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Manager Customer Service

Location:
Tucson, Arizona, 85737, United States
Posted:
March 28, 2011

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***** ******

*** * **** **

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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