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Project Manager Management

Location:
Saint Louis, Missouri, 63129, United States
Posted:
March 28, 2011

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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



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