performed revenue cycle initiatives for various hospitals, clinics,

physician groups, like coding, charge capture, and billing & collections

activities. Initiated surgical appeals, negotiations and recommended write-

offs when necessary. Audited and reviewed month-end financial analysis

reports, supervised front desk personnel regarding patient registrations,

insurance verifications and all inquiries pertaining to patients' accounts.

Worked directly with patients, other departments, physicians, outside

providers, vendors, and payers. System used: Meditech, IDX = Bar module and

P.C.S.

THE METHODIST HOSPITAL, Houston, Texas.

Billing and Collection Associate, August 1981 - May 1990

Managed patients' collections and billing to include all simple, major and

ancillary charges, electronically and manually. I managed all daily

deposits, payment posting, and monthly estimates of contractual allowances.

Audited and reviewed other financial analysis report using spreadsheets.

Responsible for maintaining insurance master dictionary, charge master

files, and patient demographic information in the system. System used:

HBOC.

EDUCATION

Texas Southern University, Houston, Texas: 1987 Bachelor of Business

Administration, Major: Economics, Minor: General Business.

University of Houston, Main Campus: 1990

Continuing Professional Education (Accounting courses)

University of New Mexico, Albuquerque, New Mexico: 2008 Human Resources

Management in Public and Private Sectors (Non-Degree Graduate Course)

US Army-Reserve: 1988 through 1995, Honorable discharge.

PROFESSIONAL LICENSE/ORGANIZATIONS MEMBERSHIP

Healthcare Financial Management Association. (HFMA)

American Association Healthcare Administrative Management (AAHAM)

American Academy of Professional Coders (AAPC)

Texas Board of Insurance: Type III Workers' Compensation Liability &

Adjuster

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