EXECUTIVE PROFILE:
A healthcare management professional with extensive amount of
experience in the industry. Areas of expertise
include Big 5 consulting experience in revenue cycle best
practice/process improvements, project management,
financial profitability, IT conversions and physician
practice/hospital operations.
ACCOMPLISHMENTS:
. Exceeded contractual financial expectations, P&L management of $4
million engagement, achieving 42% profit margin. Successful,
consistent achievement of established service level agreements
resulting in corporate gain share and increased cash flow for
client.
. Exceeded monthly collections goals, achieving 111% of goal.
Maintained 34% profit margin.
. Reduction in Days in AR from 63 to 32, Percentage of Net
Collectible Revenue ranged from 98.5% to 108%, DNFB reduced from 17
days to 2 days.
. Developed hospital compliance policy and program for billing/coding
and charge capture.
. Recognized for outstanding achievement in reducing aged accounts
receivable by nearly six million dollars in a four-month time
period.
. Identified Medicare fraud/abuse issue resulting in self-reporting
process for coding/billing errors and auditing of charts, avoiding
millions of dollars in fines.
PROFESSIONAL EXPERIENCE:
NextGen Practice Solutions, Senior Account Manager-Large Clients
. Guide the successful project management and implementation of physician
and hospital practice revenue cycle and EMR services with key clients in
various locations nationally.
. Manage, coordinate and interact with BPO partners to assure
successful offshore outsourcing of revenue cycle services.
. Work with all staff and management to develop polices and best
practices and procedures for overall division financial and
operational improvement.
The Outsource Group, Director of Operations
. Managed staff of 100+, providing Early Out and Bad Debt medical
accounts receivable collections in call center environment
requiring multiple client project plan management strategies.
. Provided strategic operations leadership by developing policies and
procedures to ensure maximum operational efficiency and compliance
with government regulations and managed care contracts.
. Established KPIs and identified performance trends and risks.
. Served as Revenue Cycle SME for hospital clients
Dell/Perot Systems Healthcare, Revenue Cycle Director/Client Executive
Servicing Forest Park Hospital and St. Anthony's Medical Center
. Project management of Patient Access Department, HIM Department
and Business Office staff of 65 FTEs
. As on-site client executive, managed client relationship with
hospital staff, physicians and administration including
implementation of projects to improve efficiencies, increase cash
collections and reduce days in A/R and DNFB.
. Monitored key indicators related to registration errors, billing
errors, denials, collection agency issues, cash and contractual
applications, bad debt, and charity care. Developed and produced
monthly reporting tools.
Sanford-Brown College, Adjunct Faculty Member (part-time as part of
SSM leadership)
Working in tandem with SSM as part of leadership program
. Provided education in the area of medical billing, coding, claims
submissions and computer technology.
. Facilitated education and training regarding regulations and payor
requirements.
SSM Healthcare-St. Joseph Hospital of Kirkwood, Director of Revenue
Management
. Revenue cycle management included coding, billing, patient
registration, insurance verification and pre-certification and
HIPPA compliance.
. Oversight of the Charge Description Master Team (CDM)-included CPT,
HCPCS and revenue codes, DNFB and claims denials management team,
member of CQI team.
. Responsible for conversion of information system in all patient
financial services areas.
Aviant Group, Contract Consultant
Business Analyst -Anheuser Busch
. Documented for audit, the payroll system,
including all schemas, interfaces and data
flows.
. Worked closely with managers and programmers to
define current workflow processes.
Business Analyst - BJC Hospitals
. Managed and supported information technology projects focused on the
implementation of hardware, operating systems and
applications within the healthcare industry.
. Developed documentation for training and educational purposes.
. Liaised with managers, financial analysts, programmers and end-users
including physicians and hospital staff to define, build, test
and implement technical solutions.
. Assisted in implementation of surgical suite computer system and web-
based physician scheduling tool.
Washington University School of Medicine, Billing Operations Manager
. Analyzed physician billing procedures to ensure proper reimbursement
for services totaling sixty
million dollars in charges, annually.
. Assisted with strategic planning, budget preparation and
managed care contracting.
. Reviewed fees, managed CPT and ICD-9 coding processes and RVU
calculations.
. Oversight of physician billing team, including
the coding, data entry and collections staff.
Ernst and Young, LLP, Senior Healthcare Consultant
. Project management of revenue cycle and performance improvement
engagements, identifying cost savings opportunities.
. Assisted with proposal writing and due diligence as part of sales
pursuit team.
. Provided interim business office management at client sites,
developing best business practices.
EDUCATION:
. Currently pursuing Master's Degree, Management, Webster
University, St. Louis, MO
. Bachelor of Science Degree, Business Administration/Political
Science, South Dakota State University, Brookings, SD
COMPUTER SKILLS:
. Software: Word, Project Manager, WordPerfect, Lotus 1-2-3,
Excel, Lotus Notes, GroupWise, Remedy, PowerPoint, Kronos, SAP,
Outlook, Access, Visio and Interface Integration
. Platforms: Novell, Windows 98, Windows 2000, Oracle and UNIX
. Healthcare specific systems: IDX, SMS, MEDITECH, Medical
Manager, MediSoft, SSI, NEBO, 3M Grouper, IMACs, McKesson
Gateway EDI, HBOC Star, McKesson HBOC Orbit and HL7 interface