Manager Customer Service
Resume:
SUSAN ROLAND
Oro Valley, AZ *****
Education/Certifications
B.S. National College Business Administration 1987
A.A. National College Computer Science 1983
Career Skills
Management A/R Reduction Project Management
Negotiation Leadership/Supervision Budgeting
Contracting Teamwork Process Analysis
Auditing Public Speaking Strategic Analysis/Planning
Policy, Procedure & Staff Development
Work Experience
UNIVERSITY PHYSICIANS HEALTHCARE -Tucson, AZ
June 1, 2009 to present
Senior Contract Negotiator
The position is responsible for negotiating the contracts to include RFP's
for 400+ Multi-Specialty Physicians affiliated with the University of
Arizona College of Medicine, DME, Behavioral Health Facility and Academic
Hospital services. Responsibilities include developing and maintaining a
comprehensive partnership with payers, providers, employers and others
through a contracted network to serve the health care needs of the
community.
RENOWN HEALTH / HOMETOWN HEALTH PROVIDERS-Reno, Nevada
December 31, 2007 to May 30, 2009
December 30, 2009 to May 30, 2009
Manager of Contract Management
The Manager of Contract Management is responsible for developing and
maintaining a comprehensive partnership with payers, providers, employers
and others through a contracted network to serve the health care needs of
the network's clients. This position is responsible for ongoing management
and implementation of new and existing contracts and is accountable for
contract performance per its terms and conditions. This position insures
all payer agreements are monitored, benchmarked, intervened upon if
performance degrades and manages to assure maximum performance for the
Health System. Negotiate letters of agreements with non-contracted payers.
Manager, Government Programs
December 31, 2007 to December 29, 2008
Renown is Northern Nevada's largest non-profit health care network
comprised of 4 hospitals, 8 medical groups, 8 imaging centers, urgent and
family care centers and surgical centers. The redesign of our Medicare and
Medicaid billing and follow-up processes allowed for an increased cash flow
of 35% monthly and a reduction in A/R days from 96 to 43 within 12 months.
Prepared quarterly Medicare credit balance reports. Established policies
and procedures for the implementation process of the Caremedic ISuite and
Medicare RT billing and follow up software. Through efficient management
for all revenue collection functions across the continuum of the Health
System led to a decrease in denials and underpayments and increases to the
optimal efficiency of revenue collection transactions.
AMERICAN MEDICAL RESPONSE-Modesto, California
April 16, 2007 to November 26, 2007
Director Patient Business Services, West Region
Director is responsible for 182 employees covering 13 States billing and
cash posting functions. Directed process redesign and outcomes focus to
assist with reducing aged A/R for the region by 48%. Exceeded cash targets
for the region by 114%. Directed Managers with the responsibilities for all
coding, insurance verification, patient entry, skip trace and initial
ambulance billing. The cash functions includes the daily operations of cash
posting, deposits, refunds, adjustments and credit balance reporting. The
records operational department responsibilities include document scanning,
custodian of records, and mail room functions. Other duties include but are
not limited to budget preparation, financial analysis and corporate
compliance reporting.
RENOWN HEALTH / HOMETOWN HEALTH PROVIDERS-Reno, Nevada
August 30, 2004 to April 13, 2007
Large Accounts Manager
Manager is responsible for developing and maintaining a comprehensive
partnership with our potential and existing network. Acting Liaison within
the Renown Health System to achieve the best practices and development of
billing and practice management with the community. Develop relationships
with the Providers, Hospital and Ancillary providers to include DME within
the community. To work directly on related billing and contract issues to
increase accounts receivables and reduce bad debt.
Network Development Manager
Manager is responsible for developing and maintaining a comprehensive
partnership with our Leased and State of Nevada Network providers in
Northern Nevada through a contracted network to serve the healthcare needs
of the health plan's members. Provider education and development of billing
and practice management. Continued troubleshooting for all TPA and Self
Funded provider issues. Direct relationship with the Provider, Hospital and
Ancillary, to include DME network office staff to resolve all billing and
contract issues. Maintain all network contract loads.
Contract Network Specialist
Liaison for Hometown Health's leased network clients. Troubleshooting all
TPA and Self Funded provider issues. Direct relationship with Provider's
office resolving all billing and contract issues. Ensure the accuracy of
the plan set-up for contracted providers. Ensure timely and accurate
provider communication and education.
TENET HEALTHCARE- San Luis Obispo, California
July 1, 2002 to August 13, 2004
Director of Patient Financial Services-Manteca, CA
Directly responsible for this 83 bed Hospital to include inpatient, out
patient and emergency department admitting, financial and daily operations.
Decreased A/R days over 90 days from 40% to 27%. Decreased the DNFB 51%.
Increased POS cash collections through training by 25% on a monthly basis.
Established and met pre-registration and financial clearance goal of 97% to
reduce denials, improve efficiencies reduce bad debt and increase cash.
Trained the admitting staffing in all aspects of operations to include
IMaCs implementation. Budget preparation, financial analysis and corporate
reporting.
Regional Patient Access Trainer-Northern California
Selected as one of eleven Regional Trainers throughout the United States.
The purpose of the newly created position is to rollout the new Corporate
Financial Directives. This includes training of the Patient Access
Department of nine hospitals in Northern California to reduce bad debt,
increase point of service and overall collections, enhance customer service
skills and financially clear each patient.
Terms & Conditions Managed Care Coordinator- San Luis Obispo, CA
Responsible for maintaining the hospital's contracts and the MaCs and IMaCs
contract data base. Auditing of payments to assure their accuracy in
accordance with the negotiated rates. Training of Business Office and
Patient Access Departments to insure their understanding of such contracts
and to ensure proper reimbursement to increase revenue. Lead of the IMaCs
systems implementation and training of collectors.
Patient Account Representative-San Luis Obispo, CA
Hospital collections, to include but not limited to private pay and
insurance collection processes. Exceeded the required collection goals
within my first month of hire. Was presented with the "Best in the West"
award for outstanding collections. Position requires experience in all
aspects of billing for Group Health Insurance, Medicare, Medicaid, HMO, PPO
and Workman's Compensation.
F. BRUCE BAILEY, D.D.S.-San Luis Obispo, California
September 2001 - May 2002
Office Manager
Directly responsible for the daily operations of the office. Conversion of
office from general ledger sheets to computerized billing. Perform all
billing and collection functions increasing over the counter and insurance
collections within the first month and continuing throughout my conversion
to computerized billing. Negotiation of current HMO & PPO contracts.
Posting of all payments and denials. Analysis of payments and denials to
monitor accuracy. Perform daily bookkeeping functions, budget preparation
and quarterly tax returns.
LIFE CARE CENTER OF TUCSON-Tucson, Arizona
June 2000 to September 2001
Business Office Manager
Reporting to the Executive Director of this 162-bed Skilled Nursing and
Rehabilitation Center, this position is responsible for supervising the
Accounts Payable/Payroll Manager, Front Office Coordinators and Human
Resource Support Coordinator. This position performs all billing,
collections and posting of the Accounts Receivables, maintains all Business
Office financial and reporting of such financial at the divisional level.
Revenues were increased by over 40% within the first three months and
continued while reducing bad debt. Maintained Patient Trust Fund Accounts.
Reconciliation of the facilities' bank accounts. Monitors all Managed Care
Contracts for accuracy of payments and payment trends. Maintain daily
census and ensure its accuracy. Complete knowledge of the Keane Financial
System.
Other Positions Held;
Admissions/Marketing Director Technical Support Manager
Administrator Operations Manager
Claims Manager Patient Financial Services Manager
Software Sales & Practice Support Consultant
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